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간세포암의 근치적 절제 후 간내 재발암의 위험 인자 분석

Other Titles
 The Risk Factors for the Intrahepatic Recurrence of Hepatocellular Carcinoma after Curative Resection 
Authors
 김강미  ;  최기홍  ;  한대훈  ;  김동현  ;  강창무  ;  최진섭  ;  박준용  ;  김도영  ;  한광협  ;  전재윤  ;  박영년  ;  이우정 
Citation
 Korean Journal of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지), Vol.12(4) : 222-231, 2008 
Journal Title
 Korean Journal of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지) 
ISSN
 1738-6349 
Issue Date
2008
Keywords
Hepatocellular carcinoma ; curative resection ; intrahepatic recurrence ; risk factor ; prognosis
Abstract
Purpose: Intrahepatic recurrent HCC has been classified according to location, the time to recurrence and the pattern of presentation. The purpose of this study is to classify intrahepatic recurrent HCCs into subgroups that have relatively similar recurrent patterns and to identify the risk factors for each recurrent type. Methods: A total of 353 patients were retrospectively studied. Intrahepatic recurrent HCC was classified into nodular recurrence (<4 nodules; type I), multinodular-diffuse recurrence (≥4 nodules; type II) and infiltrative recurrence (type III). The cut-off time between early and late recurrence was chosen to be 12 months following hepatectomy. Results: Among the 134 patients with only intrahepatic recurrence, 94 were type I, 27 were type II and 13 were type III. The median survival time following the recurrence of types I, II and III were 55, 16 and 8 months, respectively. As determined by multivariate analysis, perioperative transfusion and indocyanine green retention at 15 minutes (ICG R 15 >10%) were the independent risk factors for type I; an ICG R 15>10%, microvessel invasion and intrahepatic metastasis were the independent risk factors for type II; an ICG R 15>10% and microscopic portal vein invasion were the independent risk factors for type III. Multivariate analysis revealed that the prognosis of patients with IHR was associated with the recurrent types, the time to recurrence and the serum albumin level at the initial presentation. Following multivariate analysis, an ICG R 15>10% and intrahepatic metastasis were the independent risk factors for early type I recurrence; perioperative transfusion and a higher grade of hepatitis activity were the independent risk factors for late type I recurrence. Conclusions: The recurrent types and the time to recurrence may help us to predict the cellular origin of intrahepatic recurrent HCC and the prognosis of the patients who suffer with intrahepatic recurrent HCC.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Family Medicine (가정의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Dermatology (피부과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
강창무(Kang, Chang Moo) ORCID logo https://orcid.org/0000-0002-5382-4658
김강미(Kim, Gangmi)
김도영(Kim, Do Young) ORCID logo https://orcid.org/0000-0002-0194-9854
김동현(Kim, Dong Hyun)
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
전재윤(Chon, Chae Yoon)
최기홍(Choi, Gi Hong) ORCID logo https://orcid.org/0000-0002-1593-3773
최진섭(Choi, Jin Sub)
한광협(Han, Kwang-Hyub) ORCID logo https://orcid.org/0000-0003-3960-6539
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/22282913/165984
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