Milan Criteria, Multi-nodularity, and Microvascular Invasion Predict the Recurrence Patterns of Hepatocellular Carcinoma After Resection

Hung Hsu Hung, Hao Jan Lei, Gar Yang Chau*, Chien Wei Su, Cheng Yuan Hsia, Wei Yu Kao, Wing Yiu Lui, Wen Chieh Wu, Han Chieh Lin, Jaw Ching Wu

*此作品的通信作者

研究成果: Article同行評審

23 引文 斯高帕斯(Scopus)

摘要

Aims: This study aims to evaluate the risk factors for tumor recurrence beyond the Milan criteria (MC) for patients with hepatocellular carcinoma (HCC) after surgical resection (SR) in which salvage liver transplantation is relatively contraindicated. Methods: A total of 447 patients who underwent SR for HCC were enrolled consecutively. Among them, 248 and 199 patients were within the Milan criteria and beyond the Milan criteria (BMC group), respectively. Overall survival, recurrence, and disease-free survival were analyzed by multivariate analysis. Results: After a median follow-up of 34. 4 months, 130 patients died. Microvascular invasion, higher Edmondson stage of tumor cell differentiation, BMC group, and no anti-viral therapy were associated with poor overall survival. Multi-nodularity, higher Edmondson stage, BMC group, and no anti-viral therapy were independent risk factors for tumor recurrence, while BMC group and no anti-viral therapy were independent risk factors for disease-free survival. The Milan criteria, multi-nodularity, and microvascular invasion were used to stratify the patients into low-, medium-, and high-risk groups for tumor recurrence outside the MC and showed statistical significance (low vs. medium, p = 0. 011; low vs. high, p & 0. 001; medium vs. high, p = 0. 009). Conclusions: The combination of the MC, multi-nodularity, and microvascular invasion predict the post-operative recurrence of HCC and may provide a roadmap for further treatment.

原文English
頁(從 - 到)702-711
頁數10
期刊Journal of Gastrointestinal Surgery
17
發行號4
DOIs
出版狀態Published - 4月 2013

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