Recurrence of Hepatocellular Carcinoma in Noncirrhotic Liver After Hepatectomy

Chiche, Laurent; Menahem, Benjamin; Bazille, Céline; Bouvier, Véronique; Plard, L.; Saguet, V.; Alvès, Arnaud; Salamé, Ephrem

doi:10.1007/s00268-013-2127-1

Cited by 14 publications

(22 citation statements)

References 22 publications

(50 reference statements)

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“…Consequently, in light of reduced number of serious complications, mean post‐operative hospital stay of almost 7 days was observed. These figures are lower than those reported by other series, with POM data from 36% to 55% and mortality from 3.7% to 6.5% …”

Section: Discussioncontrasting

confidence: 70%

“…These figures are lower than those reported by other series, with POM data from 36% to 55% and mortality from 3.7% to 6.5%. 12,[26][27][28][29][30][31] Post-operative hepatic insufficiency or post-resection liver failure may be due to scarce remnant liver tissue, prolonged ischaemia resulting from vascular control manoeuvres during surgery or a combination of both. Age (>65 years), complex surgeries, extension of the resection, duration of the Pringle manoeuvre and left hepatectomies 32,33 are all factors that have been associated with post-resection hepatic failure.…”

Section: Discussionmentioning

confidence: 99%

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Surgical treatment results of hepatocellular carcinoma in non‐cirrhotic liver in southern Chile: case series with follow‐up

Manterola

Grande

Otzen

et al. 2019

ANZ Journal of Surgery

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Background Hepatocellular carcinoma is the most frequent primary tumour of the liver. Although often associated with chronic liver disease, it can also occur in non‐cirrhotic livers. The aim of this study was to describe post‐operative morbidity (POM), and survival of patients with hepatocellular carcinoma in non‐cirrhotic liver treated surgically, and to identify variables associated with prognosis. Methods Case series of patients who underwent surgery for hepatocellular carcinoma in non‐cirrhotic liver at Clínica RedSalud Mayor de Temuco, Chile (2001–2017), were studied. The minimum follow‐up time considered was 12 months. Principal outcomes were development of POM and survival. Other variables of interest were age, sex, tumour diameter, surgical time, hospital stay, follow‐up time, need for surgical re‐intervention, mortality, vascular and lymph node invasion and staging. Descriptive and analytic statistics were calculated. Results A total of 32 patients were studied. They were characterized by a mean age of 67.3 ± 7.2 years, 62.5% of whom were men. Averages of tumour diameter, surgical time and hospitalization were 12.0 ± 2.6 cm, 114.4 ± 32.3 min and 7.2 ± 2.9 days, respectively. POM was 31.3%. There was no mortality and there were no re‐interventions. The overall actuarial survival at 1, 2 and 3 years was 96.8%, 73.4% and 17.3%, respectively. Lower survival was verified in patients with vascular invasion, lymph node infiltration and stages III and IVa. Conclusion Despite the tumour diameter and extent of the resections, POM in patients with hepatocellular carcinoma in non‐cirrhotic liver is moderate. However, its prognosis is poor. Vascular invasion, lymph node invasion and advances stages were associated with worse survival.

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Section: Discussioncontrasting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Surgical treatment results of hepatocellular carcinoma in non‐cirrhotic liver in southern Chile: case series with follow‐up

Manterola

Grande

Otzen

et al. 2019

ANZ Journal of Surgery

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“…Some studies have indicated that the long-term outcomes of HCC patients with cirrhosis are significantly worse than those without cirrhosis after LR [ 20 , 25 - 29 ]. The 5-year overall survival (OS) rate after LR for HCC in patients with advanced cirrhosis is less than 30%, whereas this rate is more than 50% in those without cirrhosis [ 20 , 30 , 31 ]. Taura and colleagues [ 20 ] compared the long-term outcomes of 127 HCC patients without cirrhosis with those of 129 patients with Child A cirrhosis and 37 with Child B cirrhosis according to the oncological Milan criteria.…”

