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A survival benefit of major hepatectomy for hepatocellular carcinoma identified by preoperative [18F] fluorodeoxyglucose positron emission tomography in patients with well-preserved hepatic function

Authors
 S.G. Ahn  ;  T.J. Jeon  ;  S.D. Lee  ;  S.H. Kim  ;  H.J. Cho  ;  M. Yun  ;  Y.N. Park  ;  J.D. Lee  ;  S.J. Park  ;  K.S. Kim 
Citation
 European Journal of Surgical Oncology, Vol.39(9) : 964-973, 2013 
Journal Title
 European Journal of Surgical Oncology 
ISSN
 0748-7983 
Issue Date
2013
MeSH
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular/diagnosis ; Carcinoma, Hepatocellular/mortality ; Carcinoma, Hepatocellular/surgery* ; Cohort Studies ; Disease-Free Survival ; Female ; Fluorodeoxyglucose F18 ; Hepatectomy/methods* ; Humans ; Liver/physiology* ; Liver/surgery ; Liver Neoplasms/diagnosis ; Liver Neoplasms/mortality ; Liver Neoplasms/surgery* ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasms, Multiple Primary/diagnosis ; Neoplasms, Multiple Primary/mortality ; Neoplasms, Multiple Primary/surgery* ; Positron-Emission Tomography ; Radiopharmaceuticals ; Retrospective Studies ; Treatment Outcome
Keywords
FDG-PET ; Hepatocellular carcinoma ; Major hepatectomy ; Prognostic factor
Abstract
AIMS: Hepatic resection can cure hepatocellular carcinoma (HCC). However, the optimal extent of resection remains controversial. Major hepatectomy could minimize a tumor recurrence, but it is harmful due to decreased hepatic functional reserve. [18F] fluorodeoxyglucose positron emission tomography (FDG-PET) scans are known as their reflection tumor differentiation and biological activity in HCC. To evaluate a benefit of major hepatectomy for HCC, we performed this retrospective analysis in patients with well-preserved hepatic function, and further analyzed in the subset identified by preoperative FDG-PET. METHODS: We reviewed the medical records of 189 patients with HCC who underwent curative resection between August 2004 and December 2010 at two institutes. All patients underwent anatomical resection, either by major or minor hepatectomy. RESULTS: Median overall survival did not differ significantly between the major and minor hepatectomy groups (29.4 versus 26.3 months, p = 0.269). However, the major hepatectomy group had a better recurrence-free survival (24.5 versus 19.9 months, p = 0.004). On multivariate analysis, the presence of intrahepatic metastasis independently predicted overall survival (p = 0.009), but other examined variables did not. Overall survival and recurrence-free survival were significantly better following major hepatectomy rather than minor hepatectomy in patients whose preoperative FDG-PET indicated that the maximum standardized uptake value of the tumor (SUVtumor) was ≥4 and the tumor-to-nontumor SUV ratio (TNR) was ≥1.5. CONCLUSIONS: Our findings suggest that preoperative FDG-PET may be useful in identifying patients with favorable hepatic reserve who are most likely to benefit from major rather than minor hepatectomy.
Full Text
http://www.sciencedirect.com/science/article/pii/S0748798313004290
DOI
10.1016/j.ejso.2013.06.019
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 Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pharmacology (약리학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Park, Young Nyun(박영년) ORCID logo https://orcid.org/0000-0003-0357-7967
Ahn, Sung Gwe(안성귀) ORCID logo https://orcid.org/0000-0002-8778-9686
Yun, Mi Jin(윤미진) ORCID logo https://orcid.org/0000-0002-1712-163X
Lee, Jong Doo(이종두)
Jeon, Tae Joo(전태주) ORCID logo https://orcid.org/0000-0002-7574-6734
Cho, Hojin(조호진) ORCID logo https://orcid.org/0000-0002-8686-172X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/88184
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