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World Journal of Surgery
Erschienen in: World Journal of Surgery 5/2015

01.05.2015 | Original Scientific Report

Reappraisal of Evidence of Microscopic Portal Vein Involvement by Hepatocellular Carcinoma Cells with Stratification of Tumor Size

verfasst von: Yuesi Zhong, Meihai Deng, Ruiyun Xu

Erschienen in: World Journal of Surgery | Ausgabe 5/2015

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Abstract

Background

Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death internationally, it is necessary to reappraise evidences of HCC cells involving the portal vein, especially considering tumor size.

Materials and methods

Histopathological evidence and dynamic evidences of radiology and cytology from publication were collected and analyzed.

Results

Frequencies of microscopic portal vein involvement (MPVI) and microscopic intrahepatic metastasis (MIM) in resected specimens with single nodule HCC were lower than that of multi nodule HCC, although not significantly. Early HCC (≤1.5 cm) was with extremely low to 0 frequencies of MPVI and MIM. HCC >5 cm showed a tendency of flowing HCC cells into portal vein, which was coincident with significantly high frequency (64.1 %) of MPVI for HCC >5 cm. There were no significant difference of frequencies of MPVI and MIM between groups of tumor ≤2, ≤3, and ≤5 cm.

Conclusions

Single nodule HCC >5 cm needs anatomic resection and the root of portal vein should be firstly ligated because of tendency of flowing HCC cells into portal vein. For single nodule HCC ≤2 cm, there was a risk of about 16.2 % of MPVI, and a risk of about 16.2–26.4 % of MPVI for those single nodule HCC ≤5 cm, however, there was a risk of extremely low to 0 of MPVI for early HCC (≤1.5 cm). Surgeons have to balance liver reserve and risk of MPVI for HCC ≤5 cm before deciding anatomic or nonanatomic resection.
Literatur
1.
2.
Bosch FX, Ribes J, Diaz M et al (2004) Primary liver cancer: worldwide incidence and trends. Gastroenterology 127:S5–S16CrossRefPubMed
3.
Davila JA, El-Serag HB (2006) Racial differences in survival of hepatocellular carcinoma in the United States: a population-based study. Clin Gastroenterol Hepatol 4:104–110CrossRefPubMed
4.
Duffy JP, Hiatt JR, Busuttil RW (2008) Surgical resection of hepatocellular carcinoma. Cancer J 14:100–110CrossRefPubMed
5.
Bruix J, Llovet JM (2002) Prognostic prediction and treatment strategy in hepatocellular carcinoma. Hepatology 35:519–524CrossRefPubMed
6.
Gozzetti G, Mazziotti A, Grazi GL et al (1993) Surgical experience with 168 primary liver cell carcinomas treated with hepatic resection. J Surg Oncol Suppl 3:59–61CrossRefPubMed
7.
Fuster J, García-Valdecasas JC, Grande L et al (1996) Hepatocellular carcinoma and cirrhosis. Results of surgical treatment in a European series. Ann Surg 223:297–302CrossRefPubMedCentralPubMed
8.
Franco D, Capussotti L, Smadja C et al (1990) Resection of hepatocellular carcinomas. Results in 72 European patients with cirrhosis. Gastroenterology 98:733–738PubMed
9.
Fong Y, Sun RL, Jarnagin W et al (1999) An analysis of 412 cases of hepatocellular carcinoma at a western center. Ann Surg 229:790–799; discussion 799–800.
10.
Poon RT, Fan ST, Lo CM et al (2001) Improving survival results after resection of hepatocellular carcinoma: a prospective study of 377 patients over 10 years. Ann Surg 234:63–70CrossRefPubMedCentralPubMed
11.
Liu JH, Chen PW, Asch SM et al (2004) Surgery for hepatocellular carcinoma: does it improve survival? Ann Surg Oncol 11:298–303CrossRefPubMed
12.
