The Effect of Anatomical Distribution of Multiple Tumors for HCC Patients Meeting The Milan Criteria after Hepatic Resection_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 SHENShu , ZHANGWei , LÜTao ,  JIANGLi , YANGJia-yin , YANLü-nan , LIBo , WENTian-fu

Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China;

Corresponding author：

JIANGLi, Email: jl339@126.com

Keywords：

Multifocal tumors; Hepatocellular carcinoma; Anatomical location; Milan criteria; Resection

DOI：

10.7507/1007-9424.20150303

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To exclusively compare the short-and long-term outcomes of hepatic resection (HR) patients with multifocal tumors meeting the Milan criteria between locating in same and different sections. Methods A total of 219 consecutive HR patients with multifocal tumors meeting the Milan criteria were divided into group SS (n=97, same section) and group DS (n=122, different sections) according to their anatomical location (Couinaud's segmentation). Results The 1-, 3-, and 5-year overall survival (OS) and recurrence-free survival (RFS) rates were significantly higher in the group SS than those in the group DS (P < 0.05). The subgroup analysis showed that patients with 2 tumors and those undergoing en bloc resection were associated with better OS and RFS (P < 0.05). Conclusions For HCC patients with multifocal tumors meeting the Milan criteria, those with tumors locating in same hepatic section may have better longterm survival and lower HCC recurrence rates than those locating in different sections after HR.

Citation： SHENShu, ZHANGWei, LÜTao, JIANGLi, YANGJia-yin, YANLü-nan, LIBo, WENTian-fu. The Effect of Anatomical Distribution of Multiple Tumors for HCC Patients Meeting The Milan Criteria after Hepatic Resection. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(10): 1164-1167. doi: 10.7507/1007-9424.20150303 Copy

