Favorable outcomes of surgical resection for extrahepatic recurrent hepatocellular carcinoma
- 1 August 2020
- journal article
- research article
- Published by Wiley in Hepatology Research
- Vol. 50 (8), 978-984
- https://doi.org/10.1111/hepr.13526
Abstract
Aim Repeat resection for intrahepatic recurrent hepatocellular carcinoma (HCC) is effective for the long-term survival of patients; however, little is known about the surgical outcomes of extrahepatic nodules. The aim of this study is to investigate whether resection can contribute to the survival of patients with extrahepatic recurrent HCC. Methods Under the conditions that intrahepatic recurrent HCC was absent or controlled by locoregional therapies, patients who had resectable extrahepatic recurrent HCC in the lymph nodes, adrenal gland, peritoneum, lung, or brain were included in this study. The survival of patients who did (Surgical group) and did not (Non-surgical group, underwent other therapies) undergo resection for extrahepatic recurrent HCC was compared. Results Thirty-eight and 26 patients were included in the Surgical and Non-surgical groups, respectively. No patient had severe postoperative complications. After a median follow-up of 1.2 (range, 0.2-8.8) years, the median cumulative incidence of extrahepatic recurrent HCC was 1.2 years (95% confidence interval [CI], 0.4-3.5) in the Surgical group. The median overall survival was 5.3 (95% CI, 2.5-8.8) and 1.1 (0.8-2.3) years in the Surgical and Non-surgical groups, respectively (P < 0.001). The 5-year rates of survival were 60.5% and 9.1% in the Surgical and Non-surgical groups, respectively. Surgical resection, alpha-fetoprotein, disease-free interval, and metastasis at the adrenal gland were the independent factors for overall survival. Conclusions Due to the favorable surgical outcomes, resection should be considered as one of the therapeutic choices for patients with extrahepatic recurrent HCC if intrahepatic recurrent HCC can be controlled by locoregional therapies.Funding Information
- Japan Agency for Medical Research and Development (JP18hk0102049h0001)
This publication has 33 references indexed in Scilit:
- Concomitant lung metastasis in patients with advanced hepatocellular carcinomaWorld Journal of Gastroenterology, 2012
- Extrahepatic Spread of Hepatocellular Carcinoma: Spectrum of Imaging FindingsAmerican Journal of Roentgenology, 2011
- Hepatocellular carcinoma with extrahepatic metastasisCancer, 2011
- Predictors of Extrahepatic Recurrence After Curative Hepatectomy for Hepatocellular CarcinomaAnnals of Surgical Oncology, 2010
- Efficacy of surgical resection in management of isolatedextrahepatic metastases of hepatocellular carcinomaWorld Journal of Gastroenterology, 2009
- Sorafenib in Advanced Hepatocellular CarcinomaThe New England Journal of Medicine, 2008
- Prognostic analysis of pulmonary metastases from hepatocellular carcinomaHepatology International, 2008
- Palliative Radiotherapy Trials for Bone Metastases: A Systematic ReviewJournal of Clinical Oncology, 2007
- Patterns and clinicopathologic features of extrahepatic recurrence of hepatocellular carcinoma after curative resectionSurgery, 2007
- Aggressive management of patients with extrahepatic and intrahepatic recurrences of hepatocellular carcinoma by combined resection and locoregional therapyJournal of the American College of Surgeons, 2002