Predictors of Extrahepatic Recurrence After Curative Hepatectomy for Hepatocellular Carcinoma

Taketomi, Akinobu; Toshima, Takeo; Kitagawa, Dai; Mizutani, Takashi; Takeishi, Kazuki; Mano, Yohei; Kuwabara, Hiroto; Sugimachi, Keizō; Aishima, Shinichi; Yamashita, Yo‐ichi; Ikegami, Toru; Gion, Tomonobu; Uchiyama, Hideaki; Soejima, Yuji; Maeda, Takashi; Shirabe, Ken; Maehara, Yoshihiko

doi:10.1245/s10434-010-1076-2

Cited by 65 publications

(68 citation statements)

References 25 publications

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“…Surgical resection is regarded as a potentially curative treatment for patients with HCC and it has become a safe operation with very low morbidity and mortality rates because of the improvement in surgical techniques and perioperative managements . However, the long term survival remains unsatisfactory as results of high postoperative recurrence rate which was reported ranged from 65% to 80% in 5-year after primary surgery (Poon et al, 2002;Imamura et al, 2003;Kamiyama et al, 2009), and most of the postoperative recurrences occur in liver remnant (Poon et al, 1999;Taketomi et al, 2010). Intrahepatic recurrence of HCC after surgical resection could originate from either intrahepatic metastasis (IM) from the primary tumor or multicentric occurrence (MO) RESEARCH ARTICLE…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Early and Late Intrahepatic Recurrence in Patients with Single Hepatocellular Carcinoma Without Macrovascular Invasion after Curative Resection

Li¹,

Guo²,

Xiao³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Section: Introductionmentioning

confidence: 99%

Risk Factors for Early and Late Intrahepatic Recurrence in Patients with Single Hepatocellular Carcinoma Without Macrovascular Invasion after Curative Resection

Li¹,

Guo²,

Xiao³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…(3)(4)(5) LT can overcome the problems of intrahepatic metastasis and multicentric recurrence theoretically. However, the recurrence of HCC after LT is a critical problem to be solved because the outcomes of patients with HCC recurrence after LT are extremely poor.…”

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confidence: 99%

“…(2) Among various recurrent patterns of HCC, the prognosis of extrahepatic recurrence-metastasis (M) is much poorer than that of intrahepatic metastasis and multicentric recurrence. (3)(4)(5) LT can overcome the problems of intrahepatic metastasis and multicentric recurrence theoretically. However, the recurrence of HCC after LT is a critical problem to be solved because the outcomes of patients with HCC recurrence after LT are extremely poor.…”

mentioning

confidence: 99%

Relevance of microRNA‐18a and microRNA‐199a‐5p to hepatocellular carcinoma recurrence after living donor liver transplantation

