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New metastasectomy criteria for peritoneal metastasis of hepatocellular carcinoma: A study of the Japanese Society of Hepato‐Biliary‐Pancreatic Surgery
Author(s) -
Iida Hiroya,
Tani Masaji,
Aihara Tsukasa,
Hasegawa Kiyoshi,
Eguchi Hidetoshi,
Tanabe Minoru,
Yamamoto Masakazu,
Yamaue Hiroki
Publication year - 2020
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.796
Subject(s) - medicine , metastasectomy , metastasis , conventional pci , survival rate , hepatectomy , gastroenterology , hepatocellular carcinoma , surgery , oncology , cancer , resection , myocardial infarction
Background/Purpose Peritoneal metastasis of hepatocellular carcinoma (HCC) is rare. We investigated patients who underwent peritoneal metastasectomy in a multicenter study in Japan. Methods The study included 92 patients with HCC who underwent resection for peritoneal metastasis between January 2007 and December 2013. We investigated background and operative factors, as well as overall and recurrence‐free survival rates. Patients were classified according to the extent of peritoneal metastasis using the peritoneal cancer index (PCI) and the completeness of cytoreduction (CC) scores to examine whether peritoneal metastasectomy contributed to survival. Results The mean maximum tumor size was 4.1 cm. Forty patients (43.5%) had multiple peritoneal metastases. Peritoneal metastasectomy and hepatectomy were performed simultaneously in 48 patients (52.2%). Overall, the 5‐year survival rate after resection was 36.0%, and the recurrence‐free survival rate was 13.0%. Multivariate analysis revealed that PCI scores of ≤6 + CC scores of 0 were an independent prognostic factor. The 5‐year survival rate when these criteria were met was 43%, which was significantly better than that in those who did not meet these criteria ( P < .001). Conclusions Peritoneal metastasectomy of HCC appears to contribute to improved survival of patients with a PCI scores of ≤6, without remnant tumors.