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Erschienen in: Annals of Surgical Oncology 5/2017

05.12.2016 | Hepatobiliary Tumors

Actual 10-Year Survivors After Resection of Hepatocellular Carcinoma

verfasst von: Jian Zheng, MD, Deborah Kuk, ScM, Mithat Gönen, PhD, Vinod P. Balachandran, MD, T. Peter Kingham, MD, Peter J. Allen, MD, Michael I. D’Angelica, MD, William R. Jarnagin, MD, Ronald P. DeMatteo, MD

Erschienen in: Annals of Surgical Oncology | Ausgabe 5/2017

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Abstract

Background

Resection of hepatocellular carcinoma (HCC) offers a chance of cure, but recurrence is common and survival is often limited. The clinical and pathological characteristics of long-term survivors have not been well studied.

Methods

We retrospectively reviewed 212 patients who underwent partial hepatectomy for HCC with curative intent from 1992 to 2006. Fifty patients who survived beyond 10 years were compared with 109 patients who died of recurrence within 10 years.

Results

Multivariate analysis showed that tumors <5 cm (odds ratio [OR] 2.3, p = 0.04), solitary tumors (OR 3.2, p = 0.01), and absence of vascular invasion (OR 2.3, p = 0.04) were independently associated with actual 10-year survival. However, more than 20% of long-term survivors also possessed established poor prognostic factors, including α-fetoprotein >1000 ng/mL, unfavorable serum inflammatory indices, tumor size >10 cm, microvascular invasion, poor tumor differentiation, cirrhosis, and metabolic syndrome. None of the 10-year survivors had an R1 resection. While 77% of the short-term survivors developed recurrence within 2 years, 42% of the 10-year survivors developed recurrence during their decade of follow-up, although most of the recurrences among 10-year survivors were intrahepatic and amenable to further treatment. Among patients who survived beyond 10 years, 42% remained alive without recurrence.

Conclusions

In this largest Western series of actual 10-year survivors after HCC resection, almost one in four patients survived over a decade, even though nearly half of this subset had developed recurrence. While many well-known variables were associated with a poor outcome, only a positive microscopic margin precluded long-term survival.
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Metadaten
Titel
Actual 10-Year Survivors After Resection of Hepatocellular Carcinoma
verfasst von
Jian Zheng, MD
Deborah Kuk, ScM
Mithat Gönen, PhD
Vinod P. Balachandran, MD
T. Peter Kingham, MD
Peter J. Allen, MD
Michael I. D’Angelica, MD
William R. Jarnagin, MD
Ronald P. DeMatteo, MD
Publikationsdatum
05.12.2016
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 5/2017
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5713-2

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