1.	Hasegawa K, Kokudo N, Makuuchi M, et al. Comparison of resection and ablation for hepatocellular carcinoma:a cohort study based on a Japanese nationwide survey. J Hepatol, 2013, 58(4):724-729.
2.	Lim KC, Chow PK, Allen JC, et al. Systematic review of outcomes of liver resection for early hepatocellular carcinoma within the Milan criteria. Br J Surg, 2012, 99(12):1622-1629.
3.	Dong ZR, Zhang PF, Wang CH, et al. Postoperative adjuvant transcatheter arterial chemoembolization for resectable multiple hepatocellular carcinoma beyond the Milan criteria:a retrospective analysis. Am J Cancer Res, 2015, 5(1):450-457.
4.	Lee SY, Konstantinidis IT, Eaton AA, et al. Predicting recurrence patterns after resection of hepatocellular cancer. HPB (Oxford), 2014, 16(10):943-953.
5.	Ochiai T, Ogino S, Ishimoto T, et al. Prognostic impact of hepatectomy for patients with non-hepatitis B, non-hepatitis C hepatocellular carcinoma. Anticancer Res, 2014, 34(8):4399-4410.
6.	Germain T, Favelier S, Cercueil JP, et al. Liver segmentation:practical tips. Diagn Interv Imaging, 2014, 95(11):1003-1016.
7.	Bismuth H. Revisiting liver anatomy and terminology of hepatectomies. Ann Surg, 2013, 257(3):383-386.
8.	Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med, 1996, 334(11):693-699.
9.	Santambrogio R, Kluger MD, Costa M, et al. Hepatic resection for hepatocellular carcinoma in patients with Child-Pugh's A cirrhosis:is clinical evidence of portal hypertension a contraindication? HPB (Oxford), 2013, 15(1):78-84.
10.	Clavien PA, Barkun J, de Oliveira ML, et al. The Clavien-Dindo classification of surgical complications:five-year experience. Ann Surg, 2009, 250(2):187-196.
11.	Toyosaka A, Okamoto E, Mitsunobu M, et al. Intrahepatic metastases in hepatocellular carcinoma:evidence for spread via the portal vein as an efferent vessel. Am J Gastroenterol, 1996, 91(8):1610-1615.
12.	Toyosaka A, Okamoto E, Mitsunobu M, et al. Pathologic and radiographic studies of intrahepatic metastasis in hepatocellular carcinoma; the role of efferent vessels. HPB Surg, 1996, 10(2):97-104.
13.	Pagano D, Spada M, Parikh V, et al. Liver regeneration after liver resection:clinical aspects and correlation with infective complications. World J Gastroenterol. 2014, 20(22):6953-6960.
14.	Pang YY. The Brisbane 2000 terminology of liver anatomy and resections. HPB (Oxford), 2002, 4(2):99; author reply 99-100.
15.	Chang WT, Kao WY, Chau GY, et al. Hepatic resection can provide long-term survival of patients with non-early-stage hepatocellular carcinoma:extending the indication for resection? Surgery, 2012, 152(5):809-820.
16.	Ishizawa T, Hasegawa K, Aoki T, et al. Neither multiple tumors nor portal hypertension are surgical contraindications for hepatocellular carcinoma. Gastroenterology, 2008, 134(7):1908-1916.
17.	Jiang L, Liao A, Wen T, et al. Living donor liver transplantation or resection for Child-Pugh A hepatocellular carcinoma patients with multiple nodules meeting the Milan criteria. Transpl Int. 2014, 27(6):562-569.
18.	European Association For The Study Of The Liver1; European Organisation For Research And Treatment Of Cancer. EASLEORTC clinical practice guidelines:management of hepatocellular carcinoma. J Hepatol, 2012, 56(4):908-943.
19.	Arii S, Tanaka S, Mitsunori Y, et al. Surgical strategies for hepatocellular carcinoma with special reference to anatomical hepatic resection and intraoperative contrast-enhanced ultrasonography. Oncology, 2010, 78 Suppl 1:125-130.
20.	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(1):36-43.
21.	Bodzin AS, Leiby BE, Ramirez CG, et al. Liver resection using cavitron ultrasonic surgical aspirator (CUSA) versus harmonic scalpel:a retrospective cohort study. Int J Surg, 2014, 12(5):500-503.
22.	Kaibori M, Matsui K, Ishizaki M, et al. A prospective randomized controlled trial of hemostasis with a bipolar sealer during hepatic transection for liver resection. Surgery, 2013, 154(5):1046-1052.
23.	Huang Z, Zhang P, Wang H, et al. Comparing outcomes of two vascular inflow occlusion techniques and treatment without vascular occlusion during major hepatectomy in patients with Hepatitis B-related hepatocellular carcinoma. PLoS One, 2014, 9(9):e107303.
24.	Guo JR, Shen HC, Liu Y, et alet al. Effect of acute normovolemic hemodilution combined with controlled low central venous pressure on cerebral oxygen metabolism of patients with hepalobectomy. Hepatogastroenterology, 2014, 61(136):2321-2325.
25.	Hughes MJ, Ventham NT, Harrison EM, et al. Central venous pressure and liver resection:a systematic review and meta-analysis. HPB (Oxford), 2015 Aug 20.[Epub ahead of print].

