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Predictive factors of advanced recurrence after curative resection of small hepatocellular carcinoma
Author(s) -
Hosaka Tetsuya,
Ikeda Kenji,
Kobayashi Masahiro,
Hirakawa Miharu,
Kawamura Yusuke,
Yatsuji Hiromi,
Sezaki Hitomi,
Akuta Norio,
Suzuki Fumitaka,
Suzuki Yoshiyuki,
Saitoh Satoshi,
Arase Yasuji,
Kumada Hiromitsu
Publication year - 2009
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2008.01901.x
Subject(s) - hepatocellular carcinoma , medicine , distant metastasis , metastasis , curative treatment , surgery , gastroenterology , cancer , disease
Abstract Background: The tumour recurrence rate after resection is still high even in patients with small hepatocellular carcinoma (HCC). The advanced patterns of recurrence occasionally occur after resection. In this study, we analysed the clinical and histological characteristics of small HCC and evaluated the predictive factors of advanced tumour recurrence. Methods: One hundred and sixty‐five patients underwent resection of small HCC measuring 3 cm or less in greatest dimension. Patterns of tumour recurrences were classified into advanced recurrence and minor recurrence based on size, number, vascular invasion and extrahepatic metastasis of recurrent tumour. We created a simple index to closely evaluate the malignant potential of small HCC, named α‐foetoprotein–size ratio index (ASRI). Results: Overall tumour recurrence was significantly associated with tumour multiplicity ( P <0.001) and ASRI ( P =0.001). Tumour multiplicity, ASRI and tumour differentiation were independent and significant predictive factors of advanced recurrences. The overall survival rates were lower in the advanced recurrence group than the minor recurrence or the no recurrence group. Conclusions: Patients with advanced recurrences have a poor prognosis, although they have undergone curative resection of small HCC. On the other hand, patients with minor recurrences have a relatively good prognosis. ASRI was a useful index to predict advanced recurrence after curative resection of small HCC. The therapeutic management to prevent advanced recurrences is needed.