Section: Reviewmentioning

confidence: 99%

Severity of liver cirrhosis: a key role in the selection of surgical modality for Child-Pugh A hepatocellular carcinoma

et al. 2015

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Hepatocellular carcinoma is the third leading cause of cancer-related death in the world, and cirrhosis is the main cause of hepatocellular carcinoma and adversely affects surgical outcomes. Liver resection, liver transplantation, and local ablation are potentially curative therapies for early hepatocellular carcinoma (HCC). There exists an obvious histological variability of severity within cirrhosis which has different clinical stages. For patients with Child-Pugh B cirrhosis and/or portal hypertension and HCC within Milan criteria, consensus guidelines suggest that liver transplantation is the best treatment of choice; liver resection is widely accepted as first-line treatment for patients with early-stage HCC and preserved liver function; and local ablation is the treatment of choice in patients with small tumors who are not candidates for surgery or can be used as a temporary treatment during the waiting period for transplantation. For patients with compensated cirrhosis or Child A cirrhosis, the selection of surgical modality based on subclassification of cirrhosis remains unclear. This review examines the current status of the selection of surgical modality for hepatocellular carcinoma treatment in cirrhotic patients and aims to emphasize the effects of the severity of cirrhosis on the selection of surgical modality for the treatment of hepatocellular carcinoma.

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“…Challenges in early HCC diagnosis mean that most cases are detected too late to be curable. Surgical resection remains the preferred treatment [3, 4], but postoperative recurrence is high [5]. Therefore, understanding how HCC recurs may allow the design of treatments or interventions to reduce it.…”

Section: Introductionmentioning

confidence: 99%

Overexpression of microRNA-21 strengthens stem cell-like characteristics in a hepatocellular carcinoma cell line

et al. 2016

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BackgroundLiver cancer stem cells (LCSCs) have been shown to express higher levels of microRNA-21 (miR-21). Here, we examine the possible contributions of miR-21 to the phenotype of LCSCs in culture and in xenograft tumors in nude mice.MethodsThe hepatocellular carcinoma cell line MHCC-97H was stably transformed with a retroviral vector to establish cells overexpressing miR-21, while a cell line transformed with empty vector served as a negative control. RT-PCR and Western blotting were used to evaluate the effects of miR-21 overexpression on the expression of various LCSC markers, a Transwell assay was used to assess the effects on cell migration and invasion, and a spheroid formation assay was used to examine the effects on clonogenesis. The effects of miR-21 overexpression were also examined in tumors in nude mice.ResultsAn MHCC-97H cell line was constructed that stably overexpresses miR-21 at 7.78 ± 1.51-fold higher levels than the negative control cell line. Expression of the LCSC markers CD13, Ep-CAM, CD90, and OCT4 was significantly higher in the miR-21-overexpressing cell line than in the negative control at both mRNA and protein levels. The overexpressing cell line formed larger, tighter, and more numerous spheroids. Overexpression of miR-21 was associated with greater cell migration and invasion. Tumors of overexpressing cells in nude mice had a significantly larger mean volume after 34 days of growth (773.62 ± 163.46 mm3) than tumors of negative control cells (502.79 ± 33.94 mm3, p = 0.048), as well as greater mean weight (0.422 ± 0.019 vs. 0.346 ± 0.006 g, p = 0.003).ConclusionsOverexpression of miR-21 strengthens the phenotype of LCSCs, facilitating invasion, migration, and tumorigenesis in hepatocellular carcinoma.

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Recurrence of Hepatocellular Carcinoma in Noncirrhotic Liver After Hepatectomy

Abstract: Recurrence is the most common cause of death after hepatectomy for HCC, and patients should undergo careful, long-term follow-up. Early detection and treatment of recurrence with curative intent should improve the prognosis of these patients.

Cited by 14 publications

References 22 publications

Surgical treatment results of hepatocellular carcinoma in non‐cirrhotic liver in southern Chile: case series with follow‐up

Surgical treatment results of hepatocellular carcinoma in non‐cirrhotic liver in southern Chile: case series with follow‐up

Severity of liver cirrhosis: a key role in the selection of surgical modality for Child-Pugh A hepatocellular carcinoma

Overexpression of microRNA-21 strengthens stem cell-like characteristics in a hepatocellular carcinoma cell line

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