1. Hasegawa K, Kokudo N, Makuuchi M, et al. Comparison of resection and ablation for hepatocellular carcinoma:a cohort study based on a Japanese nationwide survey. J Hepatol, 2013, 58(4):724-729.
2. Lim KC, Chow PK, Allen JC, et al. Systematic review of outcomes of liver resection for early hepatocellular carcinoma within the Milan criteria. Br J Surg, 2012, 99(12):1622-1629.
3. Dong ZR, Zhang PF, Wang CH, et al. Postoperative adjuvant transcatheter arterial chemoembolization for resectable multiple hepatocellular carcinoma beyond the Milan criteria:a retrospective analysis. Am J Cancer Res, 2015, 5(1):450-457.
4. Lee SY, Konstantinidis IT, Eaton AA, et al. Predicting recurrence patterns after resection of hepatocellular cancer. HPB (Oxford), 2014, 16(10):943-953.
5. Ochiai T, Ogino S, Ishimoto T, et al. Prognostic impact of hepatectomy for patients with non-hepatitis B, non-hepatitis C hepatocellular carcinoma. Anticancer Res, 2014, 34(8):4399-4410.
6. Germain T, Favelier S, Cercueil JP, et al. Liver segmentation:practical tips. Diagn Interv Imaging, 2014, 95(11):1003-1016.
7. Bismuth H. Revisiting liver anatomy and terminology of hepatectomies. Ann Surg, 2013, 257(3):383-386.
8. Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med, 1996, 334(11):693-699.
9. Santambrogio R, Kluger MD, Costa M, et al. Hepatic resection for hepatocellular carcinoma in patients with Child-Pugh's A cirrhosis:is clinical evidence of portal hypertension a contraindication? HPB (Oxford), 2013, 15(1):78-84.
10. Clavien PA, Barkun J, de Oliveira ML, et al. The Clavien-Dindo classification of surgical complications:five-year experience. Ann Surg, 2009, 250(2):187-196.
11. Toyosaka A, Okamoto E, Mitsunobu M, et al. Intrahepatic metastases in hepatocellular carcinoma:evidence for spread via the portal vein as an efferent vessel. Am J Gastroenterol, 1996, 91(8):1610-1615.
12. Toyosaka A, Okamoto E, Mitsunobu M, et al. Pathologic and radiographic studies of intrahepatic metastasis in hepatocellular carcinoma; the role of efferent vessels. HPB Surg, 1996, 10(2):97-104.
13. Pagano D, Spada M, Parikh V, et al. Liver regeneration after liver resection:clinical aspects and correlation with infective complications. World J Gastroenterol. 2014, 20(22):6953-6960.
14. Pang YY. The Brisbane 2000 terminology of liver anatomy and resections. HPB (Oxford), 2002, 4(2):99; author reply 99-100.
15. Chang WT, Kao WY, Chau GY, et al. Hepatic resection can provide long-term survival of patients with non-early-stage hepatocellular carcinoma:extending the indication for resection? Surgery, 2012, 152(5):809-820.
16. Ishizawa T, Hasegawa K, Aoki T, et al. Neither multiple tumors nor portal hypertension are surgical contraindications for hepatocellular carcinoma. Gastroenterology, 2008, 134(7):1908-1916.
17. Jiang L, Liao A, Wen T, et al. Living donor liver transplantation or resection for Child-Pugh A hepatocellular carcinoma patients with multiple nodules meeting the Milan criteria. Transpl Int. 2014, 27(6):562-569.
18. European Association For The Study Of The Liver1; European Organisation For Research And Treatment Of Cancer. EASLEORTC clinical practice guidelines:management of hepatocellular carcinoma. J Hepatol, 2012, 56(4):908-943.
19. Arii S, Tanaka S, Mitsunori Y, et al. Surgical strategies for hepatocellular carcinoma with special reference to anatomical hepatic resection and intraoperative contrast-enhanced ultrasonography. Oncology, 2010, 78 Suppl 1:125-130.
20. 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(1):36-43.
21. Bodzin AS, Leiby BE, Ramirez CG, et al. Liver resection using cavitron ultrasonic surgical aspirator (CUSA) versus harmonic scalpel:a retrospective cohort study. Int J Surg, 2014, 12(5):500-503.
22. Kaibori M, Matsui K, Ishizaki M, et al. A prospective randomized controlled trial of hemostasis with a bipolar sealer during hepatic transection for liver resection. Surgery, 2013, 154(5):1046-1052.
23. Huang Z, Zhang P, Wang H, et al. Comparing outcomes of two vascular inflow occlusion techniques and treatment without vascular occlusion during major hepatectomy in patients with Hepatitis B-related hepatocellular carcinoma. PLoS One, 2014, 9(9):e107303.
24. Guo JR, Shen HC, Liu Y, et alet al. Effect of acute normovolemic hemodilution combined with controlled low central venous pressure on cerebral oxygen metabolism of patients with hepalobectomy. Hepatogastroenterology, 2014, 61(136):2321-2325.
25. Hughes MJ, Ventham NT, Harrison EM, et al. Central venous pressure and liver resection:a systematic review and meta-analysis. HPB (Oxford), 2015 Aug 20.[Epub ahead of print].

Previous Article
肝癌射频治疗现状
Next Article
Analysis on Pain Follow-Up after Discharged in Patients with Liver Resection

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The Effect of Anatomical Distribution of Multiple Tumors for HCC Patients Meeting The Milan Criteria after Hepatic Resection

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content