Patterns of recurrence after initial treatment in patients with small hepatocellular carcinoma

Abstract

able because the patients is a poor surgical risk, TAE has To assess intrahepatic metastasis (IM) and multicenbeen considered the treatment of choice. However, the value tric occurrence (MO) after initial treatment of small heof TAE is limited if the small HCCs have intracapsular or patocellular carcinomas (HCC) ß 2 cm in diameter, we extracapsular invasion. performed clinical and pathological studies in 112 pa-PEIT has been shown to be highly effective in patients with tients who underwent percutaneous ethanol injection HCCs ß3 cm in diameter. with HCC were admitted to Ogaki Municipal Hospital, and 163 of the 750 were found to have an HCC ß2 cm in diameter. One hundred and twelve of these patients who had undergone PEIT or hepatic Hepatocellular carcinoma (HCC) is one of the most maligresection were selected for this retrospective study. All cases were nant neoplasms in Japan. Because of recent progress in the diagnosed histologically. Fifteen patients were diagnosed by specific development of new diagnostic modalities, the incidence of imaging diagnosis (histological confirmation was made by analysis detection of small HCCs has increased.1-4 Therapeutic ap-of specimens obtained at surgery) and 97 patients were diagnosed proaches to HCC also have progressed markedly in recent by percutaneous liver tissue core biopsy with ultrasound guidance. years through the development of hepatic resection, trans-The PEIT was performed according to previously published methcatheter arterial embolization, and percutaneous ethanol in-ods 24 in 82 patients who had not undergone surgery because of imjection therapy (PEIT). [5][6][7] The surgical resectability rate of paired liver function or who had requested this type of therapy.Briefly, after administration of a local anesthetic, the needle was HCC, however, has remained low, this is, because most pa- A 25 ). In this series, radical hepatectomy represented the removal of Received December 29, 1995; accepted September 25, 1996. all tumors from the liver. and/or helical with contrast medium were performed every 3 months.

Midterm outcomes in patients with intermediate‐sized hepatocellular carcinoma

“…The pretreatment levels of these markers are useful predictors of local tumor progression. 33,34 However, their post-treatment levels have been considered to have limited efficacy as predictors of local tumor recurrence after TACE 35 and percutaneous ablation. 36 Elevated serum levels of alpha-fetoprotein, which reflect not only tumor-cell proliferation but also active disease with continuous necrosis and regeneration, are associated with an elevated risk of developing HCC.…”

Circulating cell-free DNA as a predictive marker for distant metastasis of hepatitis C virus-related hepatocellular carcinoma

“…There are at least three representative modes of postoperative recurrence, early and late IHRs appearing in the remnant liver and EHR appearing in distant organs such as bone and lung. Among the three types of recurrence, late IHR is a de novo primary tumour rather than a metastatic tumour, and it accounts for the majority of HCC recurrences 3 years or more after surgery (Kumada et al, 1997), suggesting that it has less influence on patient survival. The finding that our cohort included many patients with late IHR might account for the lack of association between cfDNA levels and DFS in patients with HCV-related HCC.…”

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

“…Recurrence is particularly frequent with HCV-related HCC, and a substantial proportion of recurrence, especially in late phase, is thought to represent de novo, or multicentric, hepatocarcinogenesis [396][397][398]. Therefore, it could be reasonably assumed that antiviral therapy would reduce the overall incidence of recurrence by preventing de novo carcinogenesis.…”