Makuuchi M, Hasegawa H, Yamazaki S (1985) Ultrasonically guided subsegmentectomy. Surg Gynecol Obstet 161:346–350PubMed
13.
Takayama T, Makuuchi M (1996) Intraoperative ultrasonography and other techniques for segmental resections. Surg Oncol Clin N Am 5:261–269PubMed
14.
Vauthey JN, Lauwers GY, Esnaola NF et al (2002) Simplified staging for hepatocellular carcinoma. J Clin Oncol 20:1527–1536CrossRefPubMed
15.
Llovet JM, Bru C, Bruix J (1999) Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis 19:329–338CrossRefPubMed
16.
Pawlik TM, Poon RT, Abdalla EK et al (2005) International Cooperative Study Group on Hepatocellular Carcinoma. Critical appraisal of the clinical and pathologic predictors of survival after resection of large hepatocellular carcinoma. Arch Surg 140:450–457CrossRefPubMed
17.
Nathan H, Schulick RD, Choti MA et al (2009) Predictors of survival after resection of early hepatocellular carcinoma. Ann Surg 249:799–805CrossRefPubMed
18.
Sheu JC, Sung JL, Chen DS et al (1985) Early detection of hepatocellular carcinoma by real-time ultrasonography: a prospective study. Cancer 56:660–666CrossRefPubMed
19.
Tinkle CL, Haas-Kogan D (2012) Hepatocellular carcinoma: natural history, current management, and emerging tools. Biologics 6:207–219PubMedCentralPubMed
20.
21.
Yao FY (2006) Should surveillance for hepatocellular carcinoma be increased in patients with cirrhosis and small liver nodules? Nat Clin Pract Gastroenterol Hepatol 3:544–545CrossRefPubMed
22.
Okamoto E, Yamanaka N, Toyosaka A et al (1987) Current status of hepatic resection in the treatment of hepatocellular carcinoma. In: Okuda K, Ishak KG (eds) Neoplasms of the liver. Springer-Verlag, Tokyo, pp 359–361
23.
Shirabe K, Kanematsu T, Matsumata T et al (1991) Factors linked to early recurrence of small hepatocellular carcinoma after hepatectomy: univariate and multivariate analyses. Hepatology 14:802–805CrossRefPubMed
24.
Makuuchi M, Hasegawa H, Yamazaki S (1985) Ultrasonically guided subsegmentectomy. Surg Gynecol Obstet 162:346–350
25.
Hsu HC, Shue JC, Lin YH et al (1985) Prognostic histologic features of resected small hepatocellular carcinoma (HCC) in Taiwan: a comparison with resected large HCC. Cancer 56:672–680CrossRefPubMed
26.
Kanai T, Hirohashi S, Upton MP et al (1987) Pathology of small hepatocellular carcinoma: a proposal for a new gross classification. Cancer 60:810–819CrossRefPubMed
27.
Ercolani G, Grazi GL, Ravaioli M et al (2003) Liver resection for hepatocellular carcinoma on cirrhosis: univariate and multivariate analysis of risk factorsfor intrahepatic recurrence. Ann Surg 237:536–543PubMedCentralPubMed
28.
Wakasa K, Sakurai M, Okamura J et al (1985) Pathological study of small hepatocellular carcinoma: frequency of their invasion. Virchows Arch A Pathol Anat Histopathol 407:259–270CrossRefPubMed
29.
Adachi E, Maeda T, Kajiyama K et al (1996) Factors correlated with portal venous invasion by hepatocellular carcinoma: univariate and multivariate analyses of 232 resected cases without preoperative treatments. Cancer 77:2022–2031CrossRefPubMed
30.
Kang CM, Choi GH, Kim DH et al (2010) Revisiting the role of nonanatomic resection of small (<or = 4 cm) and single hepatocellular carcinoma in patients with well-preserved liver function. J Surg Res 160:81–89CrossRefPubMed
31.
Yamamoto J, Kosuge T, Takayama T et al (1996) Recurrence of hepatocellular carcinoma after surgery. Br J Surg 83:1219–1222CrossRefPubMed
32.
Yamanaka N, Okamoto E, Fujihara S et al (1992) Do the tumor cells of hepatocellular carcinomas dislodge into the portal venous stream during hepatic resection? Cancer 70:2263–2267CrossRefPubMed
33.
