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Serosal invasion is a strong prognostic factor for hepatocellular carcinoma after hepatectomy
Author(s) -
Sakamoto Katsunori,
Ogawa Kohei,
Tohyama Taiji,
Ueno Yoshitomo,
Tamura Kei,
Inoue Hitoshi,
Nakamura Taro,
Watanabe Jota,
Takai Akihiro,
Takada Yasutsugu
Publication year - 2019
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.13285
Subject(s) - medicine , hepatocellular carcinoma , hepatectomy , perioperative , cirrhosis , gastroenterology , pathological , concomitant , metastasis , adjuvant therapy , surgery , cancer , resection
Aim The clinical impact of serosal invasion by hepatocellular carcinoma (HCC) remains unclear. This study aimed to clarify the significance of serosal invasion as a prognostic factor for patients who underwent hepatectomy for HCC. Methods This retrospective study investigated patients who underwent hepatectomy for HCC between October 2003 and September 2016 in Ehime University Hospital (Toon, Japan). A total of 161 cases were enrolled after excluding cases of concomitant distant metastasis, macroscopic tumor remnant, mixed HCC, and rehepatectomy. We classified these 161 patients into groups with serosal invasion detected (S[+]) and serosal invasion undetected (S[−]). We compared patient characteristics, perioperative data, pathological findings, and prognosis between S(+) and S(−) groups. Results Serosal invasion was observed in 19 of the 161 patients (12%). The 5‐year recurrence‐free survival rate was lower for S(+) (13.0%) than for S(−) (28.7%, P = 0.006). The 5‐year overall survival (OS) rate was lower for S(+) (24.7%) than for S(−) (63.9%, P < 0.001). Regarding OS, serosal invasion, preoperative α‐fetoprotein value, presence of invasion to hepatic veins, and liver cirrhosis were independent predictors in multivariate analyses. The 3‐year OS rate after recurrence was poorer in the S(+) group (22.9%) than in the S(−) group (49.7%, P = 0.001). Conclusions Serosal invasion was a strong predictor of worse outcomes after hepatectomy for HCC. Patients showing serosal invasion need close postoperative follow‐up or consideration of adjuvant treatment.