et al. 2016

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There are few reports about recurrence-related microRNAs (miRNAs) after liver transplantation (LT) for hepatocellular carcinoma (HCC). The purpose of this study was to identify novel recurrence-related miRNAs after living donor liver transplantation (LDLT) for HCC. First, we performed microarray analyses of samples from a liver with primary HCC, a liver that was noncancerous, and a liver that had recurrence-metastasis from 3 patients with posttransplant recurrence. Then we selected miRNAs with consistently altered expression in both primary HCC and recurrence as potential candidates of recurrence-related miRNAs. Expression of the miRNAs in HCC and noncancerous livers was assessed in 70 HCC patients who underwent LDLT. The target genes regulated by the recurrence-related miRNAs were identified. MicroRNA-18a (miR-18a) expression was increased, and microRNA-199a-5p (miR-199a-5p) expression was decreased in both primary HCC and recurrence. Increased miR-18a expression correlated with high levels of tumor markers, large tumor size, and a high recurrence rate. Decreased miR-199a-5p expression correlated with high levels of tumor markers, portal venous invasion, and a high recurrence rate. In HCC cells, miR-18a regulated the expression of tumor necrosis factor alpha-induced protein 3 (TNFAIP3), and miR-199a-5p regulated the expression of hypoxia-inducible factor 1 alpha (HIF1A), vascular endothelial growth factor A (VEGFA), insulin-like growth factor 1 receptor, and insulin-like growth factor 2. In conclusion, increased miR-18a levels and decreased miR-199a-5p levels are relevant to HCC recurrence after LDLT. MiR-18a and miR-199a-5p could be novel therapeutic targets of recurrent HCC after LDLT.Liver Transplantation 22 665-676 2016 AASLD.Received August 31, 2015; accepted December 9, 2015.Hepatocellular carcinoma (HCC) is the most frequent cancer of the liver and the third most common cause of cancer deaths worldwide.(1) Curative treatment is limited to hepatic resection and liver transplantation (LT). However, the overall cumulative recurrence rate after hepatic resection is approximately 80% at 5 years.(2) Among various recurrent patterns of HCC, the prognosis of extrahepatic recurrence-metastasis (M) is much poorer than that of intrahepatic metastasis and multicentric recurrence. (3)(4)(5) LT can overcome the problems of intrahepatic metastasis and multicentric recurrence theoretically. However, the recurrence of HCC after LT is a critical problem to be solved because the outcomes of patients with HCC recurrence after LT are extremely poor. (6) Abbreviations: AFP, alpha-fetoprotein; DCP, des-gamma-carboxyprothrombin; DDLT, deceased donor liver transplantation; HBsAg, hepatitis B surface antigen; HCC, hepatocellular carcinoma; HCV, hepatitis C virus; HIF1A, hypoxia-inducible factor 1 alpha; IGF1R, insulin-like growth factor 1 receptor; IGF2, insulin-like growth factor 2; LDLT, living donor liver transplantation; LT, liver transplantation; M, recurrence-metastasis; miR-18a, microRNA-18a; miR-199a-5p, microRNA-199a-5p;...

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“…Although a hepatectomy, such as the one performed in our patient, is considered curative, the long-term outcome remains less than ideal 13 . The cumulative 5-year recurrence rate after curative hepatectomy was 80% in one study, with the recurrences more frequently being intrahepatic than extrahepatic 13 .…”

Section: Discussionmentioning

confidence: 88%

Extrahepatic Metastasis of Hepatocellular Carcinoma Arising from a Hepatic Adenoma without Concurrent Intrahepatic Recurrence

et al. 2017

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Hepatocellular carcinoma (hcc) arising from a hepatic adenoma is a rare phenomenon accounting for fewer than 5% of hcc cases; it seldom recurs after resection of the primary tumour. We report a case of extrahepatic metastasis of hcc arising from a hepatic adenoma that presented as a solitary sternal metastasis without any evidence of intrahepatic recurrence.Our patient was initially treated with radiation therapy and bland embolization, without response. Subsequently, the patient developed progressive disease while taking sorafenib. He later received chemotherapy with docetaxel and gemcitabine, with the development of multiple pulmonary and splenic nodules. However, he remained free of intrahepatic recurrence. To the best of our knowledge, this is the first case of extrahepatic metastasis of hcc arising from a hepatic adenoma without evidence of intrahepatic recurrence.

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Predictors of Extrahepatic Recurrence After Curative Hepatectomy for Hepatocellular Carcinoma

Cited by 65 publications

References 25 publications

Risk Factors for Early and Late Intrahepatic Recurrence in Patients with Single Hepatocellular Carcinoma Without Macrovascular Invasion after Curative Resection

Risk Factors for Early and Late Intrahepatic Recurrence in Patients with Single Hepatocellular Carcinoma Without Macrovascular Invasion after Curative Resection

Relevance of microRNA‐18a and microRNA‐199a‐5p to hepatocellular carcinoma recurrence after living donor liver transplantation

Extrahepatic Metastasis of Hepatocellular Carcinoma Arising from a Hepatic Adenoma without Concurrent Intrahepatic Recurrence

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