Anatomic Resection Independently Improves Long-Term Survival in Patients with T1–T2 Hepatocellular Carcinoma

Wakai, Toshifumi; Shirai, Yoshio; Sakata, Jun; Kaneko, Kazuhiro; Cruz, Pauldion V.; Akazawa, Kouhei; Hatakeyama, Katsuyoshi

doi:10.1245/s10434-006-9318-z

Cited by 165 publications

(138 citation statements)

References 37 publications

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“…The decision to use neoadjuvant chemotherapy was made by the Institutional Cancer Committee of Niigata University Medical and Dental Hospital. Indications for neoadjuvant chemotherapy included multiple hepatic tumors or a solitary tumor >3 cm in diameter, because these preoperative factors are closely associated with vascular invasion or poor post-resection survival (15)(16)(17). In the current series, 16 patients received neoadjuvant chemotherapy, which consisted of hepatic arterial infusion of a fine-powder formulation of cisplatin (IA-call ® , Nippon Kayaku, Co., Ltd., Tokyo, Japan; recommended dose of 65 mg/m 2 ) under the guidance of hepatic angiography.…”

Section: Patient Population From March 2007 Through Decembermentioning

confidence: 99%

“…A hepatectomy procedure was selected for each patient, taking the primary tumor status (size, number, location), the hepatic functional reserve, and the patient's general condition into account (16). In the current study, the term 'major hepatectomy' indicated formal hemihepatectomy or more extensive resection, whereas less extensive hemihepatectomy was designated 'minor hepatectomy'.…”

Section: Patient Population From March 2007 Through Decembermentioning

confidence: 99%

“…In the current study, the term 'major hepatectomy' indicated formal hemihepatectomy or more extensive resection, whereas less extensive hemihepatectomy was designated 'minor hepatectomy'. Postoperative morbidity was defined as any postoperative complication that lengthened the hospital stay (16).…”

Section: Patient Population From March 2007 Through Decembermentioning

confidence: 99%

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Multidrug resistance-associated protein 2 determines the efficacy of cisplatin in patients with hepatocellular carcinoma

Korita

Wakai²,

Shirai³

et al. 2010

Oncol Rep

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Abstract.We hypothesized that expression of multidrug resistance-associated protein 2 (MRP2), a major cisplatin transporter, may determine the efficacy of cisplatin as a treatment for patients with hepatocellular carcinoma (HCC). A prospective analysis was conducted of 49 consecutive patients who underwent resection for HCC (16 patients treated with cisplatin-based neoadjuvant chemotherapy and 33 patients treated without neoadjuvant chemotherapy). Expression of MRP2 in resected specimens was assessed by immunohistochemical and Western blot analyses. The extent of tumor necrosis was assessed histologically in the greatest dimension of the tumor specimen from each patient. The median percentage of tumor necrosis was 81% (range: 0-100%) and complete tumor necrosis was found in 3 patients. Overexpression of MRP2 was detected in 24/46 (52%) tumor specimens. In 16 patients treated with cisplatin, tumor size and dose of cisplatin did not correlate with tumor necrosis of the resected specimens (P=0.706 and P=0.555, respectively). Of 13 tumor specimens containing vivid tumor from 16 patients treated with cisplatin, 8 had overexpression of MRP2. Tumor specimens with overexpression of MRP2 showed a lower percentage of tumor necrosis than those with non-overexpression (median percentage of tumor necrosis, 19% vs. 99%, P=0.003). In conclusion, overexpression of MRP2 correlates with a lower percentage of tumor necrosis in patients treated with cisplatin-based neoadjuvant chemotherapy for HCC, whereas either tumor size or dose of cisplatin does not. Expression of MRP2 determines the efficacy of cisplatinbased chemotherapy in patients with HCC.

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Section: Patient Population From March 2007 Through Decembermentioning

confidence: 99%

Section: Patient Population From March 2007 Through Decembermentioning

confidence: 99%

See 1 more Smart Citation

Multidrug resistance-associated protein 2 determines the efficacy of cisplatin in patients with hepatocellular carcinoma

