Recurrence Patterns After Hepatectomy of Hepatocellular Carcinoma: Implication of Milan Criteria Utilization

Abstract

The Milan criteria should be used to recommend hepatectomy for patients with HCC; however, it is important to consider the high recurrence rate after hepatectomy and the possible requirement of salvage transplantation.

Risk Factors for Early and Late Intrahepatic Recurrence in Patients with Single Hepatocellular Carcinoma Without Macrovascular Invasion after Curative Resection

“…Surgical resection is regarded as a potentially curative treatment for patients with HCC and it has become a safe operation with very low morbidity and mortality rates because of the improvement in surgical techniques and perioperative managements . However, the long term survival remains unsatisfactory as results of high postoperative recurrence rate which was reported ranged from 65% to 80% in 5-year after primary surgery (Poon et al, 2002;Imamura et al, 2003;Kamiyama et al, 2009), and most of the postoperative recurrences occur in liver remnant (Poon et al, 1999;Taketomi et al, 2010). Intrahepatic recurrence of HCC after surgical resection could originate from either intrahepatic metastasis (IM) from the primary tumor or multicentric occurrence (MO) RESEARCH ARTICLE…”

Usefulness18F-FDG positron emission tomography/computed tomography for detecting recurrence of hepatocellular carcinoma in posttransplant patients

“…1 The clinical staging of HCC is required to determine a treatment plan. 18 F-fluoro-2-deoxy-D-glucose ( 18 F-FDG) positron emission tomography (PET)/ computed tomography (CT) has been used at some institutions for clinical staging of HCC.…”

“…The principle of 18 F-FDG PET is that 18 F-FDG uptake allows cellular glucose metabolism to be estimated by PET. The normal cell contains a relative abundance of glucose-6-phosphatase and lower levels of hexokinase, whereas tumor cells tend to have increased hexokinase levels but little if any, glucose-6-phosphatase activity.…”

“…The normal cell contains a relative abundance of glucose-6-phosphatase and lower levels of hexokinase, whereas tumor cells tend to have increased hexokinase levels but little if any, glucose-6-phosphatase activity. [2][3][4] This difference in metabolism results in an increased accumulation of 18 F-FDG in tumors, and it potentially allows normal tissue and tumor tissue to be differentiated on PET scans. 18 F-FDG PET/CT is a well-established, noninvasive diagnostic tool for the detection of a variety of malignant tumors such as neck, lung, pancreas, and colon tumors.…”

“…[2][3][4] This difference in metabolism results in an increased accumulation of 18 F-FDG in tumors, and it potentially allows normal tissue and tumor tissue to be differentiated on PET scans. 18 F-FDG PET/CT is a well-established, noninvasive diagnostic tool for the detection of a variety of malignant tumors such as neck, lung, pancreas, and colon tumors. [5][6][7] However, 18 F-FDG PET/CT is less suitable for the detection of primary HCC because of the variable 18 F-FDG uptake pattern in HCC.…”