한국간담췌외과학회지 (Annals of Hepato-Biliary-Pancreatic Surgery)

  • 제13권4호
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  • Pages.227-234
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  • 2009
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  • 2508-5778(pISSN)
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  • 2508-5859(eISSN)
한국간담췌외과학회 (The Korean Association of Hepato-Biliary-Pancreatic Surgery)
권호 표지

다발성 간세포암 환자에서 다발 부위 간절제 또는 고주파 치료를 병합한 간절제술 후 장기 성적

Long-term Outcomes after Multiple-site Resection or Combined Resection and Radiofrequency Ablation in Patients with Multiple Hepatocellular Carcinoma

  • 조민수 (연세대학교 의과대학 외과학교실) ;
  • 최기홍 (연세대학교 의과대학 외과학교실) ;
  • 김동현 (연세대학교 의과대학 외과학교실) ;
  • 강창무 (연세대학교 의과대학 외과학교실) ;
  • 최진섭 (연세대학교 의과대학 외과학교실) ;
  • 박영년 (연세대학교 의과대학 병리학교실) ;
  • 이우정 (연세대학교 의과대학 외과학교실)
  • Cho, Min-Soo (Department of Surgery, Yonsei University College of Medicine) ;
  • Choi, Gi-Hong (Department of Surgery, Yonsei University College of Medicine) ;
  • Kim, Dong-Hyun (Department of Surgery, Yonsei University College of Medicine) ;
  • Kang, Chang-Moo (Department of Surgery, Yonsei University College of Medicine) ;
  • Choi, Jin-Sub (Department of Surgery, Yonsei University College of Medicine) ;
  • Park, Young-Nyun (Department of Pathology, Yonsei University College of Medicine) ;
  • Lee, Woo-Jung (Department of Surgery, Yonsei University College of Medicine)
  • 발행 : 2009.12.31

⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: Hepatic resection is the standard treatment for hepatocellular carcinoma (HCC). In some patients with multiple HCC, one-block resection is not feasible due to either the tumor location or the underlying liver function. In this study, we attempted to compare the outcomes of multiple - site resection or combined resection and radiofrequency ablation with those of one-block resection in patients with multiple HCC. Methods: We retrospectively reviewed 507 patients who underwent surgical resection. Among 507 patients who received surgical treatment with potentially curative aim from January 1996 to August 2006 in Yonsei University Health System, 58 patients had a radiologically detected multiple HCC. Patients with multiple HCC were divided into: group A, patients treated with one-block resection (n=40) and group B, patients with multiple-site resection or combined resection and RFA (n=18). Results: The 1-, 3- and 5-year overall survival rates for patients with single and multiple HCC were 90.2%, 76.2% and 66.7% and 82.7%, 61.4% and 37.9%, respectively (p<0.001). In group B, 6 patients received multiple-site resection and 12 patients underwent combined resection and RFA. The clinicopathological variables were not significantly different between the two groups except the distribution of multiple tumors. The postoperative complication rates for group A and B were 32.5% and 33.3%, respectively. The 1-, 3- and 5-year disease-free survival rates for group A and B were 53.0%, 27.6% and 24.1% and 18.3%, 24.1% and 18.3%, respectively (p=0.386). The overall survival rates were also not significantly different between the two group (80.0%, 59.6%, and 36.9% for group A and 88.9%, 65.7% and 39.4% for group B, p=0.528). The multivariate analysis revealed that Edmondsons-Steiner grade (III-IV) and Indocyanine green retention rate at 15 minutes (ICG R15) >10% were adverse prognostic factors for overall survival. Conclusion: Active treatments including multiple-site resection and combined resection and RFA showed similar treatment outcomes compared with one-block resection in patients with multiple HCC.

키워드

참고문헌

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