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Prediction of microvascular invasion before curative resection of hepatocellular carcinoma

Authors
 BEOM KYUNG KIM  ;  KWANG HYUB HAN  ;  YOUNG NYUN PARK  ;  MI SUK PARK  ;  KYUNG SIK KIM  ;  JIN SUB CHOI  ;  BYUNG SOO MOON  ;  CHAE YOON CHON  ;  YOUNG MYOUNG MOON  ;  SANG HOON AHN 
Citation
 JOURNAL OF SURGICAL ONCOLOGY, Vol.97(3) : 246-252, 2008 
Journal Title
 JOURNAL OF SURGICAL ONCOLOGY 
ISSN
 0022-4790 
Issue Date
2008
MeSH
Adult ; Aged ; Carcinoma, Hepatocellular/mortality ; Carcinoma, Hepatocellular/pathology* ; Carcinoma, Hepatocellular/surgery* ; Female ; Follow-Up Studies ; Hepatectomy ; Humans ; Liver Neoplasms/mortality ; Liver Neoplasms/pathology* ; Liver Neoplasms/surgery* ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Predictive Value of Tests ; Retrospective Studies ; Survival Rate ; Treatment Outcome
Keywords
hepatocellular carcinoma ; prediction ; prognosis ; vascular invasion ; surgery
Abstract
BACKGROUND: The accurate staging of hepatocellular carcinoma (HCC) is important in establishing treatment strategies and prognosis. Among tumor factors, microvascular invasion, one of TNM staging components and prognostic factors, is underestimated preoperatively, due to inaccuracy of imaging modalities. We investigated preoperative predictors of microvascular invasion. METHODS: We reviewed 190 consecutive HCC patients given curative resection from 1999 to 2006. All were treatment-naive and monitored every 3 months after resection. Tumor recurrence, survivals, and clinicopathological factors associated with microvascular invasion were analyzed. RESULTS: The 5-year disease-free survival (DFS) rate was 39.4%(median follow-up duration: 35 months). On resection pathology, 38.9% (74/190 patients) had microvascular invasion undetected preoperatively, using liver spiral computed tomography (CT) or angiography. Independent predictors of microvascular invasion were tumor size (P = 0.043), number (P = 0.011), and Edmondson grade (P = 0.001). Patients with Edmondson grade 1 and size <5 cm had no microvascular invasion, while those with grade > or =2 had higher incidences (7/18 patients, 38.8%) even in small tumor (<2 cm). When tumors recurred, presence of microvascular invasion independently increased incidences of multiple tumors, portal vein invasion, and diffuse-infiltrative patterns significantly. CONCLUSIONS: Preoperative predictors of microvascular invasion are tumor size, number, and Edmondson grade, which may be useful for making clinical decisions in both non-surgical and surgical candidates.
Full Text
http://onlinelibrary.wiley.com/doi/10.1002/jso.20953/abstract
DOI
10.1002/jso.20953
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Moon, Byung Soo(문병수)
Park, Mi-Suk(박미숙) ORCID logo https://orcid.org/0000-0001-5817-2444
Park, Young Nyun(박영년) ORCID logo https://orcid.org/0000-0003-0357-7967
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Chon, Chae Yoon(전재윤)
Choi, Jin Sub(최진섭)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/108178
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