Risk factors for early death due to recurrence after liver resection for hepatocellular carcinoma: Results of a multicenter study

被引:123
作者
Regimbeau, JM
Abdalla, EK
Vauthey, JN
Lauwers, GY
Durand, FO
Nagorney, DM
Ikai, I
Yamaoka, Y
Belghiti, J
机构
[1] Hop Beaujon, Paris, France
[2] Univ Texas, MD Anderson Canc Ctr, Houston, TX 77030 USA
[3] Massachusetts Gen Hosp, Boston, MA 02114 USA
[4] Harvard Univ, Sch Med, Boston, MA 02115 USA
[5] Mayo Clin, Rochester, MN USA
[6] Kyoto Univ, Grad Sch Med, Kyoto, Japan
关键词
hepatocellular carcinoma; liver resection; Child-Pugh class; hepatitis; fibrosis; cirrhosis;
D O I
10.1002/jso.10284
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background and Objectives: Recurrence after partial liver resection for hepatocellular carcinoma (HCC) is a major cause of death from this disease. To identify risk factors for early death from recurrence after liver resection for HCC. Methods: All 547 patients in this study had greater than 1 year of follow-up after complete resection of HCC (1980-1999) at one of the four hepatobiliary centers in Japan, France, and the United States. Patients who died of recurrence less than or equal to1 year post-resection and all of those alive at least 1 year were compared. Survival and clinicopathological factors associated with death from recurrence within 1 year of resection were analyzed. Results: Overall postoperative mortality rate was 5%. In the first postoperative year, 123 (22%) patients died. Of these, 53 (43%) died of recurrence, 30 (24%) of postoperative complications, and 40 (33%) of liver failure/hemorrhage. On multivariate analysis, tumor size greater than 5 cm (P < 0.02; odds ratio, 3.0), multiple tumors (P < 0.01; odds ratio, 3.3), and greater than 5 mitoses per 10 high-power fields (P < 0.03; odds ratio, 3) were associated with increased risk of early death due to recurrence. Conclusions: These findings enable identification of patients with HCC who are at high risk for early death due to recurrence following potentially curative resection who might be candidates for adjuvant therapy trials. (C) 2003 Wiley-Liss, Inc.
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页码:36 / 41
页数:6
相关论文
共 47 条
[41]  
SUEHIRO T, 1995, CANCER, V76, P399, DOI 10.1002/1097-0142(19950801)76:3<399::AID-CNCR2820760309>3.0.CO
[42]  
2-O
[43]   Adoptive immunotherapy to lower postsurgical recurrence rates of hepatocellular carcinoma: a randomised trial [J].
Takayama, T ;
Sekine, T ;
Makuuchi, M ;
Yamasaki, S ;
Kosuge, T ;
Yamamoto, J ;
Shimada, K ;
Sakamoto, M ;
Hirohashi, S ;
Ohashi, Y ;
Kakizoe, T .
LANCET, 2000, 356 (9232) :802-807
[44]   Close association between high serum ALT and more rapid recurrence of hepatocellular carcinoma in hepatectomized patients with HCV-associated liver cirrhosis and hepatocellular carcinoma [J].
Tarao, K ;
Rino, Y ;
Takemiya, S ;
Tamai, S ;
Ohkawa, S ;
Sugimasa, Y ;
Miyakawa, K ;
Morinaga, S ;
Yoshida, M ;
Shibuya, A ;
Kokubu, S ;
Kakita, A ;
Endo, O .
INTERVIROLOGY, 2000, 43 (01) :20-26
[45]   No-mortality liver resection for hepatocellular carcinoma in cirrhotic and noncirrhotic patients -: Is there a way?: A prospective analysis of our approach [J].
Torzilli, G ;
Makuuchi, M ;
Inoue, K ;
Takayama, T ;
Sakamoto, Y ;
Sugawara, Y ;
Kubota, K ;
Zucchi, A .
ARCHIVES OF SURGERY, 1999, 134 (09) :984-992
[46]   FACTORS AFFECTING LONG-TERM OUTCOME AFTER HEPATIC RESECTION FOR HEPATOCELLULAR-CARCINOMA [J].
VAUTHEY, JN ;
KLIMSTRA, D ;
FRANCESCHI, D ;
TAO, Y ;
FORTNER, J ;
BLUMGART, L ;
BRENNAN, M .
AMERICAN JOURNAL OF SURGERY, 1995, 169 (01) :28-35
[47]   SURGICAL MARGIN AND RECURRENCE AFTER RESECTION OF HEPATOCELLULAR-CARCINOMA IN PATIENTS WITH CIRRHOSIS - FURTHER EVALUATION OF LIMITED HEPATIC RESECTION [J].
YOSHIDA, Y ;
KANEMATSU, T ;
MATSUMATA, T ;
TAKENAKA, K ;
SUGIMACHI, K .
ANNALS OF SURGERY, 1989, 209 (03) :297-301