Different risk factors and prognosis for early and late intrahepatic recurrence after resection of hepatocellular carcinoma

Poon, Ronnie Tung‐Ping; Fan, Sheung‐Tat; Ng, Irene Oi–Lin; Lo, C. P.; Liu, Chi‐Leung; Wong, John

doi:10.1002/1097-0142(20000801)89:3<500::aid-cncr4>3.3.co;2-f

Cited by 161 publications

(248 citation statements)

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“…As a result, high Snail expression was revealed as an independent risk factor for early recurrence (o1 year). Several reports showed that vp was associated with early recurrence (Fong et al, 1999;Shimada et al, 1999;Poon et al, 2000a). However, in the present study, vp did not correlate with early recurrence.…”

Section: Discussioncontrasting

confidence: 77%

“…Several reports have indicated that early recurrence (o1 year) after hepatic resection arose mainly from im and resulted in a significantly worse prognosis than late recurrence (41 year). Conversely, late recurrence was reported to occur most likely due to MO (Jwo et al, 1992;Poon et al, 2000a;Imamura et al, 2003). Therefore, it is suggested that tumour recurrence in the high Snail expression group is associated with im, which possibly spread through the portal vein invaded by the primary tumour.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, it is suggested that tumour recurrence in the high Snail expression group is associated with im, which possibly spread through the portal vein invaded by the primary tumour. To identify risk factors affecting early tumour recurrence (o1 year), we performed multivariate analysis as well as univariate analysis with clinicopathologic parameters that were reported to be associated with the tumour recurrence (Chen et al, Snail is a key molecule in the progression of HCC A Miyoshi et al 1994;Fong et al, 1999;Poon et al, 2000a). As a result, high Snail expression was revealed as an independent risk factor for early recurrence (o1 year).…”

Section: Discussionmentioning

confidence: 99%

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Snail accelerates cancer invasion by upregulating MMP expression and is associated with poor prognosis of hepatocellular carcinoma

et al. 2005

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We have previously demonstrated in an in vitro study that Snail increased the invasion activity of hepatoma cells by upregulating matrix metalloproteinase (MMP) gene expression. In the present study, we examined whether Snail gene expression correlates with cancer invasion and prognosis of patients with hepatocellular carcinoma (HCC). Quantitative reverse transcription -polymerase chain reaction (RT -PCR) was performed to evaluate Snail, E-cadherin, and MMP mRNA expressions in eight nodule-in-nodule tumours and 47 ordinary HCC tissues. In the nodule-in-nodule tumours, Snail expression significantly increased with tumour dedifferentiation (P ¼ 0.047). In the ordinary HCC tissues, Snail expression was significantly correlated with portal vein invasion (P ¼ 0.035) and intrahepatic metastasis (P ¼ 0.050); it also showed a significant correlation with MT1-MMP expression (r ¼ 0.572, Po0.001). In recurrence-free survival, the group with high Snail expression showed significantly poorer prognosis (P ¼ 0.035). Moreover, high Snail expression was an independent risk factor for early recurrence after curative resection. During the progression of HCC, Snail expression may be induced and accelerate invasion activity by upregulating MMP expression, resulting in portal invasion, intrahepatic metastasis, and poor prognosis. British Journal of Cancer (2005) Hepatocellular carcinoma (HCC) is one of the most prevalent malignancies in the world and a frequent cause of cancer fatalities in Japan. Improvements in early diagnosis, surgical techniques, and perioperative management have contributed to decreases in mortality and morbidity among patients with HCC (Okuda et al, 1985;Fran et al, 1999). However, the long-term prognosis of patients with HCC after hepatectomy has been still poor because of a high incidence of recurrence after initial treatment (Fong et al, 1999;Poon et al, 2000b). Several centres have reported a cumulative 5-year recurrence rate ranging from 75 to 100% (Chen et al, 1994;Fong et al, 1999;Poon et al, 2000b). Pathological and genetic analyses have indicated two features in HCC recurrence: multicentric occurrence of new tumours (MO) and intrahepatic metastasis of the original tumour (im) (Tsuda et al, 1992;Matsumoto et al, 2001). It has been reported that MO is significantly influenced by the underlying liver status, such as the presence of active hepatitis (Belghiti et al, 1991;Ko et al, 1996). On the other hand, im is thought to be more closely associated with tumour factors, especially portal vein invasion (vp) (Vauthey et al, 1995;Shimada et al, 1999). Several published studies have demonstrated that vp plays an important role in the im process and influences the survival rate of patients with HCC (Fuster et al, 1996;Mitsunobu et al, 1996; The Liver Cancer Study Group of Japan, 1994). Therefore, it is important to elucidate the molecular mechanisms of vp and im; the subsequent establishment of markers for predicting vp and im may contribute to improvement in the prognosis of patients with HCC.Recently, the z...

