Infiltrative Hepatocellular Carcinoma: Assessment of Factors Associated With Outcomes in Patients Undergoing Hepatectomy. Issue 19 (May 2016)

• Record Type: Journal Article
• Authors: Yan, Xiaopeng; Fu, Xu; Deng, Min; Chen, Jun; He, Jian; Shi, Jiong; Qiu, Yudong
• Editors: Amornyotin., Somchai
• Is Part Of: Medicine. Volume 95:Issue 19(2016)
• Page Start: e3589
• Publication Date: 2016-05
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000003589
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Abstract: Data on infiltrative hepatocellular carcinoma (iHCC) receiving hepatectomy are unclear. Our study assessed the outcomes, effects of anatomical resection, and prognostic factors in a cohort of Chinese patients with iHCC undergoing hepatectomy. Data from 47 patients with iHCC undergoing hepatectomy were analyzed in a retrospective study. Independent prognostic factors of overall survival (OS) and recurrence-free survival (RFS) were identified using univariate and multivariate analyses. Correlations between microvascular invasion (MVI) and clinicopathological features were assessed using the χ 2 test, Student t test, or the Mann–Whitney U test. Survival outcomes were estimated using the Kaplan-Meier method. The median OS was 27.37 months and the 1-year RFS rate were 61.7%. Alpha-fetoprotein (AFP) level was not a specific parameter in iHCC patients undergoing hepatectomy. Anatomic resection was significantly associated with increased RFS ( P = 0.007). Patients showing MVI were observed with decreased RFS ( P < 0.001). A high lactate dehydrogenase (LDH) level was significantly associated with decreased OS and RFS ( P = 0.003 and P = 0.020, respectively). MVI was shown correlated with the levels of aspartate aminotransferase (AST), gamma glutamyl transpeptidase (GGT), and LDH. Subgroup analysis indicated that in mild MVI group, survival outcome was significantly more favorable in patients with high LDH level ( P = 0.019). iHCC patients are related with higher MVI rate and patients may still derive survival benefit from anatomic resection at early and intermediate stages. MVI classification could be used to identify iHCC patients with a poorer survival, especially those with a high preoperative LDH level.