Ueno S, Kubo F, Sakoda M et al (2008) Efficacy of anatomic resection vs nonanatomic resection for small nodular hepatocellular carcinoma based on gross classification. J Hepatobiliary Pancreat Surg 15:493–500CrossRefPubMed
34.
Yamamoto M, Takasaki K, Ohtsubo T et al (2001) Effectiveness of systematized hepatectomy with Glisson’s pedicle transection at the hepatic hilus for small nodular hepatocellular carcinoma: retrospective analysis. Surgery 130:443–448CrossRefPubMed
35.
Regimbeau JM, Kianmanesh R, Farges O et al (2002) Extent of liver resection influences the outcome in patients with cirrhosis and small hepatocellular carcinoma. Surgery 131:311–317CrossRefPubMed
36.
Tanaka K, Shimada H, Matsumoto C et al (2008) Anatomic versus limited nonanatomic resection for solitary hepatocellular carcinoma. Surgery 143:607–615CrossRefPubMed
37.
Dahiya D, Wu TJ, Lee CF et al (2010) Minor versus major hepatic resection for small hepatocellular carcinoma (HCC) in cirrhotic patients: a 20-year experience. Surgery 147:676–685CrossRefPubMed
38.
Nakashima Y, Nakashima O, Tanaka M et al (2003) Portal vein invasion and intrahepatic micrometastasis in small hepatocellular carcinoma by gross type. Hepatol Res 26:142–147CrossRefPubMed
39.
Takayama T, Makuuchi M, Hirohashi S et al (1998) Early hepatocellular carcinoma as an entity with a high rate of surgical cure. Hepatology 28:1241–1246CrossRefPubMed
40.
Kojiro M (2005) Histopathology of liver cancers. Best Pract Res Clin Gastroenterol 19:39–62CrossRefPubMed
41.
Lai EC, Ng IO, Ng MM et al (1990) Long-term results of resection for large hepatocellular carcinoma: a multivariate analysis of clinicopathological features. Hepatology 11:815–818CrossRefPubMed
42.
Okusaka T, Okada S, Ueno H et al (2002) Satellite lesions in patients with small hepatocellular carcinoma with reference to clinicopathologic features. Cancer 95:1931–1937CrossRefPubMed
43.
44.
Kubo S, Tanaka H, Takemura S et al (2007) Surgical treatment for hepatocellular carcinoma detected after successful interferon therapy. Surg Today 37:285–290CrossRefPubMed
45.
46.
Roayaie S, Obeidat K, Sposito C et al (2013) Resection of hepatocellular cancer ≤2 cm: results from two western centers. Hepatology 57:1426–1435CrossRefPubMedCentralPubMed
47.
Shindoh J, Hasegawa K, Inoue Y et al (2013) Risk factors of post-operative recurrence and adequate surgical approach to improve long-term outcomes of hepatocellular carcinoma. HPB (Oxford). 15:31–39CrossRefPubMedCentralPubMed
48.
Ochiai T, Sonoyama T, Kikuchi S et al (2007) Anatomic wide hepatectomy for treatment of hepatocellular carcinoma. J Cancer Res Clin Oncol 133:563–569CrossRefPubMed
49.
Imamura H, Matsuyama Y, Tanaka E et al (2003) Risk factors contributing to early and late phase intrahepatic recurrence of hepatocellular carcinoma after hepatectomy. J Hepatol 38:200–207CrossRefPubMed
50.
Sasaki A, Iwashita Y, Shibata K et al (2006) Preoperative transcatheter arterial chemoembolization reduces long-term survival rate after hepatic resection for resectable hepatocellular carcinoma. Eur J Surg Oncol 32:773–779CrossRefPubMed
51.
Chiappa A, Zbar AP, Audisio RA et al (2000) Factors affecting survival and long-term outcome in the cirrhotic patient undergoing hepatic resection for hepatocellular carcinoma. Eur J Surg Oncol 26:387–392CrossRefPubMed
52.
Kobayashi A, Miyagawa S, Miwa S et al (2008) Prognostic impact of anatomical resection on early and late intrahepatic recurrence in patients with hepatocellular carcinoma. J Hepatobiliary Pancreat Surg 15:515–521CrossRefPubMed
53.
54.
Shirabe K, Kajiyama K, Harimoto N et al (2009) Prognosis of hepatocellular carcinoma accompanied by microscopic portal vein invasion. World J Gastroenterol 15:2632–2637CrossRefPubMedCentralPubMed