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Section: Discussioncontrasting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Snail accelerates cancer invasion by upregulating MMP expression and is associated with poor prognosis of hepatocellular carcinoma

et al. 2005

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“…Recurrence is particularly frequent with HCV-related HCC, and a substantial proportion of recurrence, especially in late phase, is thought to represent de novo, or multicentric, hepatocarcinogenesis [396][397][398]. Therefore, it could be reasonably assumed that antiviral therapy would reduce the overall incidence of recurrence by preventing de novo carcinogenesis.…”

Section: Tertiary Prevention Of Hcv-related Hccmentioning

confidence: 99%

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

et al. 2010

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Introduction The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party on the management of hepatocellular carcinoma (HCC) in December 2008 to develop consensus recommendations. Methods The working party consisted of expert hepatologist, hepatobiliary surgeon, radiologist, and oncologist from Asian-Pacific region, who were requested to make drafts prior to the consensus meeting held at Bali, Indonesia on 4 December 2008. The quality of existing evidence and strength of recommendations were ranked from 1 (highest) to 5 (lowest) and from A (strongest) to D (weakest), respectively, according to the Oxford system of evidence-based approach for developing the consensus statements. 123Hepatol Int (2010) 4: 439-474 DOI 10.1007/s12072-010-9165-7 Results Participants of the consensus meeting assessed the quality of cited studies and assigned grades to the recommendation statements. Finalized recommendations were presented at the fourth APASL single topic conference on viral-related HCC at Bali, Indonesia and approved by the participants of the conference.

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“…Statistically significant differences in risk factors for metastases at different time intervals after definitive treatment have been demonstrated in other cancers, such as gastric and hepatocellular carcinomas. 8,9 Shiraishi et al 8 have demonstrated that, compared with patients who had a late recurrence, patients who had an early recurrence of gastric carcinoma had a significantly increased likelihood of having a larger tumor size at presentation, lymphatic invasion, extensive lymph node metastasis, and more advanced initial stage of disease. In examining hepatocellular carcinoma, multivariate analysis by Poon et al 9 observed that preoperative ''tumor rupture'' and vascular invasion were significant risk factors for early intrahepatic recurrence, whereas cirrhosis was a significant risk factor for late intrahepatic recurrence.…”

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confidence: 99%

Characteristics associated with early and late melanoma metastases

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Wriston

Troxel

et al. 2009

Cancer

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BACKGROUND: Differences in risk factors for metastases at different time intervals after treatment have been described in several malignancies; however, to the authors' knowledge, no extensive study examining this issue in melanoma has been conducted to date. METHODS: The authors performed a nested case-control study of patients with melanoma who presented with only local disease. Patients in the case group included 549 patients who developed metastases 6 months after surgery. Of these, 320 patients developed metastasis within 3 years after undergoing definitive surgery (early metastases [EM]), and 70 patients developed metastasis 8 years after undergoing definitive surgery (late metastases [LM]). For each case, a control patient was chosen who had melanoma but who did not develop metastases in the same interval. Univariate and conditional multivariate logistic regression were used in the analysis of 34 clinical and tumor characteristics. RESULTS: Multivariate analysis confirmed previously established risk factors for metastases, such as increasing tumor thickness. In addition, the authors discovered that a personal history of nonmelanoma skin cancer (P ¼ .006) and a history of cancer other than skin cancer (P ¼ .020) also were associated with metastasis. In comparing the 320 EM patients with the 70 LM patients, EM patients were more likely to have thicker lesions (P < .001), ulcerated lesions (P ¼ .016), and a history of nonmelanoma skin cancer (P ¼ .024). CONCLUSIONS: In this study, 2 potentially novel risk factors for melanoma metastases were identified, and different profiles of risk factors were constructed for EM versus LM. These differences may be important in future risk identification and stratification for clinical trials and for the management and treatment of patients with melanoma.

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Different risk factors and prognosis for early and late intrahepatic recurrence after resection of hepatocellular carcinoma

Cited by 161 publications

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Snail accelerates cancer invasion by upregulating MMP expression and is associated with poor prognosis of hepatocellular carcinoma

Snail accelerates cancer invasion by upregulating MMP expression and is associated with poor prognosis of hepatocellular carcinoma

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

Characteristics associated with early and late melanoma metastases

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