Impact of Anatomical Resection for Hepatocellular Carcinoma With Microportal Invasion (vp1): A Multi-institutional Study by the Kyushu Study Group of Liver Surgery.

Tytuł:: Impact of Anatomical Resection for Hepatocellular Carcinoma With Microportal Invasion (vp1): A Multi-institutional Study by the Kyushu Study Group of Liver Surgery.
Autorzy:: Hidaka M; Kyushu Study Group of Liver Surgery, Omura, Nagasaki, Japan.; Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Eguchi S; Kyushu Study Group of Liver Surgery, Omura, Nagasaki, Japan.; Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Okuda K; Kyushu Study Group of Liver Surgery, Omura, Nagasaki, Japan.
Beppu T; Kyushu Study Group of Liver Surgery, Omura, Nagasaki, Japan.
Shirabe K; Kyushu Study Group of Liver Surgery, Omura, Nagasaki, Japan.
Kondo K; Kyushu Study Group of Liver Surgery, Omura, Nagasaki, Japan.
Takami Y; Kyushu Study Group of Liver Surgery, Omura, Nagasaki, Japan.
Ohta M; Kyushu Study Group of Liver Surgery, Omura, Nagasaki, Japan.
Shiraishi M; Kyushu Study Group of Liver Surgery, Omura, Nagasaki, Japan.
Ueno S; Kyushu Study Group of Liver Surgery, Omura, Nagasaki, Japan.
Nanashima A; Kyushu Study Group of Liver Surgery, Omura, Nagasaki, Japan.
Noritomi T; Kyushu Study Group of Liver Surgery, Omura, Nagasaki, Japan.
Kitahara K; Kyushu Study Group of Liver Surgery, Omura, Nagasaki, Japan.
Fujioka H; Kyushu Study Group of Liver Surgery, Omura, Nagasaki, Japan.
Źródło:: Annals of surgery [Ann Surg] 2020 Feb; Vol. 271 (2), pp. 339-346.
Typ publikacji:: Journal Article; Multicenter Study
Język:: English
Imprint Name(s):: Original Publication: Philadelphia, PA : Lippincott Williams & Wilkins
MeSH Terms:: Carcinoma, Hepatocellular/*surgery
Hepatectomy/*methods
Liver Neoplasms/*surgery
Neoplasm Invasiveness/*pathology
Vascular Neoplasms/*pathology
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular/mortality ; Female ; Humans ; Japan ; Liver Neoplasms/mortality ; Male ; Middle Aged ; Prognosis ; Propensity Score ; Retrospective Studies ; Survival Rate ; Vascular Neoplasms/mortality
References:: Park JW, Chen M, Colombo N, et al. Global patterns of hepatocellular carcinoma management from diagnosis to death: the RIDGE Study. Liver Int 2015; 35:2155–2166.
Makuuchi M, Hasegawa H, Yamasaki S. Ultrasonically guided subsegmentectomy. Surg Gynecol Obstet 1986; 161:364–450.
Hasegawa K, Kokudo N, Imamura H, et al. Prognostic impact of anatomic resection for hepatocellulara carcinoma. Ann Surg 2005; 242:252–259.
Zhou Y, Xu D, Wu L, et al. Meta-analysis of anatomic resection versus nonanatomic resection for hepatocellular carcinoma. Langenbecks Arch Surg 2011; 396:1109–1117.
Cucchetti A, Qiao GL, Cescon M, et al. Anatomic versus nonanatomic resection in cirrhotic patients with early hepatocellular carcinoma. Surgery 2014; 155:512–521.
Shindoh J, Hasegawa K, Inoue Y, et al. Risk factors of post-operative recurrence and adequate surgical approach to improve long-term outcomes of hepatocellular carcinoma. HPB (Oxford) 2013; 15:31–39.
Shindoh J, Makuuchi M, Matsuyama Y, et al. Complete removal of the tumor-bearing portal territory decreases local tumor recurrence and improves disease-specific survival of patients with hepatocellular carcinoma. J Hepatol 2016; 64:594–600.
Zhao H, Chen C, Gu S, et al. Anatomical versus non-anatomical resection for solitary hepatocellular carcinoma without macroscopic vascular invasion: a propensity score matching analysis. J Gastroenterol Hepatol 2017; 32:870–878.
Matsumoto T, Kubota K, Aoki T, et al. Clinical impact of anatomical liver resection for hepatocellular carcinoma with pathologically proven portal vein invasion. World J Surg 2016; 40:402–411.
Kanematsu T, Takenaka K, Matsumata T, et al. Limited hepatic resection effective for selected cirrhotic patients with primary liver cancer. Ann Surg 1984; 199:51–56.
Kaibori M, Matsui Y, Hijikawa T, et al. Comparison of limited and anatomic hepatic resection for hepatocellular carcinoma with hepatitis C. Surgery 2006; 139:385–394.
Okamura Y, Ito T, Sugiura T, et al. Anatomic versus nonanatomic hepatectomy for a solitary hepatocellualar carcinoma: a case-controlled study with propensity score matching. J Gastrointest Surg 2014; 18:1994–2002.
Marubashi S, Gotoh K, Akita H, et al. Anatomical versus non-anatomical resection for hepatocellular carcinoma. Br J Surg 2015; 102:776–784.
Hirokawa F, Kubo S, Nagano H, et al. Do patients with small solitary hepatocellular carcinomas without macroscopically vascular invasion require anatomic resection? Propensity score analysis. Surgery 2015; 157:27–36.
Yamamoto Y, Ikoma H, Morimura R, et al. Clinical analysis of anatomical resection for the treatment of hepatocellular carcinoma based on the stratification of liver function. World J Surg 2014; 38:1154–1163.
Eguchi S, Kanematsu T, Arii S, et al. Comparison of the outcomes between anatomical subsegmentectomy and a non-anatomical minor hepatectomy for single hepatocellular carcinoma based on a Japanese nationwide survey. Surgery 2008; 143:469–475.
The Liver Cancer Study Group of JapanThe General Rules for the Clinical and Pathological Study of Primary Liver Cancer. 3rd ed.2010; Tokyo: Kanehara, 1–110.
Hidaka M, Eguchi S, Okudaira S, et al. Multicentric occurrence and spread of hepatocellular carcinoma in whole explanted end-stage liver. Hepatol Res 2009; 39:143–148.
Shi M, Zhang CQ, Zhang YQ, et al. Micrometastases of solitary hepatocellular carcinoma and appropriate resection margin. World J Surg 2004; 28:376–381.
Cucchetti A, Cescon M, Ercolani G, et al. A comprehensive meta-regression analysis on outcome of anatomic resection versus nonanatomic resection for hepatocellular carcinoma. Ann Surg Oncol 2012; 19:3697–3705.
Shi M, Guo RP, Lin XJ, et al. Partial hepatectomy with wide versus narrow resection margin for solitary hepatocellular carcinoma: a prospective randomized trial. Ann Surg 2007; 245:36–43.
Lee JW, Lee YJ, Park KM, et al. Anatomical resection but not surgical margin width influence survival following resection for HCC, a propensity score analysis. World J Surg 2016; 40:1429–1439.
Entry Date(s):: Date Created: 20180727 Date Completed: 20200511 Latest Revision: 20211213
Update Code:: 20240104
DOI:: 10.1097/SLA.0000000000002981
PMID:: 30048313
: Czasopismo naukowe

