원발성 간암환자에서 절제술후 간내재발에 미치는 요인분석

Abstract

Background/Aims: The prognosis of hepatocellular carcinoma is very grave. The most effective method of improving survival in patients with hepatocellular carcinoma is early diagno. ' and curative hepatic resection. Recently, diagnosis of HCC at early stage has been greatly enhanced by the advent of screening techniques. However long-term survival after curative resection remains low because of high recurrence rate. To identify factors affecting intrahepatic recurrence and to analyze patterns of intrahepatic recurrence, we evaluated 72 patients who underwent curative hepatic resection. Methods: Total 72 patients were evaluated and 33 recurred cases were divided into the three patterns according to the recurrence pattern. Pattern I;recurrence near the resected margin, and pattern II;nodular recurrence, and pattern III;widespread multinodular recurrence. Results: We found 33 cases of intrahepatic recurrence. The serum AFP level of recurred group was significantly higher than that of non-recurred group, and tumor size was larger in recurred group. No difference was noted in age, sex, serum albumin, bilirubin and HBsAg between two groups. The recurrence time of pattern I was earlier than other patterns, and cirrhosis combining rate was higher in pattern 11. The portal vein and bile duct invasion rate was higher in pattern I and III than pattern Il. The survival rate of recurred group was lower than that of non-recurred group, and survival of pattern I was lower than other groups. Conclusions: It is suggested that careful follow-up is needed when tumor size is larger than 10 cm, portal vein and bile duct is infiltrated by tumor cel), and AFP is higher than 400 ng/ml.