Multicentric occurrence and spread of hepatocellular carcinoma in whole explanted end-stage liver

被引:12
作者
Hidaka, Masaaki [1 ]
Eguchi, Susumu [1 ]
Okudaira, Sadayuki [1 ]
Takatsuki, Mitsuhisa [1 ]
Tokai, Hirotaka [1 ]
Soyama, Akihiko [1 ]
Nagayoshi, Shigeki [1 ]
Mochizuki, Satoshi [1 ]
Hamasaki, Koji [1 ]
Tajima, Yoshitsugu [1 ]
Kanematsu, Takashi [1 ]
机构
[1] Nagasaki Univ, Dept Surg, Grad Sch Biomed Sci, Nagasaki 8528102, Japan
关键词
hepatocellular carcinoma; liver transplantation; Milan criteria; whole explanted liver; CIRRHOTIC LIVER; HELICAL CT; TRANSPLANTATION; ANGIOGRAPHY; ACCURACY; LESIONS; SIZE;
D O I
10.1111/j.1872-034X.2008.00443.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Hepatocellular carcinoma (HCC) arising from the end stages of liver cirrhosis is a fair indication for liver transplantation (LT). To pathologically investigate the multicentric occurrence of relatively early staged HCC in cirrhosis, we studied whole explanted livers. Fourteen explanted livers from patients undergoing living donor LT (LDLT) were examined. The stage of the HCCs was judged to be within the Milan criteria (M-C; a single HCC less than 5 cm or three HCCs less than 3 cm). Histological examination was performed using serially sectioned specimens 5-7 mm in width. Characterization of preoperatively detectable and undetectable lesions was also performed. In nine patients (64.3%), a total of 34 nodules were found after whole liver histological examination (WLHE). In five patients (31%), the results exceeded the M-C. The characteristics of undetectable HCCs included a minute (median size 6 mm), well-differentiated appearance (80%), with indistinct margins (85.3%) and without vascular invasion (94%). There was no recurrence in any patients at the time of follow up (median follow-up period, 30.1 months). A multicentric occurrence of HCCs was demonstrated in cirrhotic livers with HCCs within the M-C. Undetectable HCCs in cirrhotic livers may have no impact on recurrence after LT.
引用
收藏
页码:143 / 148
页数:6
相关论文
共 20 条
[1]  
ADHAM M, 1998, TRANSPL INT S, V1, pS197
[2]   Liver transplantation in cirrhotic patients with small hepatocellular carcinoma: An analysis of pre-operative imaging, explant histology and prognostic histologic indicators [J].
Bhattacharjya, S ;
Bhattacharjya, T ;
Quaglia, A ;
Dhillon, AP ;
Burroughs, AK ;
Patch, DW ;
Tibballs, JM ;
Watkinson, AF ;
Rolles, K ;
Davidson, BR .
DIGESTIVE SURGERY, 2004, 21 (02) :152-159
[3]   LIVER RESECTION VERSUS TRANSPLANTATION FOR HEPATOCELLULAR-CARCINOMA IN CIRRHOTIC-PATIENTS [J].
BISMUTH, H ;
CHICHE, L ;
ADAM, R ;
CASTAING, D ;
DIAMOND, T ;
DENNISON, A .
ANNALS OF SURGERY, 1993, 218 (02) :145-151
[4]   Helical CT screening for hepatocellular carcinoma in patients with cirrhosis: Frequency and causes of false-positive interpretation. [J].
Brancatelli, G ;
Baron, RL ;
Peterson, MS ;
Marsh, W .
AMERICAN JOURNAL OF ROENTGENOLOGY, 2003, 180 (04) :1007-1014
[5]   Prognostic prediction and treatment strategy in hepatocellular carcinoma [J].
Bruix, J ;
Llovet, JM .
HEPATOLOGY, 2002, 35 (03) :519-524
[6]   MRI angiography is superior to helical CT for detection of HCC prior to liver transplantation:: An explant correlation [J].
Burrel, M ;
Llovet, JM ;
Ayuso, C ;
Iglesias, C ;
Sala, M ;
Miquel, R ;
Caralt, T ;
Ayuso, JR ;
Solé, M ;
Sanchez, M ;
Brú, C ;
Bruix, J .
HEPATOLOGY, 2003, 38 (04) :1034-1042
[7]   Liver transplantation and recurrent hepatocellular carcinoma: Predictive value of nodule size in a retrospective and explant study [J].
Grasso, Alessandro ;
Stigliano, Rosa ;
Morisco, Filomena ;
Martines, Hugo ;
Quaglia, Alberto ;
Dhillon, Amar P. ;
Patch, David ;
Davidson, Brian R. ;
Rolles, Keith ;
Burroughs, Andrew K. .
TRANSPLANTATION, 2006, 81 (11) :1532-1541
[8]   Vascular invasion and histopathologic grading determine outcome after liver transplantation for hepatocellular carcinoma in cirrhosis [J].
Jonas, S ;
Bechstein, WO ;
Steinmüller, T ;
Herrmann, M ;
Radke, C ;
Berg, T ;
Settmacher, U ;
Neuhaus, P .
HEPATOLOGY, 2001, 33 (05) :1080-1086
[9]   Focal lesions in cirrhotic explant livers: Pathological evaluation and accuracy of pretransplantation imaging examinations [J].
Libbrecht, L ;
Bielen, D ;
Verslype, C ;
Vanbeckevoort, D ;
Pirenne, J ;
Nevens, F ;
Desmet, V ;
Roskams, T .
LIVER TRANSPLANTATION, 2002, 8 (09) :749-761
[10]   Hepatocellular carcinoma [J].
Llovet, JM ;
Burroughs, A ;
Bruix, J .
LANCET, 2003, 362 (9399) :1907-1917