Vascular invasion affects survival in early hepatocellular carcinoma

Hsieh,Chen‑Hsi; Wei,Chang‑Kuo; Yin,Wen‑Yao; Chang,Chun‑Ming; Tsai,Shiang‑Jiun; Wang,Li‑Ying; Chiou,Wen‑Yen; Lee,Moon‑Sing; Lin,Hon‑Yi; Hung,Shih‑Kai

doi:10.3892/mco.2014.420

Vascular invasion affects survival in early hepatocellular carcinoma

Authors:
- Chen‑Hsi Hsieh
- Chang‑Kuo Wei
- Wen‑Yao Yin
- Chun‑Ming Chang
- Shiang‑Jiun Tsai
- Li‑Ying Wang
- Wen‑Yen Chiou
- Moon‑Sing Lee
- Hon‑Yi Lin
- Shih‑Kai Hung
View Affiliations

Affiliations: Department of Radiation Oncology, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan, R.O.C., Department of General Surgery, Buddhist Dalin Tzu Chi Hospital, Dalin, Chiayi 62247, Taiwan, R.O.C., Department of Radiation Oncology, Buddhist Dalin Tzu Chi Hospital, Dalin, Chiayi 62247, Taiwan, R.O.C., School and Graduate Institute of Physical Therapy, College of Medicine, Taipei City 100, Taiwan, R.O.C.
Published online on: September 18, 2014 https://doi.org/10.3892/mco.2014.420
Pages: 252-256

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Hepatocellular carcinoma (HCC) is an aggressive malignant tumor with a high mortality rate. The optimal therapeutic choice for early HCC is surgical resection. However, the rate of intrahepatic recurrence is high. The objective of this study was to evaluate the effect of various factors on the survival of patients with early HCC. Between January 1st, 2006 and December 31st, 2013, a total of 89 patients who underwent surgery for HCC were retrospectively enrolled. The analysis was conducted using the Student's t‑test, Chi‑square test, Kaplan‑Meier method and Cox proportional hazard regression model to assess potential confounding and predictive variables. The 3‑year overall survival (OS) rate was 71%. The 3‑year OS rates in patients with and those without vascular invasion were 62.1 and 92.8%, respectively (p<0.003). Based on the multivariate analysis, postoperative pathological vascular invasion (hazard ratio = 4.96; 95% confidence interval: 1.55‑15.9) remained an independent predictor of adverse long‑term outcome. Furthermore, vascular invasion was significantly associated with intrahepatic metastasis. These data emphasize the need for effective adjuvant therapy in selected high‑risk patients with early HCC. Further studies are required to determine the optimal approach to further improving the prognosis of early HCC.

