Risk Factors of Peritoneal Recurrence and Outcome of Resected Peritoneal Recurrence After Liver Resection in Hepatocellular Carcinoma: Review of 1222 Cases of Hepatectomy in a Tertiary Institution.
Summary of "Risk Factors of Peritoneal Recurrence and Outcome of Resected Peritoneal Recurrence After Liver Resection in Hepatocellular Carcinoma: Review of 1222 Cases of Hepatectomy in a Tertiary Institution."
BACKGROUND:
Reports on the risk factors of peritoneal recurrence (PR) after liver resection for hepatocellular carcinoma are lacking. We examined the risk factors of PR after hepatectomy and the outcome of resected PR at our institution.
METHODS:
We retrospectively reviewed the data from 1,222 patients who underwent hepatectomies for hepatocellular carcinoma in Samsung Medical Center from January 2006 to August 2010. We identified patients with PR and studied the risk factors and outcomes of resected PR.
RESULTS:
The rate of PR was 3.0% (n = 36). The mean ± SD age of patients was 54.0 ± 10.2 years. Among those with PR, 23 patients (63.9%) had unresectable disease and 13 patients (36.1%) had resectable disease. Multivariate analysis found that tumor size >50 mm, presence of microvascular invasion, bile duct invasion, and positive margins were significant risk factors of PR after liver resection. The median overall survival (OS) for resectable PR was 33.0 (28.0-61.6) months compared to 14.0 (6.8-21.2) months for unresectable PR (P = 0.009). Cox regression analysis demonstrated that resected PR [hazard ratio (HR) 0.042, P = 0.001] and interval between hepatectomy and PR (>6months) (HR 0.195, P = 0.016) were positive prognostic factors for OS, while alfa-fetoprotein >200 ng/dl at detection of PR (HR 11.321, P = 0.015) and serosal involvement of primary hepatocellular carcinoma (HR 25.616, P = 0.007) were negative prognostic factors for OS.
CONCLUSIONS:
We found that tumor size >50 mm, presence of microvascular invasion, bile duct invasion, and positive resection margins were significant risk factors of PR after liver resection. Selected patients with resected PR had significantly better OS.
Affiliation
Department of HPB Surgery and Liver Transplantation, University Surgical Cluster, National University Health System, Singapore, Singapore.
Journal Details
This article was published in the following journal.
Name: Annals of surgical oncology
ISSN: 1534-4681
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22402812
- DOI: http://dx.doi.org/10.1245/s10434-012-2260-3
Medical and Biotech [MESH] Definitions
Peritoneal Dialysis, Continuous Ambulatory
Portable peritoneal dialysis using the continuous (24 hours a day, 7 days a week) presence of peritoneal dialysis solution in the peritoneal cavity except for periods of drainage and instillation of fresh solution.
Peritoneal Fibrosis
Disorder characterized by a wide range of structural changes in PERITONEUM, resulting from fibrogenic or inflammatory processes. Peritoneal fibrosis is a common complication in patients receiving PERITONEAL DIALYSIS and contributes to its gradual decrease in efficiency.
Peritoneal Stomata
Natural openings in the subdiaphragmatic lymphatic plexus in the PERITONEUM, delimited by adjacent mesothelial cells. Peritoneal stomata constitute the principal pathways for the drainage of intraperitoneal contents from the PERITONEAL CAVITY to the LYMPHATIC SYSTEM.
Peritoneal Lavage
Washing out of the peritoneal cavity. The procedure is a diagnostic as well as a therapeutic technique following abdominal trauma or inflammation.
Neoplasm Recurrence, Local
The local recurrence of a neoplasm following treatment. It arises from microscopic cells of the original neoplasm that have escaped therapeutic intervention and later become clinically visible at the original site.
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