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Title: | Risk factors of peritoneal recurrence and outcome of resected peritoneal recurrence after liver resection in hepatocellular carcinoma: Review of 1222 cases of hepatectomy in a tertiary institution | Authors: | Chieh Kow, A.W David Kwon, C.H Song, S Shin, M Kim, J.M Joh, J.-W |
Keywords: | abdominal wall adult bile duct invasion cancer prognosis cancer staging cancer surgery cancer survival diaphragm female follow up human inoperable cancer liver cell carcinoma liver resection major clinical study male medical record review microvascular invasion omentum overall survival peritoneal recurrence peritoneum metastasis portal vein invasion positive resection margin review risk factor serosal involvement tertiary health care thorax wall totally necrotic nodule treatment outcome tumor localization tumor recurrence tumor volume Carcinoma, Hepatocellular Female Follow-Up Studies Hepatectomy Humans Liver Neoplasms Male Middle Aged Neoplasm Invasiveness Neoplasm Recurrence, Local Neoplasm Staging Peritoneal Neoplasms Prognosis Retrospective Studies Risk Factors Survival Rate |
Issue Date: | 2012 | Citation: | Chieh Kow, A.W, David Kwon, C.H, Song, S, Shin, M, Kim, J.M, Joh, J.-W (2012). Risk factors of peritoneal recurrence and outcome of resected peritoneal recurrence after liver resection in hepatocellular carcinoma: Review of 1222 cases of hepatectomy in a tertiary institution. Annals of Surgical Oncology 19 (7) : 2246-2255. ScholarBank@NUS Repository. https://doi.org/10.1245/s10434-012-2260-3 | Rights: | Attribution 4.0 International | Abstract: | Background. Reports on the risk factors of peritoneal recurrence (PR) after liver resection for hepatocellular carcinoma are lacking. We examined the risk factors of PR after hepatectomy and the outcome of resected PR at our institution. Methods. We retrospectively reviewed the data from 1,222 patients who underwent hepatectomies for hepatocellular carcinoma in Samsung Medical Center from January 2006 to August 2010. We identified patients with PR and studied the risk factors and outcomes of resected PR. Results. The rate of PR was 3.0% (n = 36). The mean ± SD age of patients was 54.0 ± 10.2 years. Among those with PR, 23 patients (63.9%) had unresectable disease and 13 patients (36.1%) had resectable disease. Multivariate analysis found that tumor size >50 mm, presence of microvascular invasion, bile duct invasion, and positive margins were significant risk factors of PR after liver resection. The median overall survival (OS) for resectable PR was 33.0 (28.0-61.6) months compared to 14.0 (6.8-21.2) months for unresectable PR (P = 0.009). Cox regression analysis demonstrated that resected PR [hazard ratio (HR) 0.042, P = 0.001] and interval between hepatectomy and PR (>6months) (HR 0.195, P = 0.016) were positive prognostic factors for OS, while alfa-fetoprotein >200 ng/dl at detection of PR (HR 11.321, P = 0.015) and serosal involvement of primary hepatocellular carcinoma (HR 25.616, P = 0.007) were negative prognostic factors for OS. Conclusions. We found that tumor size >50 mm, presence of microvascular invasion, bile duct invasion, and positive resection margins were significant risk factors of PR after liver resection. Selected patients with resected PR had significantly better OS. © 2012 Society of Surgical Oncology. | Source Title: | Annals of Surgical Oncology | URI: | https://scholarbank.nus.edu.sg/handle/10635/180828 | ISSN: | 1068-9265 | DOI: | 10.1245/s10434-012-2260-3 | Rights: | Attribution 4.0 International |
Appears in Collections: | Staff Publications Elements |
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