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Hepatectomy is Beneficial in Select Patients with Multiple Hepatocellular Carcinomas

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Title: Hepatectomy is Beneficial in Select Patients with Multiple Hepatocellular Carcinomas
Authors: Orimo, Tatsuya Browse this author →KAKEN DB
Kamiyama, Toshiya Browse this author →KAKEN DB
Kakisaka, Tatsuhiko Browse this author →KAKEN DB
Nagatsu, Akihisa Browse this author
Asahi, Yoh Browse this author
Aiyama, Takeshi Browse this author
Kamachi, Hirofumi Browse this author →KAKEN DB
Taketomi, Akinobu Browse this author →KAKEN DB
Issue Date: 1-Dec-2022
Publisher: Springer
Journal Title: Annals of surgical oncology
Volume: 29
Issue: 13
Start Page: 8436
End Page: 8445
Publisher DOI: 10.1245/s10434-022-12495-z
Abstract: Background A single hepatocellular carcinoma (HCC) is a good indication for hepatic resection regardless of tumor size, but the surgical indications for cases with multiple HCCs remain unclear. Methods We retrospectively reviewed the outcomes of hepatectomies for Barcelona Clinic Liver Cancer (BCLC) stage 0, A, and B HCCs. We further subclassified stage A and B into A1 (single nodule <5 cm, or three or fewer nodules <= 3 cm), A2 (single nodule 5-10 cm), A3 (single nodule >= 10 cm), B1 (two to three nodules >3 cm), and B2 (four or more nodules). Results A total of 1088 patients were enrolled, comprising 88 stage 0, 750 stage A (A1: 485; A2: 190; A3: 75), and 250 stage B (B1: 166; B2: 84) cases. The 5-year overall survival (OS) rates for stage 0, A1, A2, A3, B1, and B2 patients were 70.4%, 74.2%, 63.8%, 47.7%, 47.5%, and 31.9%, respectively (p < 0.0001). Significant differences in OS were found between stages A1 and A2 (p = 0.0118), A2 and A3 (p = 0.0013), and B1 and B2 (p = 0.0050), but not between stages A3 and B1 (p = 0.4742). In stage B1 patients, multivariate analysis indicated that Child-Pugh B cirrhosis was the only independent prognostic factor for the OS outcome. Conclusions A hepatectomy should be considered for multiple HCCs if the number of tumors is three or fewer, especially in patients with no cirrhosis or in Child-Pugh A cases, because the long-term results are equivalent to those for a single HCC.
Rights: This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at:
Type: article (author version)
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)

Submitter: 折茂 達也

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