Patterns,treatments, and prognosis of tumor recurrence after resection for hepatocellular carcinoma with microvascular invasion: a multicenter study from China |
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| Institution: | 1. Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China;2. Department of General Surgery, Zhejiang Provincial Armed Police Corps Hospital, Hangzhou, Zhejiang, China;3. Department of Hepatopancreatobiliary Surgical Oncology, Military Institution of Hepatopancreatobiliary Surgery, The First Medical Center of Chinese People''s Liberation Army (PLA) General Hospital, Beijing, China;4. Department of Hepatobiliary Surgery, Affiliated Tumour Hospital of Guangxi Medical University, Nanning, Guangxi, China;5. Department of Hepatobiliary Surgery, Affiliated Hospital of Binzhou Medical College, Binzhou, Shandong, China;6. Department of General Surgery, Wenzhou People''s Hospital, Wenzhou, Zhejiang, China;7. Department of Hepatobiliary Surgery, LongYan First Hospital, Affiliated to Fujian Medical University, Longyan, Fujian, China;8. Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, SAR, China;1. Department of Radiology, Section of Interventional Oncology - Microinvasive Therapy (SIP), Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria;2. Department of Radiology, The Royal Marsden Hospital, 203 Fulham Road, Chelsea, London, SW3 6JJ, UK;3. Department of Anesthesia, Medical University of Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria;4. Department of Internal Medicine V, Medical University of Innsbruck, Anichstr. 35, 6020 Innsbruck Austria;5. Department of General, Visceral and Vascular Surgery, Salzkammergut Klinikum, D.Wilhelm Bock Strasse 1, 4840, Vöcklabruck Austria;6. Department of Visceral, Transplant and Thoracic Surgery, Center of Operative Medicine, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria;1. Department of General, Visceral, and Transplantation Surgery, University Hospital of RWTH Aachen, Aachen, Germany;2. Department of Surgery, Maastricht University Medical Center (MUMC), Maastricht, the Netherlands;3. Institute of Pathology, University Hospital RWTH Aachen, Aachen, Germany;4. NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands;5. Department of Internal Medicine, Division of Medical Oncology, GROW – School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands;6. Department of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands;1. Department of Surgery, Mayo Clinic, Rochester, MN, USA;2. Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA;3. Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA;4. Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA;1. Mount Sinai Medical Center NY, RMTI, Transplantation, NY, NY, USA;2. Division of Gastroenterology and Hepatology, Beth Israel, Deaconess Medical Center, Harvard Medical School, Boston, MA, USA;1. Department of Radiology, Vestre Viken Hospital Trust, Drammen, Norway;2. Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway;3. Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway;4. Institute of Clinical Medicine, University of Oslo, Norway;5. Department of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital, Oslo, Norway;1. Department of Radiology and Nuclear Medicine, University of Magdeburg, Leipziger Str. 44, 39112 Magdeburg, Germany;2. Department of Surgery, University Hospital Magdeburg, Germany;3. Profile Area Clinical Studies & Biostatistics, Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 8, 06097, Halle, Germany |
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| Abstract: | BackgroundMicrovascular invasion (MVI) is a risk factor of post-hepatectomy tumor recurrence for hepatocellular carcinoma (HCC). The patterns, treatments, and prognosis have not been documented in HCC patients with MVI.MethodsA multicenter database of patients with HCC and MVI following resection was analyzed. The clinicopathological and initial operative data, timing and first sites of recurrence, recurrence management, and long-term survival outcomes were analyzed.ResultsOf 1517 patients included, the median follow-up was 39.7 months. Tumor recurrence occurred in 928 patients, with 49% within 6 months of hepatectomy and 60% only in the liver. The incidence of intrahepatic only recurrence gradually increased with time after 6 months. Patients who developed recurrence within 6 months of hepatectomy had worse survival outcomes than those who developed recurrence later. Patients who developed intrahepatic only recurrence had better prognosis than those with either extrahepatic only recurrence or those with intra- and extrahepatic recurrence. Repeat resection of recurrence with curative intent resulted in better outcomes than other treatment modalities.ConclusionPost-hepatectomy tumor recurrence in patients with HCC and MVI had unique characteristics and recurrence patterns. Early detection of tumor recurrence and repeat liver resection with curative intent resulted in improved long-term survival outcomes. |
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