Recurrence-free survival more than 10 years after liver resection for hepatocellular carcinoma

Author:

,Eguchi S1,Kanematsu T1,Arii S2,Omata M3,Kudo M4,Sakamoto M5,Takayasu K6,Makuuchi M7,Matsuyama Y8,Monden M9

Affiliation:

1. Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

2. Department of Hepato-Biliary-Pancreatic Surgery, Tokyo Medical and Dental University, Graduate School of Medicine, Japan

3. Department of Gastroenterology, Yamanashi Prefectural Central Hospital, Yamanashi, Japan

4. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kinki University School of Medicine, Japan

5. Department of Pathology, University of Keio, Japan

6. Department of Diagnostic Radiology, National Cancer Centre Hospital, Japan

7. Department of Surgery, Japanese Red Cross Medical Centre, Japan

8. Department of Biostatistics, School of Health Sciences and Nursing, University of Tokyo, Tokyo, Japan

9. Department of Surgery, Osaka University Graduate School of Medicine, Osaka, Japan

Abstract

Abstract Background High recurrence rates after liver resection with curative intent for hepatocellular carcinoma (HCC) remain a problem. The characterization of long-term survivors without recurrence after liver resection may help improve the therapeutic strategy for HCC. Methods A nationwide Japanese database was used to analyse 20 811 patients with HCC who underwent liver resection with curative intent. Results The 10-year recurrence-free survival rate after liver resection for HCC with curative intent was 22·4 per cent. Some 281 patients were recurrence-free after more than 10 years. The HCCs measured less than 5 cm in 83·2 per cent, a single lesion was present in 91·7 per cent, and a simple nodular macroscopic appearance was found in 73·3 per cent of these patients; histologically, most HCCs showed no vascular invasion or intrahepatic metastases. Multivariable analysis revealed tumour differentiation as the strongest predictor of death from recurrent HCC within 5 years. Conclusion Long-term recurrence-free survival is possible after liver resection for HCC, particularly in patients with a single lesion measuring less than 5 cm with a simple nodular appearance and low tumour marker levels.

Publisher

Oxford University Press (OUP)

Subject

Surgery

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