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10년간 단일 기관에서 간세포암의 수술적 절제의 경험 - 수술 후 장기 성적을 향상시킬 수 있는 전략

Other Titles
 Single Center Experience (Ten Years) with Surgical Resection for Treating Hepatocellular Carcinoma - Strategies for improving the long-term survival after resection 
Authors
 한대훈  ;  최기홍  ;  김동현  ;  최새별  ;  강창무  ;  김경식  ;  최진섭  ;  박영년  ;  박준용  ;  김도영  ;  한광협  ;  전재윤  ;  이우정 
Citation
 Korean Journal of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지), Vol.12(4) : 245-253, 2008 
Journal Title
 Korean Journal of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지) 
ISSN
 1738-6349 
Issue Date
2008
Keywords
hepatocellular carcinoma ; curative resection ; long-term outcome
Abstract
Purpose: Although surgical resection is the most effective treatment for hepatocellular 4 carcinoma (HCC), high recurrence after resection is a major challenging problem. We attempted to determine the optimal strategies for improving the long-term surgical outcome through the review of our 10 years’ experience with surgically treating HCC. Methods: We retrospectively reviewed 497 patients who received curative resection at the Yonsei University Health System from January 1996 to August 2006. Results: The 5 year disease-free rate and the overall survival rate after curative resection were 45.0% and 63.9%, respectively. Of the 497 patients, 491 (98.8%) were Child-Pugh A and 107 (56.3%) were diagnosed with liver cirrhosis. The postoperative complication and mortality rates were 28.6% and 1.8%, respectively. Of the 243 recurrent patients, 184 (75.7%) were diagnosed with intrahepatic recurrence alone. Of these intrahepatic recurrent patients, 169 (91.9%) received active treatment, including transplantation (n=7), re-resection (n=12), local ablation therapy (n=18) and transarterial chemoembolization (n=132). Multivariate analysis revealed that perioperative transfusion, a satellite nodule, the pathologic TNM stage, the Edmondsons-Steiner grade, the serum alkaline phosphatase (ALP) and aspartate aminotransferase levels and cirrhosis were associated with disease free survival, and perioperative transfusion, a satellite nodule, macroscopic vascular invasion, the Edmondsons-Steiner grade, the ALP and serum albumin levels and the platelet count were related with overall survival after resection. Conclusions: The long-term surgical outcome of HCC can be further improved by proper patient selection, delicately performed surgery and administering postoperative adjuvant therapy for patients with a high risk of recurrence. Early diagnosis and aggressive treatment are needed to treat the recurrence.
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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
Yonsei Authors
강창무(Kang, Chang Moo) ORCID logo https://orcid.org/0000-0002-5382-4658
김경식(Kim, Kyung Sik) ORCID logo https://orcid.org/0000-0001-9498-284X
박영년(Park, Young Nyun) ORCID logo https://orcid.org/0000-0003-0357-7967
박준용(Park, Jun Yong) ORCID logo https://orcid.org/0000-0001-6324-2224
이우정(Lee, Woo Jung) ORCID logo https://orcid.org/0000-0001-9273-261X
최진섭(Choi, Jin Sub)
한대훈(Han, Dai Hoon) ORCID logo https://orcid.org/0000-0003-2787-7876
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/165961
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