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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2009.12
- 수록면
- 227 - 234 (8page)
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Purpose: Hepatic resection is the standard treatment for hepatocellular carcinoma (HCC). In some patients with multiple HCC, one-block resection is not feasible due to either the tumor location or the underlying liver function. In this study, we attempted to compare the outcomes of multiple - site resection or combined resection and radiofrequency ablation with those of one-block resection in patients with multiple HCC.
Methods: We retrospectively reviewed 507 patients who underwent surgical resection. Among 507 patients who received surgical treatment with potentially curative aim from January 1996 to August 2006 in Yonsei University Health System, 58 patients had a radiologically detected multiple HCC. Patients with multiple HCC were divided into: group A, patients treated with one-block resection (n=40) and group B, patients with multiple-site resection or combined resection and RFA (n=18).
Results: The 1-, 3- and 5-year overall survival rates for patients with single and multiple HCC were 90.2%, 76.2% and 66.7% and 82.7%, 61.4% and 37.9%, respectively (p＜0.001). In group B, 6 patients received multiple-site resection and 12 patients underwent combined resection and RFA. The clinicopathological variables were not significantly different between the two groups except the distribution of multiple tumors. The postoperative complication rates for group A and B were 32.5% and 33.3%, respectively. The 1-, 3- and 5-year disease-free survival rates for group A and B were 53.0%, 27.6% and 24.1% and 18.3%, 24.1% and 18.3%, respectively (p=0.386). The overall survival rates were also not significantly different between the two group (80.0%, 59.6%, and 36.9% for group A and 88.9%, 65.7% and 39.4% for group B, p=0.528). The multivariate analysis revealed that Edmondsons-Steiner grade (III-IV) and Indocyanine green retention rate at 15 minutes (ICG R15) ＞10% were adverse prognostic factors for overall survival.
Conclusion: Active treatments including multiple-site resection and combined resection and RFA showed similar treatment outcomes compared with one-block resection in patients with multiple HCC.
Methods: We retrospectively reviewed 507 patients who underwent surgical resection. Among 507 patients who received surgical treatment with potentially curative aim from January 1996 to August 2006 in Yonsei University Health System, 58 patients had a radiologically detected multiple HCC. Patients with multiple HCC were divided into: group A, patients treated with one-block resection (n=40) and group B, patients with multiple-site resection or combined resection and RFA (n=18).
Results: The 1-, 3- and 5-year overall survival rates for patients with single and multiple HCC were 90.2%, 76.2% and 66.7% and 82.7%, 61.4% and 37.9%, respectively (p＜0.001). In group B, 6 patients received multiple-site resection and 12 patients underwent combined resection and RFA. The clinicopathological variables were not significantly different between the two groups except the distribution of multiple tumors. The postoperative complication rates for group A and B were 32.5% and 33.3%, respectively. The 1-, 3- and 5-year disease-free survival rates for group A and B were 53.0%, 27.6% and 24.1% and 18.3%, 24.1% and 18.3%, respectively (p=0.386). The overall survival rates were also not significantly different between the two group (80.0%, 59.6%, and 36.9% for group A and 88.9%, 65.7% and 39.4% for group B, p=0.528). The multivariate analysis revealed that Edmondsons-Steiner grade (III-IV) and Indocyanine green retention rate at 15 minutes (ICG R15) ＞10% were adverse prognostic factors for overall survival.
Conclusion: Active treatments including multiple-site resection and combined resection and RFA showed similar treatment outcomes compared with one-block resection in patients with multiple HCC.
목차
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방법
결과
고찰
참고문헌
참고문헌 (25)
참고문헌 신청
1. [학술지(정기간행물)] - Fan ST / 1999 / Hepatectomy for hepatocellular carcinoma: toward zero hospital deaths / Ann Surg 229 : 322 ~ 330
2. [학술지(정기간행물)] - Torzilli G / 1999 / No-mortality liver resection for hepatocellular carcinoma in cirrhotic and noncirrhotic patients: is there a way? A prospective analysis of our approach / Arch Surg 134 : 984 ~ 992
3. [학술지(정기간행물)] - Capussotti L / 1994 / Results of major hepatectomy for large primary liver cancer in patients with cirrhosis / Br J Surg 81 : 427 ~ 431
4. [학술지(정기간행물)] - Llovet JM / 1999 / Intention-to-treat analysis of surgical treatment for early hepatocellular carcinoma: resection versus transplantation / Hepatology 30 : 1434 ~ 1440
5. [학술지(정기간행물)] - Yamamoto J / 2001 / Treatment strategy for small hepatocellular carcinoma: comparison of long-term results after percutaneous ethanol injection therapy and surgical resection / Hepatology 34 : 707 ~ 713
2. [학술지(정기간행물)] - Torzilli G / 1999 / No-mortality liver resection for hepatocellular carcinoma in cirrhotic and noncirrhotic patients: is there a way? A prospective analysis of our approach / Arch Surg 134 : 984 ~ 992
3. [학술지(정기간행물)] - Capussotti L / 1994 / Results of major hepatectomy for large primary liver cancer in patients with cirrhosis / Br J Surg 81 : 427 ~ 431
4. [학술지(정기간행물)] - Llovet JM / 1999 / Intention-to-treat analysis of surgical treatment for early hepatocellular carcinoma: resection versus transplantation / Hepatology 30 : 1434 ~ 1440
5. [학술지(정기간행물)] - Yamamoto J / 2001 / Treatment strategy for small hepatocellular carcinoma: comparison of long-term results after percutaneous ethanol injection therapy and surgical resection / Hepatology 34 : 707 ~ 713
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UCI(KEPA) : I410-ECN-0101-2014-514-001253389