View Figures

View References

1	Jemal A, Siegel R, Ward E, Hao Y, Xu J and Thun MJ: Cancer statistics, 2009. CA Cancer J Clin. 59:225–249. 2009. View Article : Google Scholar
2	Hwang S, Moon DB and Lee SG: Liver transplantation and conventional surgery for advanced hepatocellular carcinoma. Transpl Int. 23:723–727. 2010. View Article : Google Scholar
3	Hsieh CH, Liu CY, Shueng PW, et al: Comparison of coplanar and noncoplanar intensity-modulated radiation therapy and helical tomotherapy for hepatocellular carcinoma. Radiat Oncol. 5:402010. View Article : Google Scholar : PubMed/NCBI
4	Fan ST, Lo CM, Liu CL, et al: Hepatectomy for hepatocellular carcinoma: toward zero hospital deaths. Ann Surg. 229:322–330. 1999. View Article : Google Scholar : PubMed/NCBI
5	Huang ZY, Liang BY, Xiong M, et al: Long-term outcomes of repeat hepatic resection in patients with recurrent hepatocellular carcinoma and analysis of recurrent types and their prognosis: a single-center experience in China. Ann Surg Oncol. 19:2515–2525. 2012. View Article : Google Scholar
6	Poon RT, Fan ST, Lo CM, Liu CL and Wong J: Intrahepatic recurrence after curative resection of hepatocellular carcinoma: long-term results of treatment and prognostic factors. Ann Surg. 229:216–222. 1999. View Article : Google Scholar : PubMed/NCBI
7	Arnaoutakis DJ, Mavros MN, Shen F, et al: Recurrence patterns and prognostic factors in patients with hepatocellular carcinoma in noncirrhotic liver: a multi-institutional analysis. Ann Surg Oncol. 21:147–154. 2014. View Article : Google Scholar : PubMed/NCBI
8	Kornberg A, Kupper B, Tannapfel A, et al: Long-term survival after recurrent hepatocellular carcinoma in liver transplant patients: clinical patterns and outcome variables. Eur J Surg Oncol. 36:275–280. 2010. View Article : Google Scholar
9	Sumie S, Nakashima O, Okuda K, et al: The significance of classifying microvascular invasion in patients with hepatocellular carcinoma. Ann Surg Oncol. 21:1002–1009. 2014. View Article : Google Scholar : PubMed/NCBI
10	Pawlik TM, Poon RT, Abdalla EK, et al: Critical appraisal of the clinical and pathologic predictors of survival after resection of large hepatocellular carcinoma. Arch Surg. 140:450–458. 2005. View Article : Google Scholar : PubMed/NCBI
11	Chok KS, Ng KK, Poon RT, Lo CM and Fan ST: Impact of postoperative complications on long-term outcome of curative resection for hepatocellular carcinoma. Br J Surg. 96:81–87. 2009. View Article : Google Scholar : PubMed/NCBI
12	Yamamoto J, Kosuge T, Takayama T, Shimada K, Yamasaki S, Ozaki H, Yamaguchi N and Makuuchi M: Recurrence of hepatocellular carcinoma after surgery. Br J Surg. 83:1219–1222. 1996. View Article : Google Scholar
13	Nagasue N, Uchida M, Makino Y, et al: Incidence and factors associated with intrahepatic recurrence following resection of hepatocellular carcinoma. Gastroenterology. 105:488–494. 1993.PubMed/NCBI
14	Shah SA, Cleary SP, Wei AC, et al: Recurrence after liver resection for hepatocellular carcinoma: risk factors, treatment, and outcomes. Surgery. 141:330–339. 2007. View Article : Google Scholar : PubMed/NCBI
15	Cha C, Fong Y, Jarnagin WR, Blumgart LH and DeMatteo RP: Predictors and patterns of recurrence after resection of hepatocellular carcinoma. J Am Coll Surg. 197:753–758. 2003. View Article : Google Scholar : PubMed/NCBI
16	Wu L, Hu A, Tam N, et al: Salvage liver transplantation for patients with recurrent hepatocellular carcinoma after curative resection. PLoS One. 7:e418202012. View Article : Google Scholar : PubMed/NCBI
17	Lee DH, Lee JM, Lee JY, Kim SH, Han JK and Choi BI: Radiofrequency ablation for intrahepatic recurrent hepatocellular carcinoma: long-term results and prognostic factors in 168 patients with cirrhosis. Cardiovasc Intervent Radiol. 37:705–715. 2014. View Article : Google Scholar : PubMed/NCBI
18	Huang WY, Jen YM, Lee MS, et al: Stereotactic body radiation therapy in recurrent hepatocellular carcinoma. Int J Radiat Oncol Biol Phys. 84:355–361. 2012. View Article : Google Scholar : PubMed/NCBI
19	Sugahara S, Nakayama H, Fukuda K, et al: Proton-beam therapy for hepatocellular carcinoma associated with portal vein tumor thrombosis. Strahlenther Onkol. 185:782–788. 2009. View Article : Google Scholar : PubMed/NCBI
20	Abou-Alfa GK, Schwartz L, Ricci S, et al: Phase II study of sorafenib in patients with advanced hepatocellular carcinoma. J Clin Oncol. 24:4293–4300. 2006. View Article : Google Scholar : PubMed/NCBI
21	Feng YX, Wang T, Deng YZ, et al: Sorafenib suppresses postsurgical recurrence and metastasis of hepatocellular carcinoma in an orthotopic mouse model. Hepatology. 53:483–492. 2011. View Article : Google Scholar : PubMed/NCBI
22	Shah SA, Greig PD, Gallinger S, et al: Factors associated with early recurrence after resection for hepatocellular carcinoma and outcomes. J Am Coll Surg. 202:275–283. 2006. View Article : Google Scholar : PubMed/NCBI