55.
Kamiyama T, Nakanishi K, Yokoo H et al (2010) theimpact of anatomical resection for hepatocellular carcinoma that meets the milan criteria. J Surg Oncol 101:54–60CrossRefPubMed
56.
Nanashima A, Tobinaga S, Kunizaki M et al (2010) Strategy of treatment for hepatocellular carcinomas with vascular infiltration in patients undergoing hepatectomy. J Surg Oncol 101:557–563CrossRefPubMed
57.
58.
Fujita N, Aishima S, Iguchi T et al (2011) Histologic classification of microscopic portal venous invasion to predict prognosis in hepatocellular carcinoma. Hum Pathol 42:1531–1538CrossRefPubMed
59.
Giuliante F, Ardito F, Pinna AD et al (2012) Liver Resection for Hepatocellular Carcinoma <3cm: results of an Italian Multicenter Study on 588 Patients. J Am Coll Surg 215:244–254CrossRefPubMed
60.
61.
Shimada S, Kamiyama T, Yokoo H et al (2013) Clinicopathological characteristics and prognostic factors in young patients after hepatectomy for hepatocellular carcinoma. World J Surg Oncol 11:52CrossRefPubMedCentralPubMed
62.
Kim JM, Kwon CH, Joh JW et al (2013) C-reactive protein may be a prognostic factor in hepatocellular carcinoma with malignant portal vein invasion. World J Surg Oncol 11:92CrossRefPubMedCentralPubMed
63.
Shirabe K, Kajiyama K, Abe T et al (2009) Predictors of microscopic portal vein invasion by hepatocellular carcinoma: measurement of portal perfusion defect area ratio. J Gastroenterol Hepatol 24:1431–1436CrossRefPubMed
64.
Ohashi M, Wakai T, Korita PV et al (2010) Histological evaluation of intracapsular venous invasion for discrimination between portal and hepatic venous invasion in hepatocellular carcinoma. J Gastroenterol Hepatol 25:143–149CrossRefPubMed
65.
Shimada M, Rikimaru T, Hamatsu T et al (2001) The role of macroscopic classification in nodular-type hepatocellular carcinoma. Am J Surg 182:177–182CrossRefPubMed
66.
Utsunomiya T, Shimada M, Taguchi KI et al (2000) Clinicopathologic features and postoperative prognosis of multicentric small hepatocellular carcinoma. J Am Coll Surg 190:331–335CrossRefPubMed
67.
Yamamoto M, Takasaki K, Otsubo T et al (2004) Favorable surgical outcomes in patients with early hepatocellular carcinoma. Ann Surg 239:395–399CrossRefPubMedCentralPubMed
68.
Sumie S, Kuromatsu R, Okuda K et al (2008) Microvascular invasion in patients with hepatocellular carcinoma and its predictable clinicopathological factors. Ann Surg Oncol 15:1375–1382CrossRefPubMed
69.
Nakashima T (1976) Vascular changes and hemodynamic in hepatocellular carcinoma. In: Okuda K, Peters RL (eds) Hepatocellular carcinoma. Wiley, New York, pp 169–203
70.
Toyosaka A, Okamoto E, Mitsunobu M, et al (1996) Pathologic and radiographic studies of intrahepatic metastasis in hepatocellular carcinoma; the role of efferent vessels. HPB Surg 10:97–103; discussion 103–104.
71.
Yamamoto M, Takasaki K, Yagawa A et al (1990) Cancer cells in the portal and hepatic veins of resected specimens of hepatocellular carcinomas. Gan No Rinsho 36:2123–2125 In JapanesePubMed
72.
Makuuchi M, Hasegawa H, Yamazaki S (1981) Intraoperative ultrasonic examination for hepatectomy. Jpn J Clin Oncol 11:367–390
Metadaten
Titel
Reappraisal of Evidence of Microscopic Portal Vein Involvement by Hepatocellular Carcinoma Cells with Stratification of Tumor Size
verfasst von
Yuesi Zhong
Meihai Deng
Ruiyun Xu
Publikationsdatum
01.05.2015
Verlag
Springer International Publishing
Erschienen in
World Journal of Surgery / Ausgabe 5/2015
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-014-2807-5

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