Risk Factors, Clinical Features, and Prognosis of the Hepatocellular Carcinoma with Peritoneal Metastasis

Kwak, Min‐Sun; Lee, Jeong-Hoon; Yoon, Jung‐Hwan; Yu, Su Jong; Cho, Eun Ju; Jang, Eun Sun; Kim, Yoon Jun; Lee, Hyo‐Suk

doi:10.1007/s10620-011-1995-1

Cited by 36 publications

(26 citation statements)

References 24 publications

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“…Meanwhile, the number of BM was found to be prognostic in the RTOG 9508 trial [14], and was incorporated in the original GPA score [15]. Additionally, Child Pugh Score and AFP level are important prognostic factors in HCC [26][27][28][29][30]. Therefore, we utilized these parameters to build a prognostic index specific for HCC, as they seemed to be the most clinically relevant.…”

Section: Discussionmentioning

confidence: 99%

Hepatocellular carcinoma specific graded prognostic assessment can predict outcomes for patients with brain metastases from hepatocellular carcinoma

et al. 2014

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Stratifying patients with brain metastasis (BM) from hepatocellular carcinoma (HCC) by prognostic factors can be useful when making treatment decisions. Nevertheless, a diagnosis-specific graded prognostic assessment (GPA) for HCC has not been well established. We retrospectively reviewed the data from 118 HCC patients newly diagnosed with BM at the Yonsei University Health System between 1985 and 2011. After univariate and multivariate analyses of prognostic factors, those shown to significantly affect survival were used to develop a HCC-specific GPA (HCC-GPA) index. The median overall survival after BM in all patients was 6.1 weeks (95% confidence interval 4.8-7.4 weeks). Using the prognostic factors identified via multivariate analysis, we developed a HCC-GPA index, including number of brain metastases (single: 0.5, multiple: 0 points), alpha-feto protein (<400 ng/mL: 0.5, ≥400 ng/mL: 0 points), and Child-Pugh-Score (A: 3, B: 2, C: 0 points). There were no survival differences for age, sex, performance status, and time interval from initial diagnosis to development of BM. Median survival times from BM were discriminable when applying the HCC-GPA scoring system: 1.7, 3.2, 7.9, and 27.0 weeks for HCC-GPA scores of 0-1.0 (N = 16), 1.5-2.5 (N = 32), 3.0-3.5 (N = 49), and 4.0 (N = 21), respectively (P < 0.001). Although the prognoses of patients with BM from HCC are dismal, the newly developed HCC-GPA index can be used to discriminate the expected prognoses thereof. Moreover, the index may hold value as a tool for selecting patients who may be good candidates for active local treatment.

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Section: Discussionmentioning

confidence: 99%

Hepatocellular carcinoma specific graded prognostic assessment can predict outcomes for patients with brain metastases from hepatocellular carcinoma

et al. 2014

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“…Yeh and Chen observed that the rate of a spontaneous rupture was comparable between patients with peritoneal localization and patients who never recurred (25.5% and 16.4%) [8]. Kwak and colleagues, comparing the patients with peritoneal localization to a randomly matched control group, noted the same rate of needle tract injury (30.9% and 26.5%) while HCC rupture (19.1% and 4.4%) was confirmed as an independent risk factor (P = 0.008) [5]. These studies stated that a peritoneal recurrence does not necessarily appear in every patient after a spontaneous rupture of HCC, as in our experience too, but were unable to define the pathogenetic role of the percutaneous procedures.…”

Section: Discussionmentioning

confidence: 90%

“…The main pathogenetic mechanism seems to be related to the preoperative violation of the cancer integrity rather than to an intraoperative dissemination; a needle tract injury or a spontaneous rupture of the tumor was documented in 71.4% of our cases. This hypothesis is easy to demonstrate in the parietal localization with the exact coincidence of the lesion with the trajectory of the needle, while it is not proven that percutaneous procedures or HCC rupture carry a significant increase of the risk of peritoneal localization as well [5]. Yeh and Chen observed that the rate of a spontaneous rupture was comparable between patients with peritoneal localization and patients who never recurred (25.5% and 16.4%) [8].…”

Section: Discussionmentioning

confidence: 99%

Parietal and peritoneal localizations of hepatocellular carcinoma: Is there a place for a curative surgery?

Portolani

Baiocchi

Molfino

et al. 2015

European Journal of Surgical Oncology (EJSO)

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Background: The clinical course of peritoneal and parietal recurrence of hepatocellular carcinoma (HCC-PPL) is not well known. Methods: Twenty-eight patients with a histologically proven HCC-PPL were analyzed out of a series of 515 patients operated for HCC (group 1). The risk factors, histological features, growing dynamic and results of surgical treatment were analyzed and compared with patients having other extrahepatic localizations of HCC (group 2; 26 patients). Survival data were also compared with patients with intrahepatic-only recurrence (group 3; 211 patients).

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“…Since peritoneal metastasis is not a prognostic factor, with no influence on the survival time, active treatment may be meaningless. However, its treatment is generally considered to reduce the risk of complications, i.e., ileus and hydronephrosis, and improve patients' quality of life (QOL) [15]. Thus, it may be treated when liver function is relatively favorable and the intrahepatic lesion is controllable to some extent.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical resection has mainly been reported, and chemotherapy, TACE, PEIT, and RFA have occasionally been reported [15,16]. However, to our knowledge, there have been no reports of cases treated with B-TACE.…”

Section: Discussionmentioning

confidence: 99%

Balloon-Occluded Transarterial Chemoembolization for Peritoneal Metastasis of Hepatocellular Carcinoma

Shiozawa¹,

Watanabe²,

Ikehara³

2015

J Hepatol Gastroint Dis

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We report unusual 2 cases treated with Balloon-occluded transarterial chemoembolization (B-TACE) for peritoneal hepatocellular carcinoma (HCC) metastasis. An 87-year-old female with hepatitis-C related cirrhosis underwent radiofrequency ablation (RFA) repeatedly. Computed tomography showed a 30 mm diameter tumor seeding adjacent to the ascending colon. Digital subtraction angiography (DSA) of the gastroduodenal artery showed a tumor stain fed by an omental arterial branch distributing from the greater curvature of the stomach. Since ultra-selective cannulation was difficult, a micro-balloon catheter was selected and advanced to the right gastroepiploic artery on the central side of the omental artery, and B-TACE was performed at this point. A 78-yearold male with hepatitis-C related cirrhosis underwent RFA and TACE repeatedly, but multiple HCC developed and a 45 mm diameter metastatic tumor adjacent to the descending colon was observed. DSA of the inferior mesenteric artery showed a tumor stain fed by the several peripheral branches of the left colic artery. Since one of this several branches was noted the normal mesenteric blood vessel by selective angiography, the position of the tip of the micro-balloon catheter was finely adjusted by balloon inflation to prevent inflow of the contrast medium into the normal blood vessel, and then B-TACE was performed.

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Risk Factors, Clinical Features, and Prognosis of the Hepatocellular Carcinoma with Peritoneal Metastasis

Cited by 36 publications

References 24 publications

Hepatocellular carcinoma specific graded prognostic assessment can predict outcomes for patients with brain metastases from hepatocellular carcinoma

Hepatocellular carcinoma specific graded prognostic assessment can predict outcomes for patients with brain metastases from hepatocellular carcinoma

Parietal and peritoneal localizations of hepatocellular carcinoma: Is there a place for a curative surgery?

Balloon-Occluded Transarterial Chemoembolization for Peritoneal Metastasis of Hepatocellular Carcinoma

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