Factors Affecting the Prognosis of Small Hepatocellular Carcinoma in Taiwanese Patients Following Hepatic ResectionReport as inadecuate




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Canadian Journal of Gastroenterology - Volume 25 2011, Issue 9, Pages 485-491

Original Article

Department of General Surgery, Changhua Christian Hospital, Changhua, Taiwan

Department of Pharmacology, Changhua Christian Hospital, Changhua, Taiwan

Department of Radiology, Changhua Christian Hospital, Changhua, Taiwan

Laboratory of Biostatistics, Changhua Christian Hospital, Changhua, Taiwan

Department of Surgical Pathology, Changhua Christian Hospital, Changhua, Taiwan

College of Medicine, Chung Shan Medical University, Taichung, Taiwan

Received 3 September 2010; Accepted 16 March 2011

Copyright © 2011 Hindawi Publishing Corporation. This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License CC BY-NC http:-creativecommons.org-licenses-by-nc-4.0-, which permits reuse, distribution and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes.

Abstract

BACKGROUND: Small hepatocellular carcinoma HCC affects millions of individuals worldwide. Surveillance of high-risk patients increases the early detection of small HCC.

OBJECTIVE: To identify prognostic factors affecting the overall survival OS and recurrence-free survival RFS of patients with small HCC.

METHODS: The present prospective study enrolled 140 Taiwanese patients with stage I or stage II small HCC. Clinical parameters of interest included operation type, tumour size, tumour histology, Child-Pugh class, presence of hepatitis B surface antigen and liver cirrhosis, hepatitis C status, alpha-fetoprotein, total bilirubin and serum albumin levels, and administration of antiviral and salvage therapies.

RESULTS: Tumour size correlated significantly with poorer OS in patients with stage I small HCC P=0.014; however, patients with stage II small HCC experienced a significantly poorer RFS P=0.033. OS rates did not differ significantly between patients with stage I and stage II small HCC. Tumour margins, tumour histology and cirrhosis did not significantly affect OS or RFS P>0.05.

DISCUSSION: Increasing tumour size has generally been associated with poorer prognoses in cases of HCC. The present study verified the relationship between small HCC tumour size and OS; however, a reduction in OS with increasing tumour size was demonstrated for patients with stage I – but not for stage II – small HCC.

CONCLUSION: Patients with stage II small HCC may benefit from aggressive surveillance for tumour recurrence and appropriate salvage treatment. Further studies are needed for additional stratification of stage I patients to identify those at increased risk of death.





Author: Chih-Jan Ko, Su-Yu Chien, Chen-Te Chou, Li-Sheng Chen, Mei-Ling Chen, and Yao-Li Chen

Source: https://www.hindawi.com/



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