Milan Criteria, Multi-nodularity, and Microvascular Invasion Predict the Recurrence Patterns of Hepatocellular Carcinoma After Resection

被引：32

作者：

Hung, Hung-Hsu ^{[1
,2
,3
]}

Lei, Hao-Jan ^{[2
,4
]}

Chau, Gar-Yang ^{[2
,4
]}

Su, Chien-Wei ^{[1
,2
,5
]}

Hsia, Cheng-Yuan ^{[2
,4
]}

Kao, Wei-Yu ^{[1
,2
,6
]}

Lui, Wing-Yiu ^{[2
,7
]}

Wu, Wen-Chieh ^{[1
]}

Lin, Han-Chieh ^{[1
,2
]}

Wu, Jaw-Ching ^{[5
,8
]}

机构：

[1] Taipei Vet Gen Hosp, Dept Med, Div Gastroenterol, Taipei 112, Taiwan

[2] Natl Yang Ming Univ, Sch Med, Fac Med, Taipei 112, Taiwan

[3] Cheng Hsin Gen Hosp, Dept Med, Div Gastroenterol, Taipei, Taiwan

[4] Taipei Vet Gen Hosp, Dept Surg, Div Gen Surg, Taipei 112, Taiwan

[5] Natl Yang Ming Univ, Sch Med, Inst Clin Med, Taipei 112, Taiwan

[6] Taipei Vet Gen Hosp, Dept Med, Div Gastroenterol, Taoyuan Branch, Taipei 112, Taiwan

[7] Taichung Vet Gen Hosp, Dept Surg, Div Gen Surg, Taichung, Taiwan

[8] Taipei Vet Gen Hosp, Dept Med Res & Educ, Taipei 112, Taiwan

来源：

JOURNAL OF GASTROINTESTINAL SURGERY | 2013年 / 17卷 / 04期

关键词：

Hepatocellular carcinoma; Liver transplantation; Milan criteria; Surgical resection; LONG-TERM PROGNOSIS; LIVER-TRANSPLANTATION; RADIOFREQUENCY ABLATION; SURGICAL RESECTION; RISK-FACTORS; CANCER; RECOMMENDATIONS; MANAGEMENT; SURVIVAL; THERAPY;

D O I：

10.1007/s11605-012-2087-z

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

This study aims to evaluate the risk factors for tumor recurrence beyond the Milan criteria (MC) for patients with hepatocellular carcinoma (HCC) after surgical resection (SR) in which salvage liver transplantation is relatively contraindicated. A total of 447 patients who underwent SR for HCC were enrolled consecutively. Among them, 248 and 199 patients were within the Milan criteria and beyond the Milan criteria (BMC group), respectively. Overall survival, recurrence, and disease-free survival were analyzed by multivariate analysis. After a median follow-up of 34.4 months, 130 patients died. Microvascular invasion, higher Edmondson stage of tumor cell differentiation, BMC group, and no anti-viral therapy were associated with poor overall survival. Multi-nodularity, higher Edmondson stage, BMC group, and no anti-viral therapy were independent risk factors for tumor recurrence, while BMC group and no anti-viral therapy were independent risk factors for disease-free survival. The Milan criteria, multi-nodularity, and microvascular invasion were used to stratify the patients into low-, medium-, and high-risk groups for tumor recurrence outside the MC and showed statistical significance (low vs. medium, p = 0.011; low vs. high, p < 0.001; medium vs. high, p = 0.009). The combination of the MC, multi-nodularity, and microvascular invasion predict the post-operative recurrence of HCC and may provide a roadmap for further treatment.

引用

页码：702 / 711

页数：10

共 33 条

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