Intrahepatic metastasis is more risky than multiple occurrence in hepatocellular carcinoma patients after curative liver resection.

Abstract

BACKGROUND/AIMS:

The characteristics of multiple nudules in hepatocellular carcinomas (HCCs) after curative liver resection remain obscure. We compare the clinicopathologic characteristics and prognoses between patients with hepatic lesions with multicentric occurrence (MO) and intrahepatic metastasis (IM) at the time of surgical resection.

METHODOLOGY:

The histopathologic features of multiple tumors from 198 patients of HCC were analyzed and divided into MO group (n = 51, 25.8%) for multicentric HCCs and an IM group (n = 147, 74.2%) in cases with intrahepatic metastases. Overall survival rate, disease-free survival and clinicopathologic differences were compared between the two groups.

RESULTS:

Microvascular invasion and increased tumor size were the most important factors discriminating the IM group from the MO group (P < 0.001 and P = 0.027, respectively). Kaplan-Meier and log rank tests revealed that disease-free survival and overall survival rates in the MO group were significantly higher than those for the IM group (P < 0.001 and P < 0.001, respectively). A multivariate analysis of Cox's proportional hazards model showed that increased alpha-fetoprotein (AFP) and protein induced by vitamin K antagonist-II (PIVKA-II) levels, portal vein invasion and intrahepatic metastases were the most important prognostic factors.

CONCLUSIONS:

Among HCCs, the prognosis of patients with MO is significantly better than that of patients with IM.

• Authors: Jong Man Kim, Choon Hyuck David Kwon, Jae-Won Joh, Jae Berm Park, Joon Hyeok Lee, Sung Joo Kim, Seung Woon Paik, Cheol Keun Park
• Journal: Hepato-gastroenterology (Hepatogastroenterology) 2015 Mar-Apr Vol. 62 Issue 138 Pg. 399-404 ISSN: 0172-6390 [Print] Greece
• PMID: 25916071 (Publication Type: Comparative Study, Journal Article)

Chemical References

• AFP protein, human
• Biomarkers
• Protein Precursors
• alpha-Fetoproteins
• acarboxyprothrombin
• Prothrombin

Topics

• Adult
• Biomarkers (blood)
• Carcinoma, Hepatocellular (blood, mortality, secondary, surgery)
• Disease-Free Survival
• Female
• Hepatectomy (adverse effects, mortality)
• Humans
• Kaplan-Meier Estimate
• Liver Neoplasms (blood, mortality, pathology, surgery)
• Male
• Middle Aged
• Multivariate Analysis
• Neoplasm Invasiveness
• Neoplasms, Multiple Primary (blood, mortality, pathology, surgery)
• Portal Vein (pathology)
• Proportional Hazards Models
• Protein Precursors (blood)
• Prothrombin
• Retrospective Studies
• Risk Factors
• Time Factors
• Treatment Outcome
• Tumor Burden
• alpha-Fetoproteins (analysis)