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Clinicopathological Characteristics of Hepatocellular Carcinoma with Microscopic Portal Venous Invasion and the Role of Anatomical Liver Resection in These Cases

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Title: Clinicopathological Characteristics of Hepatocellular Carcinoma with Microscopic Portal Venous Invasion and the Role of Anatomical Liver Resection in These Cases
Other Titles: Predictive factors for microscopic portal venous invasion and the place of anatomic liver resection
Authors: Shimada, Shingo Browse this author
Kamiyama, Toshiya Browse this author →KAKEN DB
Yokoo, Hideki Browse this author →KAKEN DB
Orimo, Tatsuya Browse this author
Wakayama, Kenji Browse this author
Einama, Takahiro Browse this author
Kakisaka, Tatsuhiko Browse this author →KAKEN DB
Kamachi, Hirofumi Browse this author →KAKEN DB
Taketomi, Akinobu Browse this author →KAKEN DB
Keywords: hepatocellular carcinoma
microscopic portal venous invasion
anatomic liver resection
Issue Date: Aug-2017
Publisher: Springer
Journal Title: World journal of surgery
Volume: 41
Issue: 8
Start Page: 2087
End Page: 2094
Publisher DOI: 10.1007/s00268-017-3964-0
PMID: 28271260
Abstract: Background: The aims of this study were to investigate predictive factors for microscopic portal venous invasion (mPVI) in hepatocellular carcinoma (HCC) and whether anatomical liver resection (ALR) was useful in such cases. Methods: We analyzed 852 patients with HCC without macroscopic portal venous invasion who were treated at our hospital between January 1990 and May 2014. These patients were stratified into a microscopic portal venous invasion group (mPVI group; n = 153) and non-microscopic portal venous invasion group (NmPVI group; n = 699). Results: PIVKA-II ≥100 mAU/ml, a tumor size ≥5 cm, a confluent lesion, and poor differentiation were found to be independent risk factors for mPVI. Among the mPVI group who had single HCC under 5 cm, serum albumin level <4.0 g/dl, PIVKA-II ≥100 mAU/ml, a positive surgical margin, and non-ALR (NALR) were independent unfavorable prognostic factors for overall survival (OS). PIVKA-II ≥100 mAU/ml, a positive surgical margin and NALR were independent unfavorable prognostic factors for relapse-free survival (RFS). ALR was significantly favorable factor for both OS and RFS of the mPVI group who had single HCC under 5 cm. Conclusions: Even if no portal venous invasion is detectable in HCC patients preoperatively, a PIVKA-II ≥100 mAU/ml, tumor size ≥5 cm, and a confluent lesion indicate a high risk of mPVI. ALR should be considered for the patients with these characteristics because it is a favorable prognostic factor in these cases with mPVI.
Rights: The original publication is available at www.springerlink.com
Type: article (author version)
URI: http://hdl.handle.net/2115/71141
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 島田 慎吾

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