Staging of Hepatocellular Carcinoma

Duseja, Ajay

doi:10.1016/j.jceh.2014.03.045

Cited by 70 publications

(40 citation statements)

References 24 publications

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“…Many studies have demonstrated the prominent role of tumor burden and grade, liver function, degree of hepatic dysfunction, and performance status in the prognosis of HCC. 27,28 The TNM staging system only classifies the tumor burden and has limited applicability in clinical practice. 29,30 Okuda combined tumor status (tumor size <50% or >50%) and liver function (ascites, albumin, bilirubin) for the first time.…”

Section: Discussionmentioning

confidence: 99%

New nomogram predicts the recurrence of hepatocellular carcinoma in patients with negative preoperative serum AFP subjected to curative resection

Gan

Zhang

et al. 2018

Journal of Surgical Oncology

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Section: Discussionmentioning

confidence: 99%

New nomogram predicts the recurrence of hepatocellular carcinoma in patients with negative preoperative serum AFP subjected to curative resection

Gan

Zhang

et al. 2018

Journal of Surgical Oncology

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“…Various staging systems adopted in HCC include the AJCC TNM staging system, European systems like BCLC staging system and Asian systems like Okuda staging system 25. Among these, the AJCC TNM staging system is the only one to address the issue of spontaneous tumor rupture.…”

Section: Discussionmentioning

confidence: 99%

Impact of spontaneous tumor rupture on prognosis of patients with T4 hepatocellular carcinoma

Chan

Hung

Pan

et al. 2016

Journal of Surgical Oncology

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Background and objectivesCompare the outcomes of three groups of patients with T4 hepatocellular carcinoma (HCC): tumor rupture with shock (RS group), tumor rupture without shock (R group), and no tumor rupture (NR group).Materials and MethodsWe retrospectively reviewed 221 patients with T4 HCC from 2010 to 2012. The clinical background and prognosis were analyzed.ResultsOverall in‐hospital mortality rate was 18.1%; overall median survival time was 4 months. The NR group were more likely to have multiple and infiltrative tumors (P < 0.001). Relative to the NR group, the R + RS group had better survival rates at 6 months (49.2% vs. 32.2%), 1 year (35.3% vs. 21.0%), 3 years (22.5% vs. 11.0%), and 5 years (17.7% vs. 5.5%) (P = 0.010). Patients in the RS group had a higher in‐hospital mortality rate, but significantly better long‐term survival than the NR and R group (P < 0.001). Multivariate analysis indicated that Child‐Pugh class B or C, presence of portal venous thrombosis, and absence of shock were significantly associated with poor survival.ConclusionPatients with tumor rupture and shock had worse in‐hospital survival. However, patients without decompensated liver cirrhosis and portal venous thrombosis, and eligible for curative treatment had favorable long‐term outcome. J. Surg. Oncol. 2016;113:789–795. © 2016 The Authors. Journal of Surgical Oncology Published by Wiley Periodicals, Inc.

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“…Regarding CEUS a recent discussion is ongoing and concerns have been raised about the differentiation between HCC and intrahepatic cholangiocarcinoma, where the latter may present with HCC typical enhancement patterns (early arterial enhancement followed by wash out) [10][11][12]. The most important role of PET/CT in HCC is the detection of extrahepatic disease [13].…”

Section: Hepatocellular Carcinoma (Hcc)mentioning

confidence: 99%

Impact of Contrast-Enhanced Intraoperative Ultrasound on Operation Strategy in Case of Colorectal Liver Metastasis

et al. 2012

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Background Surgical treatment is the only option for long-term survival in patients with colorectal liver metastasis (CRLM). Contrast-enhanced CT and MRI are usually used for preoperative liver imaging. The initial surgical strategy for liver resection is based upon these findings. Further optimization of the surgical strategy by contrast-enhanced intraoperative ultrasound (CE-IOUS) might further improve the surgical outcome. Purpose To evaluate the current impact of CE-IOUS with SonoVue® on the initial surgical strategy for CRLM. Material and Methods Eighty-six consecutive patients undergoing open liver resection for CRLM were evaluated retrospectively over a 2.5-year period. The patients underwent 97 operations. Preoperative staging was performed with contrast-enhanced CT in all patients and MRI was available in 66 of 86 patients. CE-IOUS was performed in all patients according to a standardized examination technique. Curved array and linear transducers were used. CRLM were identified in venous phase as hypovascular lesions. CE-IOUS findings were compared with preoperative staging. Results Combined CT/MRI identified preoperatively 328 CRLM (mean 3.4, range 0-14). Seventy-two additional lesions (18%) were identified in 38 patients during the operation. Intraoperatively 41 additional CRLM in 20 patients were identified by inspection, palpation, and CE-IOUS (10%), and another 31 CRLM in 17 patients were identified by CE-IOUS alone (8%). All additional CRLM detected by CE-IOUS were confirmed by histology if resection was performed. CE-IOUS changed planned operation strategy in 29.9% of operations. A larger resection was necessary in 13.4% of the cases, reduced liver resection was found sufficient in 11.3%, and 5.2% were found inoperable. For patients diagnosed preoperatively with solitary lesions CE-IOUS changed operation strategy in 19% and radical tumor resection would have failed in 4.8% without CE-IOUS. Conclusion CE-IOUS is essential to ensure optimal and complete tumor resection both in patient with solitary CRLM and multiple metastases.

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Staging of Hepatocellular Carcinoma

Cited by 70 publications

References 24 publications

New nomogram predicts the recurrence of hepatocellular carcinoma in patients with negative preoperative serum AFP subjected to curative resection

New nomogram predicts the recurrence of hepatocellular carcinoma in patients with negative preoperative serum AFP subjected to curative resection

Impact of spontaneous tumor rupture on prognosis of patients with T4 hepatocellular carcinoma

Impact of Contrast-Enhanced Intraoperative Ultrasound on Operation Strategy in Case of Colorectal Liver Metastasis

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