Authors: Susumu Eguchi Mitsuhisa Takatsuki Masaaki Hidaka Akihiko Soyama Tetsuo Tomonaga Izumi Muraoka Takashi Kanematsu
Publish Date: 2010/02/02
Volume: 34, Issue: 5, Pages: 1034-1038
Abstract
Microscopic vascular invasion is an important risk factor for recurrent hepatocellular carcinoma HCC even after curative liver resection or orthotopic liver transplantation To predict microscopic portal venous invasion the following two questions were examined retrospectively Is it possible to detect microvascular invasion preoperatively What are the characteristics of a group of early HCC recurrences even with no microvascular invasionStudy 1 included 229 patients with HCC who underwent curative liver resection between 1991 and 2008 127 had HCC without microscopic portal venous invasion and 52 had HCC with microscopic portal venous invasion MPVI These two distinct groups were analyzed with regard to various clinicopathologic factors Subsequently we specifically investigated if HCCs 5 cm with vascular invasion n = 32 have some characteristics that would allow detection of latent microvascular invasion Study 2 included 127 HCC patients without MVPI 42 had a recurrence within 2 years and 85 patients were recurrencefree for at least 2 years These two distinct groups were analyzed with regard to various clinicopathologic factorsHCC diameter of 5 cm the macroscopic appearance of HCC and high levels of preoperative desγcarboxyprothrombin are significant prognostic factors in identifying microvascular invasion of HCC The strongest predictor of early recurrence within 2 years was the serum αfetoprotein level in patients without clear microvascular invasion
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