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Surgical Resection After Down-Staging of Locally Advanced Hepatocellular Carcinoma by Localized Concurrent Chemoradiotherapy

DC FieldValueLanguage
dc.contributor.author최기홍-
dc.contributor.author최진섭-
dc.contributor.author한광협-
dc.contributor.author김경식-
dc.contributor.author김도영-
dc.contributor.author김범경-
dc.contributor.author김승업-
dc.contributor.author박준용-
dc.contributor.author성진실-
dc.contributor.author안상훈-
dc.contributor.author이형순-
dc.date.accessioned2015-01-06T17:15:50Z-
dc.date.available2015-01-06T17:15:50Z-
dc.date.issued2014-
dc.identifier.issn1068-9265-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/99647-
dc.description.abstractBACKGROUND: This study evaluated the down-staging efficacy and impact on resectability of concurrent chemoradiotherapy (CCRT) followed by hepatic arterial infusion chemotherapy (HAIC) in locally advanced hepatocellular carcinoma, and identified prognostic factors of disease-free survival (DFS) and overall survival (OS) after curative resection. METHODS: DFS and OS were investigated using clinicopathologic variables. Functional residual liver volume (FRLV) was assessed before CCRT and again before surgery in patients with major hepatectomy. Tumor marker response was defined as elevated tumor marker levels at diagnosis but levels below cutoff values before surgery (α-fetoprotein < 20 ng/mL, protein induced by vitamin K absence or antagonist-II < 40 mAU/mL). RESULTS: Of 243 patients who received CCRT followed by HAIC between 2005 and 2011, 41 (16.9 %) underwent curative resection. Tumor down-staging was demonstrated in 32 (78 %) of the resected patients. FRLV significantly increased from 47.5 to 69.9 % before surgery in patients who underwent major hepatectomy. In addition, the OS of the curative resection group was significantly higher than the OS of the CCRT followed by HAIC alone group (49.6 vs. 9.8 % at 5-year survival; p < 0.001). By multivariate analysis, the poor prognostic factors for DFS after curative resection were tumor marker non-response and the presence of a satellite nodule; however, tumor marker non-response was the only independent poor prognostic factor of OS. CONCLUSIONS: CCRT followed by HAIC increased resectability by down-staging tumors and increasing FRLV. Curative resection may provide good long-term survival in tumor marker responders who undergo CCRT followed by HAIC.-
dc.description.statementOfResponsibilityopen-
dc.format.extent3646~3653-
dc.relation.isPartOfANNALS OF SURGICAL ONCOLOGY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAdult-
dc.subject.MESHAged-
dc.subject.MESHAged, 80 and over-
dc.subject.MESHAntineoplastic Combined Chemotherapy Protocols/therapeutic use*-
dc.subject.MESHCarcinoma, Hepatocellular/mortality-
dc.subject.MESHCarcinoma, Hepatocellular/pathology-
dc.subject.MESHCarcinoma, Hepatocellular/therapy*-
dc.subject.MESHChemoradiotherapy*-
dc.subject.MESHCombined Modality Therapy-
dc.subject.MESHFemale-
dc.subject.MESHFollow-Up Studies-
dc.subject.MESHHepatectomy*-
dc.subject.MESHHumans-
dc.subject.MESHInfusions, Intra-Arterial-
dc.subject.MESHLiver Neoplasms/mortality-
dc.subject.MESHLiver Neoplasms/pathology-
dc.subject.MESHLiver Neoplasms/therapy*-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHNeoplasm Staging-
dc.subject.MESHPrognosis-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHSurvival Rate-
dc.titleSurgical Resection After Down-Staging of Locally Advanced Hepatocellular Carcinoma by Localized Concurrent Chemoradiotherapy-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학)-
dc.contributor.googleauthorHyung Soon Lee-
dc.contributor.googleauthorGi Hong Choi-
dc.contributor.googleauthorJin Sub Choi-
dc.contributor.googleauthorKyung Sik Kim-
dc.contributor.googleauthorKwang-Hyub Han-
dc.contributor.googleauthorJinsil Seong-
dc.contributor.googleauthorSang Hoon Ahn-
dc.contributor.googleauthorDo Young Kim-
dc.contributor.googleauthorJun Yong Park-
dc.contributor.googleauthorSeung Up Kim-
dc.contributor.googleauthorBeom Kyung Kim-
dc.identifier.doi10.1245/s10434-014-3652-3-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA04046-
dc.contributor.localIdA04199-
dc.contributor.localIdA04268-
dc.contributor.localIdA00299-
dc.contributor.localIdA00487-
dc.contributor.localIdA00654-
dc.contributor.localIdA01675-
dc.contributor.localIdA01956-
dc.contributor.localIdA02226-
dc.contributor.localIdA03304-
dc.contributor.localIdA00385-
dc.relation.journalcodeJ00179-
dc.identifier.eissn1534-4681-
dc.identifier.pmid24916746-
dc.identifier.urlhttp://link.springer.com/article/10.1245%2Fs10434-014-3652-3-
dc.subject.keywordOverall Survival-
dc.subject.keywordCurative Resection-
dc.subject.keywordPortal Vein Embolization-
dc.subject.keywordBiliary Complication-
dc.subject.keywordPortal Vein Tumor Thrombus-
dc.contributor.alternativeNameChoi, Gi Hong-
dc.contributor.alternativeNameChoi, Jin Sub-
dc.contributor.alternativeNameHan, Kwang Hyup-
dc.contributor.alternativeNameKim, Kyung Sik-
dc.contributor.alternativeNameKim, Do Young-
dc.contributor.alternativeNameKim, Beom Kyung-
dc.contributor.alternativeNameKim, Seung Up-
dc.contributor.alternativeNamePark, Jun Yong-
dc.contributor.alternativeNameSeong, Jin Sil-
dc.contributor.alternativeNameAhn, Sang Hoon-
dc.contributor.alternativeNameLee, Hyung Soon-
dc.contributor.affiliatedAuthorChoi, Gi Hong-
dc.contributor.affiliatedAuthorChoi, Jin Sub-
dc.contributor.affiliatedAuthorHan, Kwang Hyup-
dc.contributor.affiliatedAuthorKim, Kyung Sik-
dc.contributor.affiliatedAuthorKim, Beom Kyung-
dc.contributor.affiliatedAuthorKim, Seung Up-
dc.contributor.affiliatedAuthorPark, Jun Yong-
dc.contributor.affiliatedAuthorSeong, Jin Sil-
dc.contributor.affiliatedAuthorAhn, Sang Hoon-
dc.contributor.affiliatedAuthorLee, Hyung Soon-
dc.contributor.affiliatedAuthorKim, Do Young-
dc.rights.accessRightsfree-
dc.citation.volume21-
dc.citation.number11-
dc.citation.startPage3646-
dc.citation.endPage3653-
dc.identifier.bibliographicCitationANNALS OF SURGICAL ONCOLOGY, Vol.21(11) : 3646-3653, 2014-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers

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