Clinicopathologic analysis of stage II–III hepatocellular carcinoma showing early massive recurrence after liver resection

Yamanaka, Junichi; Yamanaka, Naoaki; Nakasho, Keiji; Tanaka, Tsuneo; Ando, Tatsuya; Yasui, Chiaki; Kuroda, N.; Takata, Masafumi; Maeda, Shuichi; Matsushita, Kazuhiro; Uematsu, Kazuyoshi; Okamoto, Eizo

doi:10.1046/j.1440-1746.2000.02323.x

Cited by 48 publications

(35 citation statements)

References 31 publications

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“…This finding is particularly important because HCC invades vessel walls and metastasizes inside the liver, which is considered a major cause of death from the disease (29,30). It may be argued that the inhibitory effects of AS to CDC25A on cancer cell invasion may simply reflect reduced tumor cell growth.…”

Section: Discussionmentioning

confidence: 99%

CDC25A inhibition suppresses the growth and invasion of human hepatocellular carcinoma cells

Yamamoto²,

Liu³

et al. 2008

Int J Mol Med

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Abstract. CDC25A is a cell cycle-activating phosphatase that promotes transition from the G1 to S phase. We previously reported that overexpression of CDC25A in human hepatocellular carcinoma (HCC) tissue samples was associated with poor prognosis. In this study, we attempted suppression of CDC25A in HCC cells to elucidate the therapeutic potential of this approach. Administration of CDC25A antisense (AS) oligonucleotide resulted in 25-50% inhibition of cell growth at 48 h, G0-G1 arrest, and significant inhibition of cancer cell invasion. To elucidate the underlying mechanism of the inhibitory effects of HCC cell invasion, we examined several invasion-associated molecules, and we found that membranetype 3 (MT3)-matrix metalloproteinase (MMP) mRNA was greatly reduced following treatment with AS oligonucleotide to CDC25A or siRNA treatment. Notably, screening of a panel of gastrointestinal cancer cells indicated that MT3-MMP was generally expressed by HCC cells, whereas other cell types did not express this type of matrix metalloproteinase so frequently. We also found that CDC25A facilitated cellular differentiation by increasing albumin expression in the PLC cell line. These results suggest that CDC25A, by inhibiting HCC growth and invasion, may be a feasible therapeutic target for human HCC.

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Section: Discussionmentioning

confidence: 99%

CDC25A inhibition suppresses the growth and invasion of human hepatocellular carcinoma cells

Yamamoto²,

Liu³

et al. 2008

Int J Mol Med

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“…Tanaka and Izumi showed that postoperative adjuvant TACE improved the survival of HCC patients [28,29] . The patients selected in their clinical trials had advanced stages (TNM III or TNM IV) or characteristics of uncompleted encapsulated, intrahepatic metastasis, or vascular invasion which was thought to have a close relation with residual tumor and earlier massive recurrence [22,30] . For these patients postoperative adjuvant TACE played a role in earlier therapy of the residual tumor and could decrease the earlier recurrence and prolong survival.…”

Section: Discussionmentioning

confidence: 99%

Postoperative adjuvant arterial chemoembolization improves survival of hepatocellular carcinoma patients with risk factors for residual tumor: A retrospective control study

Ren

Lin²,

Xia³

et al. 2004

WJG

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AIM:To evaluate the effect of postoperative adjuvant transcatheter arterial chemoembolization (TACE) on the prognosis of hepatocellular carcinoma (HCC) patients with or without risk factors for the residual tumor. METHODS:From January 1995 to December 1998, 549 consecutive HCC patients undergoing surgical resection were included in this research. There were 185 patients who underwent surgical resection with adjuvant TACE and 364 patients who underwent surgical resection only. Tumors with a diameter more than 5 cm, multiple nodules, and vascular invasion were defined as risk factors for residual tumor and used for patient stratification. Kaplan-Meier method was used to analyze survival curve and Cox proportional hazard model was used to evaluate the prognostic significance of adjuvant TACE. RESULTS:In the patients without any risk factors for the residual tumor, the 1-, 3-, 5-year survival rates were 93.48%, 75.85%, 62.39% in the control group and 97.39%, 70.37%, 50.85% in the adjuvant TACE group, respectively. There was no significant difference in the survival between two groups (P = 0.3956). However, in the patients with risk factors for residual tumor, postoperative adjuvant TACE significantly prolonged the patients' survival. There was a statistically significant difference in survival between two groups (P = 0.0216). The 1-, 3-, 5-year survival rates were 69.95%, 49.86%, 37.40% in the control group and 89.67%, 61.28%, 44.36% in the adjuvant TACE group, respectively. Cox proportional hazard model showed that tumor diameter and cirrhosis, but not the adjuvant TACE, were the significantly independent prognostic factors in the patients without risk factors for residual tumor. However, in the patients with risk factors for residual tumor adjuvant TACE, and also tumor diameter, AFP level, vascular invasion, were the significantly independent factors associated with the decreasing risk for patients' death from HCC. CONCLUSION:Postoperative adjuvant TACE can prolong the survival of patients with risk factors for residual tumor, but can not prolong the survival of patients without risk factors for residual tumor.Ren ZG, Lin ZY, Xia JL, Ye SL, Ma ZC, Ye QH, Qin LX, Wu ZQ, Fan J, Tang ZY. Postoperative adjuvant arterial chemoembolization improves survival of hepatocellular carcinoma patients with risk factors for residual tumor: A retrospective control study.