Korita

Wakai²,

Shirai³

et al. 2010

Oncol Rep

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“…Because HCC has a high propensity to invade the intrahepatic vascular structures and spreads mainly via the closest portal veins [9,10], anatomic resection (AR) including systematic removal of the tumor-bearing portal territories was proposed in the 1980s as a theoretically curative surgical procedure for HCC to eradicate potential micrometastases surrounding tumors [11]. Some studies [5,[12][13][14][15] have demonstrated the superiority of AR over non-anatomic resection (NAR) for HCC. However, the optimum liver resection technique in patients with liver dysfunction remains controversial, and there is no clear evidence that AR results in better long-term survival than does NAR [16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Comparison of anatomic and non‐anatomic hepatic resection for hepatocellular carcinoma

Kaibori

Kon

Kitawaki

et al. 2017

J Hepato Biliary Pancreat

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Background The aim of the present study was to compare the prognostic impact of anatomic resection (AR) versus non-anatomic resection (NAR) on patient survival after resection of a single hepatocellular carcinoma (HCC). Methods To control for confounding variable distributions, a 1-to-1 propensity score match was applied to compare the outcomes of AR and NAR. Among 710 patients with a primary, solitary HCC of <5.0 cm in diameter that was resectable by either AR or NAR from 2003 to 2007 in Japan and Korea, 355 patients underwent NAR and 355 underwent AR of at least one section with complete removal of the portal territory containing the tumor. Results Overall survival (OS) was better in the AR than NAR group (hazard ratio 1.67, 95% confidence interval 1.28-2.19, P < 0.001) while disease-free survival showed no significant difference. Significantly fewer patients in the AR than NAR group developed intrahepatic HCC recurrence and multiple intrahepatic recurrences. Patients with poorly differentiated HCC who underwent AR had improved disease-free survival and OS. Conclusions Anatomic resection decreases the risk of tumor recurrence and improves OS in patients with a primary, solitary HCC of <5.0 cm in diameter.

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“…Regarding method of hepatectomy, the EASL recommends anatomical resection and, although some studies17, 18, 19, 20 have reported survival benefits with anatomical resection, others21, 22, 23, 24 have been unable to do so. Non‐anatomical resection (NAR) is an attractive treatment option for patients with cirrhotic livers, so a comparison of NAR and RFA seems appropriate in the context of achieving local control.…”

Section: Introductionmentioning

confidence: 99%

Propensity score‐matched comparison of non‐anatomical resection and radiofrequency ablation for hepatocellular carcinoma in patients with up to three tumours, each measuring up to 3 cm in diameter

et al. 2018

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BackgroundNon‐anatomical liver resection (NAR) and radiofrequency ablation (RFA) are treatment options for early‐stage hepatocellular carcinoma (HCC). The aim was to compare the outcomes of NAR and RFA for HCC in patients with three or fewer tumour nodules, each measuring not more than 3 cm in maximum diameter.MethodsEligible patients undergoing NAR or RFA with curative intent between September 2002 and December 2014 were identified. A propensity score‐matching analysis was performed to reduce bias, and outcomes in these patients were analysed.ResultsFrom a total of 199 patients, 1:1 propensity score matching identified 70 matched pairs. Patients having NAR had a longer hospital stay (median 10 days versus 4 days for those who had RFA; P < 0·001) and a higher morbidity rate (24 versus 10 per cent respectively; P = 0·042). Patients who had NAR had slightly better recurrence‐free survival but this failed to reach statistical significance in univariable analysis (P = 0·064). There was no significant difference in overall survival between the two groups (P = 0·475). RFA was identified as an independent risk factor for recurrence‐free survival (hazard ratio (HR) 1·57; P = 0·041) in multivariable analysis. Local recurrence was significantly more common in patients receiving RFA (23 versus 1 per cent; P < 0·001).ConclusionRFA was an independent risk factor for shorter recurrence‐free survival, with a significantly higher local recurrence rate than NAR. Despite these differences, overall survival was not affected.

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Anatomic Resection Independently Improves Long-Term Survival in Patients with T1–T2 Hepatocellular Carcinoma

Abstract: Anatomic resection independently improves long-term survival in patients with T1-T2 hepatocellular carcinoma, probably because of the clearance of venous tumor thrombi within the resected domain.

Cited by 165 publications

References 37 publications

Multidrug resistance-associated protein 2 determines the efficacy of cisplatin in patients with hepatocellular carcinoma

Multidrug resistance-associated protein 2 determines the efficacy of cisplatin in patients with hepatocellular carcinoma

Comparison of anatomic and non‐anatomic hepatic resection for hepatocellular carcinoma

Propensity score‐matched comparison of non‐anatomical resection and radiofrequency ablation for hepatocellular carcinoma in patients with up to three tumours, each measuring up to 3 cm in diameter

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