Korean J Hepatobiliary Pancreat Surg.  2013 Nov;17(4):157-161. 10.14701/kjhbps.2013.17.4.157.

Role of the 1-month protocol transarterial chemoinfusion in detecting intrahepatic metastasis after resection of large hepatocellular carcinoma greater than 10 cm

• Shin HN
• Hwang S
• Kim KH
• Ahn CS
• Moon DB
• Ha TY
• Song GW
• Lee YJ
• Lee SG

• KMID: 2083340
• DOI: http://doi.org/10.14701/kjhbps.2013.17.4.157

Abstract

BACKGROUNDS/AIMS
Tumor recurrence is very common after hepatic resection of hepatocellular carcinoma (HCC) > or =10 cm. The purpose of this study was to validate the prognostic significance of the preoperative alkaline phosphatase (ALP) level and early intrahepatic metastasis in HCC patients who underwent resection of large HCC.
METHODS
Clinical data of 100 large HCC patients who underwent liver resection were retrospectively reviewed. All of them underwent protocol transarterial chemoinfusion (TACI) at 1 month.
RESULTS
Median tumor diameter was 13.8 cm, and 94% were single lesions. Systematic and non-systematic resections were performed in 91% and 9%, respectively, with R0 resection achieved in 84%. Overall 1-, 3- and 5-year survival rates were 76%, 38.5%, and 30.4%, respectively. Univariate analyses on patient survival revealed that intrahepatic metastasis on 1-month protocol TACI was the only significant risk factor (p=0.002). Mean ALP values according to the intrahepatic metastasis on 1-month protocol TACI were 124.6+/-76.9 IU/L and 145.1+/-92.6 IU/L, which did not show a statistical difference (p=0.23).
CONCLUSIONS
In patients with large HCC, 1-month protocol TACI combined with hepatic resection may contribute to the early detection and timely treatment of potentially preexisting metastatic lesions.

Keyword

Intrahepatic metastasis; Hepatocellular carcinoma; Recurrence; Transarterial chemoinfusion

MeSH Terms

Alkaline Phosphatase
Carcinoma, Hepatocellular*
Humans
Liver
Neoplasm Metastasis*
Recurrence
Retrospective Studies
Risk Factors
Survival Rate
Alkaline Phosphatase

Figure

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  Fig. 1 Patterns of intrahepatic metastasis at 1-month protocol transarterial chemoinfusion. Arrows indicate single (A and B) and multiple lesions (C and D).

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  Fig. 2 Overall patient survival curve of 100 patients who underwent resection of hepatocellular carcinomas larger than 10 cm in diameter.

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  Fig. 3 Comparison of the patient survival curve according to preoperative alpha-fetoprotein (AFP) levels.

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  Fig. 4 Comparison of the patient survival curve according to preoperative alkaline phosphatase (ALP) levels.

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  Fig. 5 Comparison of the patient survival curve according to intrahepatic metastasis detected on 1-month protocol transarterial chemoinfusion.

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