Roentgenologic Demonstration of Spontaneous Reversal of Portal Blood Flow in Cirrhosis and Primary Carcinoma of the Liver

Okuda, Kunio; Moriyama, Mikio; Yasumoto, Masatake; Jinnouchi, Shigenobu; Shimokawa, Yutaka; Nakayama, Toshimichi; Kanda, Y; FUKYUAMA, YOSHIO; Musha, Hirotaka; Kuratomi, S.; Nakashima, Toshiro

doi:10.2214/ajr.119.2.419

Cited by 60 publications

(22 citation statements)

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“…The lung has been reported to be the most frequent hematogenous metastatic site for HCC [33]. Although the vascular invasion is associated with blood stream metastasis via the systemic and portal venous system [34], the reason why invasion to adjacent organs or tumor rupture tended to lead hematogenous metastasis was unclear. However, this finding suggested that antiangiogenic drugs as part of the adjuvant therapy might improve the prognosis of patients with S 2 /S 3 , who are considered to have a poor prognosis.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Serosal Invasion on Prognosis after Curative Hepatectomy for Hepatocellular Carcinoma: Invasion to Adjacent Organs and Rupture of Tumor Were Crucial Tumor-Related Prognostic Factors Needed for Survival

Kato

Okamura²,

Sugiura³

et al. 2017

Dig Surg

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Background/Aims: Several tumor factors seem to be related to the hepatocellular carcinoma (HCC) prognosis, but they are not definitive, except for major vascular invasion. We analyzed the impact of serosal invasion, which is histologically classified into four groups according to the definition of the Liver Cancer Study Group of Japan - S₀: no tumor invasion of serosa, S₁: tumor invasion of serosa, S₂: tumor invasion of adjacent organs, S₃: tumor rupture with intraperitoneal bleeding. Methods: This retrospective study included 421 consecutive patients who underwent hepatectomy as an initial treatment for HCC between September 2002 and December 2014. Results: Kaplan-Meier analysis and log-rank tests revealed that both recurrence-free survival (RFS) and disease-specific survival (DSS) worsened as the serosal invasion status advanced. Multivariate analyses showed that S₂/S₃ was independently correlated with RFS (hazard ratio [HR] 3.52; p < 0.001) and DSS (HR 2.58; p = 0.039). Another multivariate analysis showed that serosal invasion (S₁-S₃) was independently correlated with RFS (HR 1.70; p = 0.015) but not with DSS (HR 1.38; p = 0.27). Conclusion: Invasion to adjacent organs and tumor rupture were crucial prognostic factors for both DSS and RFS. Serosal invasion was an independent prognostic factor only for RFS.

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Section: Discussionmentioning

confidence: 99%

The Impact of Serosal Invasion on Prognosis after Curative Hepatectomy for Hepatocellular Carcinoma: Invasion to Adjacent Organs and Rupture of Tumor Were Crucial Tumor-Related Prognostic Factors Needed for Survival

Kato

Okamura²,

Sugiura³

et al. 2017

Dig Surg

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“…Of the various characteristic, angiographic findings described, AV shunting seems to be one of the most pathognomonic, as it is seldom seen in other liver neoplasms (1,5,9). AV shunts have been described in regenerating liver (7), cirrhosis (14), and portacaval shunting (4); the courses of arteries and veins were normal throughout in these cases, in contrast to HCC, which almost always shows some irregularity of vessels due to either cancerous invasion or compression onto the vessels or tumor growth in the lumen of the portal branch. Thus AV shunts of other etiologies can be differentiated in a similar manner (10).…”

Section: Discussionmentioning

confidence: 99%

“…H EPATIC angiography by selective catheterization of the celiac or hepatic artery is a useful procedure in the diagnosis of liver carcinoma. A number of investigators have shown that one of the characteristic findings in hepatocellular carcinoma (HCC) is intrahepatic arteriovenous (AV) shunts, or more precisely arterio-portal communications as indicated chiefly by opacification of portal branches during or following the arterial phase (10, 11, 16) and less frequently by retrograde portal blood flow (3,14). We have recently described a striking feature peculiar to HCC which we call the "thread and streaks" sign, representing a tumor cast growing in a large branch of the portal vein (15).…”

Section: Methodsmentioning

confidence: 99%

Angiographic Demonstration of Intrahepatic Arterio-Portal Anastomoses in Hepatocellular Carcinoma

Okuda¹,

Musha²,

Yamasaki³

et al. 1977

Radiology

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121

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Hepatic angiograms of 114 patients with hepatocellular carcinoma (HCC) were studied, particularly changes in the portal vein branches. Arterio-portal shunts of varying sizes, evidenced by opacification of intrahepatic portal branches, were seen in 72 cases (63.2%), with retrograde opacification of the portal vein trunk in 29 (25.4%). At least four types of shunts were found: (a) through a tumor thrombus in the portal branch, (b) in a retrograde direction via a peripheral tumor nodule, (c) through a small tumor invading or amputating an artery, and (d) through a tumor located near a major portal vein branch and supplied by a large, coiling artery. Postmortem angiography of the liver in 50 patients with HCC suggests that arterio-portal shunts are the result of the special vasculature in HCC and are highly diagnostic when accompanied by other angiographic changes.

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“…This metastasis is presumed to be caused by tumor thrombi infiltrating via the portal system, at which point they are disseminated by hepatofugal portal blood flow to the gastrointestinal (GI) tract (2,3). We present here a rare case of premortem-diagnosed esophageal metastasis from HCC.…”

Section: Introductionmentioning

confidence: 99%

Unusual Metastasis of Hepatocellular Carcinoma to the Esophagus

et al. 2005

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Roentgenologic Demonstration of Spontaneous Reversal of Portal Blood Flow in Cirrhosis and Primary Carcinoma of the Liver

Cited by 60 publications

References 0 publications

The Impact of Serosal Invasion on Prognosis after Curative Hepatectomy for Hepatocellular Carcinoma: Invasion to Adjacent Organs and Rupture of Tumor Were Crucial Tumor-Related Prognostic Factors Needed for Survival

The Impact of Serosal Invasion on Prognosis after Curative Hepatectomy for Hepatocellular Carcinoma: Invasion to Adjacent Organs and Rupture of Tumor Were Crucial Tumor-Related Prognostic Factors Needed for Survival

Angiographic Demonstration of Intrahepatic Arterio-Portal Anastomoses in Hepatocellular Carcinoma

Unusual Metastasis of Hepatocellular Carcinoma to the Esophagus

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