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“…As a predictive factor for recurrence after resection of HCC, the extratumor spreads was found to be more accurate than is any single invasiveness parameter such as Vp or IM [53] . The patients with macroscopic portal vein invasion, microscopic vascular invasion, intrahepatic metastasis, poor differentiation, pleomorphism, sarcomatous change, vascular lake, and angiographic condensed pooling were more frequently found to have extremely poor prognosis [54] . The prognosis of patients with lymph nodal metastasis from HCC is generally poor, even if hepatic resection with regional LN dissection is performed [52,55] .…”

Section: Venous Invasion and Intra-or Extrahepatic Spreadingmentioning

confidence: 99%

The prognostic significance of clinical and pathological features in hepatocellular carcinoma

Qin¹,

Tang²

2002

WJG

160

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The prognosis of patients with HCC still remains dismal. The life expectancy of HCC patients is hard to predict because of the high possibility of postoperative recurrence. Many factors, s u c h a s p a t i e n t ' s g e n e r a l c o n d i t i o n s , macroscopic tumor morphology, as well as tumor hitopathology features, have been proven of prognostic significance. Female HCC patient often has a better prognosis than male patient, which might be due to the receptor of sex hormones. Younger patients often have tumors with higher invasiveness and metastatic potentials, and their survival and prognosis are w o r s e t h a n t h e o l d e r o n e s . C o -e x i s t i n g hepatitis status and hepatic functional reserve h a v e b e e n c o n f i r m e d a s r i s k f a c t o r s f o r recurrence. Serum alpha-fetoprotein (AFP) is useful not only for diagnosis, but also as a prognostic indicator for HCC patients. AFP mRNA has been proposed as a predictive marker of HCC cells disseminated into the circulation and for metastatic recurrence. Many pathologic features, such as tumor size, number, capsule state, cell differentiation, venous invasion, intrahepatic spreading, and a d v a n c e d p T N M s t a g e , a r e t h e b e s testablished risk factors for recurrence and important aspects affecting the prognosis of patients with HCC. Marked inflammatory cell infiltration in the tumor could predict a better prognosis. Clinical stage is still the most important factor influencing on the prognosis. E x t r a t u m o r s p r e a d i n g a n d l y m p h n o d a l metastasis are independent predictors for poor outcome. Some new predictive systems h a v e r e c e n t l y b e e n p r o p o s e d . D i f f e r e n t strategies of treatment might have significant different effects on the patients' prognosis. To date, surgical resection is still the only p o t e n t i a l l y c u r a t i v e t r e a t m e n t f o r H C C , including localized postoperative recurrences. Extent of resection, blood transfusion, occlusion of porta hepatis, and blood loss affect the survival and prognosis of HCC patients. Regional therapies provide alternative ways to improve the prognosis of HCC patients who have no opportunity to receive surgical treatment or postoperative recurrence. The combination of these treatment modalities is hopeful to further improve the prognosis. The efficacies of neoadjuvant (preoperative) or adjuvant (postoperative) chemotherapy or chemoembolization in preventing recurrence and on the HCC prognosis still remain great controversy, and deserves further evaluation. Biotherapy, including IFN-alpha therapy, will play more important role in preventing recurrence and metastasis of HCC after operation.Qin LX,Tang ZY.The prognostic significance of clinical and pathological features in hepatocellular carcinoma.

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Clinicopathologic analysis of stage II–III hepatocellular carcinoma showing early massive recurrence after liver resection

Abstract: Highly malignant HCC with extremely poor prognosis exhibits peculiar clinicopathologic characteristics, particularly histologic immaturity, and can be predicted by preoperative indicators such as markedly elevated tumor marker concentrations and condensed pooling on angiography.

Cited by 48 publications

References 31 publications

CDC25A inhibition suppresses the growth and invasion of human hepatocellular carcinoma cells

CDC25A inhibition suppresses the growth and invasion of human hepatocellular carcinoma cells

Postoperative adjuvant arterial chemoembolization improves survival of hepatocellular carcinoma patients with risk factors for residual tumor: A retrospective control study

The prognostic significance of clinical and pathological features in hepatocellular carcinoma

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