1.Alpha-fetoprotein is correlated with intrahepatic recurrence of hepatocellular carcinoma after a hepatectomy
Hyunyou KIM ; So Jeong LEE ; Myunghee YOON
Annals of Surgical Treatment and Research 2020;98(4):168-176
Purpose:
Intrahepatic recurrence has a significant effect on the survival of hepatocellular carcinoma (HCC) patients. We aimed to determine if there are useful indicators in predicting the recurrence of liver cancer after a hepatic resection.
Methods:
We retrospectively reviewed medical records of 210 HCC patients who underwent hepatectomy between January 2009 and December 2015. We examined clinic-pathological variables comparing 2 groups of HCC patients, either intrahepatic recurrence or not.
Results:
We divided 184 patients into 2 groups; 94 patients (51.1%) with intrahepatic recurrence and 90 patients (48.9%) without intrahepatic recurrence. Multivariate analysis showed operation type, preoperative α-FP, postoperative protein induced by vitamin K absence-II (PIVKA-II) elevation, and multiple tumor number were closely associated with intrahepatic recurrence. The preoperative PIVKA-II level was not statistically significant in postoperative intrahepatic recurrence rate. The recurrence rate was 46.2% in 132 of 184 cases of α-FP < 100 ng/mL group. Of the 184 cases, α-FP 100–200 ng/mL were 14 cases (12 cases recurred (85.7%)). Alpha-fetoprotein > 200 ng/mL was 38 of 184 cases, 21 of which recurred (55.3%). According to the multivariate analysis, OR ratio was 8.003 (95% confidence interval [CI], 1.549–41.353) in the α-FP 100–200 ng/mL group and 1.867 (95% CI, 0.784–4.444) in α-FP 200 ng/mL or higher group (P = 0.013). Three-year survival rate of intrahepatic recurrence patients was 80.7%, 3-year survival rate of no intrahepatic recurrence patients was 95.0%.
Conclusion
The intrahepatic recurrence rates were high in the group preop α-FP over 100 ng/mL. Close observation is needed. Prospective study for α-FP genes of HCC patients should be planned for predicting intrahepatic recurrence after hepatectomy.
2.Hepatic resection for isolated stomach cancer liver metastases: A single-center experience
Korean Journal of Clinical Oncology 2019;15(2):68-71
PURPOSE: The objective of this study was to investigate the outcomes of selected patients with stomach cancer liver metastasis (SCLM) without extrahepatic metastases after hepatic resection.METHODS: Patients whose imaging results did not detect extrahepatic disease were selected for hepatic resection. If R0 resection was possible and if the operative risk was low in the preoperative tests, the patients underwent hepatic resection.RESULTS: Between 2011 and 2016, seven patients underwent hepatic resection for SCLM. All patients received hepatic resection to achieve an R0 resection. Minor liver resection was performed in all patients. Two patients showed long-term survival with a single lesion and human epidermal growth factor receptor 2 (HER2)-negative tumor. The 5-year overall survival and disease-free survival rates after hepatic resection were 38.1% and 28.6%, respectively.CONCLUSION: Hepatic resection for isolated SCLM may be considered as a multimodality treatment. However, it has only limited benefits in select patients. It has long-term survival benefit in patients with single metastases and HER2-negative hormonal status.
Disease-Free Survival
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Humans
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Liver
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Neoplasm Metastasis
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Receptor, Epidermal Growth Factor
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Stomach Neoplasms
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Stomach