Objective: The aim of the present study was to evaluate the value of anatomical resection for hepatocellular carcinoma (HCC) with microportal vascular invasion (vp1) between 2000 and 2010.
Background: Vascular invasion has been reported as a prognostic factor of liver resection for HCC. Anatomical resection for HCC has resulted in optimum outcomes of eradicating intrahepatic micrometastases through the portal vein, but opposite results have also been reported.
Methods: A clinical chart review was performed for 546 patients with HCC with vp1. We retrospectively evaluated the recurrence-free survival (RFS) between anatomical (AR) and nonanatomical resection (NAR). The site of recurrence was also compared between these groups. The influence of AR on the overall survival (OS) and RFS rates was analyzed in patients selected by propensity score matching, and the prognostic factors were identified.
Results: A total of 546 patients were enrolled, including 422 in the AR group and 124 in the NAR group. There was no difference in the 5-year OS and RFS rates between the 2 groups. Local recurrence was significantly more frequent in the NAR group than in the AR group. In a multivariate analysis, hepatitis C virus, serum protein induced by vitamin K absence II of 380 mAU/mL or more, tumor diameter of 5 cm or more, and age of 70 years or older were significant predictors of a poor RFS after liver resection. There were no significant differences in the OS or RFS between the AR and NAR groups by a propensity score-matched analysis.
Conclusions: Although local recurrence around the resection site was suppressed by AR, AR for HCC with vp1 did not influence the RFS or OS rates after hepatectomy in the modern era.

Comment in: Transl Gastroenterol Hepatol. 2019 Jan 07;4:3. (PMID: 30854490)
Comment in: Hepatobiliary Surg Nutr. 2019 Jun;8(3):274-276. (PMID: 31245412)
Comment in: Ann Surg. 2021 Dec 1;274(6):e717-e718. (PMID: 32773625)

Informacja