Annals of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지)

The Korean Association of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회)
권호 표지

The Risk Factors for Extrahepatic Recurrence after Curative Resection of Hepatocellular Carcinoma

간세포암 근치적 절제 후 발생한 간외 재발암의 위험인자 분석

  • Lee, Hyung-Soon (Department of Surgery, Yonsei University College of Medicine) ;
  • Choi, Gi-Hong (Department of Surgery, Yonsei University College of Medicine) ;
  • Hwang, Ho-Kyung (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) ;
  • Lee, Woo-Jung (Department of Surgery, Yonsei University College of Medicine)
  • 이형순 (연세대학교 의과대학 외과학교실) ;
  • 최기흥 (연세대학교 의과대학 외과학교실) ;
  • 황호경 (연세대학교 의과대학 외과학교실) ;
  • 강창무 (연세대학교 의과대학 외과학교실) ;
  • 최진섭 (연세대학교 의과대학 외과학교실) ;
  • 이우정 (연세대학교 의과대학 외과학교실)
  • Published : 2010.12.31
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Abstract

Purpose: A few studies have been reported on extrahepatic metastasis after curative resection for hepatocellular carcinoma (HCC). We investigated the patterns of extrahepatic recurrence and we identified the risk factors for extrahepatic recurrence after curative resection for HCC. Methods: We retrospectively reviewed 587 patients who underwent surgical resection with a curative aim from January 1998 to December 2007 in the Yonsei University Health Care System. Among the 571 patients, 291 (51.0%) patients developed recurrence. Sixty five patients initially presented with extrahaptic recurrence. The patients with extrahepatic recurrence were divided into Group A (peritoneal recurrence) and Group B (non-peritoneal extrahepatic recurrence). Results: Group A had higher rates of intraoperative bleeding>1,500 ml and perioperative transfusion too. On the multivariate analysis, perioperative transfusion, satellite nodule and the tumor size were the independent risk factors for Group A. The Edmondson-Steiner grade, satellite nodule and the tumor size were the independent risk factors for Group B. The 1, 3 and 5-year overall survival rates after curative resection for the patients with extrahepatic recurence were 83.1%, 48.9% and 27.4%, respectively. The recurrence patterns and treatment modalities did not affect the overall survival after treatment for extrahepatic recurrence. Conclusion: A perioperative transfusion was found to be a different risk factor for peritoneal recurrence, as compared to those risk factors for non-peritoneal extrahepatic recurrence. Therefore, efforts by physicians to decrease intraoperative bleeding may prevent peritoneal recurrence after performing curative resection for HCC.

Keywords

References

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