Comparison of the surgical outcomes in patients with synchronous versus metachronous multiple hepatocellular carcinoma
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- Midorikawa Yutaka
- Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan.
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- Takayama Tadatoshi
- Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan.
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- Higaki Tokio
- Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan.
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- Aramaki Osamu
- Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan.
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- Teramoto Kenichi
- Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan.
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- Yoshida Nao
- Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan.
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- Mitsuka Yusuke
- Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan.
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- Tsuji Shingo
- Genome Science Division, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan.
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<p>Multiplicity is one of the characteristics of hepatocellular carcinoma (HCC), and patients with multiple HCC (≤ 3 nodules) are recommended as candidates for liver resection. To confirm the validity of resecting multiple HCC, we compared the surgical outcomes in patients with synchronous and metachronous multiple HCC. Patients who underwent resection for multiple HCC (2 or 3 nodules) were classified into the "synchronous multiple HCC" group, while those undergoing resection for solitary HCC and repeated resection for 1 or 2 recurrent nodules within 2 years after initial operation were classified into the "metachronous multiple HCC" group. After one-to-one matching, longer operation time and more bleeding were seen in the synchronous multiple HCC group (n = 98) than those in the metachronous multiple HCC group (n = 98); however, the complication rates were not different between the two groups. The median overall survival times were 4.0 years (95% CI, 3.0-5.9) and 5.9 years (4.0-NA) for the synchronous and metachronous multiple HCC (after second operation) groups, respectively (P = 0.041). The recurrence-free survival times were shorter in the synchronous multiple HCC group than in the metachronous multiple HCC group (median, 1.5 years [95% CI, 0.9-1.8] versus 1.8 years, [1.3-2.2]) (P = 0.039). On multivariate analysis, independent factors for overall survivals in the synchronous multiple HCC group were older age, cirrhosis, larger tumor, and tumor thrombus. Taken together, resection of metachronous multiple HCC still has good therapeutic effect, even better than synchronous multiple HCC, so resection is suggested for metachronous multiple HCC.</p>
収録刊行物
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- BioScience Trends
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BioScience Trends 14 (6), 415-421, 2020-12-31
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