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.

Adjuvant Hepatic Arterial Infusional Chemotherapy with 5-Fluorouracil and Cisplatin after Curative Resection of Hepatocellular Carcinoma

“…The risk factors for early recurrence have been reported to include tumor-related factors, such as vascular invasion and tumor size [23,24]. The present study also revealed that microvascular invasion was the only independent risk factor of 2-year recurrence after resection.…”

CD34 Expression in Noncancerous Liver Tissue Predicts Multicentric Recurrence of Hepatocellular Carcinoma

“…In Japan, 45-60% of recurrence after surgical resection was reported to be multicentric. Kumada et al [8] reported that 50.9% of recurrence after ethanol infection therapy was multicentric. However in China, Li et al [9] reported that the rate of multicentric recurrence after surgical resection was 30%.…”

Clinical significance of early hepatocellular carcinoma

“…[13][14][15][16] However, recurrence in the early HCC group generally occurred 3 years after surgery and was detected as a single nodule in a different segment, suggesting multifocal development of HCC. 12,17 Multicentricity, however, is probably not the sole cause of recurrence, since the cumulative 5-year recurrence rate (53%) in this group was higher than the rate of newly developed HCC (35%) in an at-risk cohort with cirrhosis alone.…”

“…This difference may be explained by a study showing that patients with a history of HCC are at greater risk of multicentric hepatocarcinogenesis than those without such a history. 15 It is possible that multifocal tumors or precursors may have become detectable at various times during postoperative follow-up.…”