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Hokkaido University Collection of Scholarly and Academic Papers >
Graduate School of Medicine / Faculty of Medicine >
Peer-reviewed Journal Articles, etc >
Outcomes of reduction hepatectomy combined with postoperative multidisciplinary therapy for advanced hepatocellular carcinoma
| Title: | Outcomes of reduction hepatectomy combined with postoperative multidisciplinary therapy for advanced hepatocellular carcinoma |
| Authors: | Asahi, Yoh Browse this author | | Kamiyama, Toshiya Browse this author | | Kakisaka, Tatsuhiko Browse this author | | Orimo, Tatsuya Browse this author | | Shimada, Shingo Browse this author | | Nagatsu, Akihisa Browse this author | | Aiyama, Takeshi Browse this author | | Sakamoto, Yuzuru Browse this author | | Kamachi, Hirofumi Browse this author | | Taketomi, Akinobu Browse this author →KAKEN DB |
| Keywords: | Hepatocellular carcinoma | | Reduction hepatectomy | | Multidisciplinary therapy | | Tyrosine kinase inhibitors | | Postoperative complete remission |
| Issue Date: | 27-Oct-2021 |
| Publisher: | Baishideng Publishing Group |
| Journal Title: | World journal of gastrointestinal surgery |
| Volume: | 13 |
| Issue: | 10 |
| Start Page: | 1245 |
| End Page: | 1257 |
| Publisher DOI: | 10.4240/wjgs.v13.i10.1245 |
| Abstract: | BACKGROUND</p> The prognosis of advanced hepatocellular carcinoma (HCC) that is not indicated for curative hepatectomy remains poor, despite advances in the treatment of HCC, including the development of tyrosine kinase inhibitors (TKIs). The outcomes of reduction hepatectomy and multidisciplinary postoperative treatment for advanced HCC that is not indicated for curative hepatectomy, including those of recently treated cases, should be investigated.</p> AIM</p> To examine the outcomes of combination treatment with reduction hepatectomy and multidisciplinary postoperative treatment for advanced HCC that is not indicated for curative hepatectomy.</p> METHODS</p> Thirty cases of advanced HCC that were not indicated for curative hepatectomy, in which reduction hepatectomy was performed between 2000 and 2018 at the Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, were divided into postoperative complete remission (POCR) (+) and POCR (-) groups, depending on whether POCR of all evaluable lesions was achieved through postoperative treatment. The cases in the POCR (-) group were subdivided into POCR (-) TKI (+) and POCR (-) TKI (-) groups, depending on whether TKIs were administered postoperatively.</p> RESULTS</p> The 5-year overall survival rate and mean survival time (MST) after reduction hepatectomy were 15.7% and 28.40 mo, respectively, for all cases; 37.5% and 56.55 mo, respectively, in the POCR (+) group; and 6.3% and 14.84 mo, respectively, in the POCR (-) group (P = 0.0041). Tumor size, major vascular invasion, and the number of tumors in the remnant liver after the reduction hepatectomy were also found to be related to survival outcomes. The number of tumors in the remnant liver was the only factor that differed significantly between the POCR (+) and POCR (-) groups, and POCR was achieved significantly more frequently when & LE; 3 tumors remained in the remnant liver (P = 0.0025). The MST was 33.52 mo in the POCR (-) TKI (+) group, which was superior to the MST of 10.74 mo seen in the POCR (-) TKI (-) group (P = 0.0473).</p> CONCLUSION</p> Reduction hepatectomy combined with multidisciplinary postoperative treatment for unresectable advanced HCC that was not indicated for curative hepatectomy was effective when POCR was achieved via multidisciplinary postoperative therapy. To achieve POCR, reduction hepatectomy should aim to ensure that & LE; 3 tumors remain in the remnant liver. Even in cases in which POCR is not achieved, combined treatment with reduction hepatectomy and multidisciplinary therapy can improve survival outcomes when TKIs are administered.</p> |
| Type: | article |
| URI: | http://hdl.handle.net/2115/83655 |
| Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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