Factors Affecting Local and Intra Hepatic Distant Recurrence After Surgery for Hcc: An Alternative Perspective on Microvascular Invasion and Satellitosis - A Western European Multicentre Study.

Autor: Famularo S; Department of Surgery, School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy. simone.famularo@gmail.com., Piardi T; Department of General and Digestive Surgery, Hôpital Robert Debré, Centre Hospitalier Universitaire de Reims, Université de Reims Champagne-Ardenne, Reims, France., Molfino S; Department of Clinical and Experimental Sciences, Surgical Clinic, University of Brescia, Brescia, Italy., Di Martino M; Department of Surgery, HPB Unit, La Princesa University Hospital, Madrid, Spain., Ferrari C; HPB Surgical Unit, San Paolo Hospital, Savona, Italy., Ielpo B; HPB unit, León University Hospital, Leon, Spain., Diago MV; HPB unit, León University Hospital, Leon, Spain., Giani A; Department of Surgery, School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy., Griseri G; HPB Surgical Unit, San Paolo Hospital, Savona, Italy., Terés LB; Department of Surgery, HPB Unit, La Princesa University Hospital, Madrid, Spain., Gianotti L; Department of Surgery, School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy., Baiocchi GL; Department of Clinical and Experimental Sciences, Surgical Clinic, University of Brescia, Brescia, Italy., Sommacale D; Department of General and Digestive Surgery, Hôpital Robert Debré, Centre Hospitalier Universitaire de Reims, Université de Reims Champagne-Ardenne, Reims, France., Romano F; Department of Surgery, School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy.
Jazyk: angličtina
Zdroj: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract [J Gastrointest Surg] 2021 Jan; Vol. 25 (1), pp. 104-111. Date of Electronic Publication: 2020 Jan 21.
DOI: 10.1007/s11605-019-04503-7
Abstrakt: Background: Few studies have focused on risk factors which may predict an intrahepatic local recurrence (LR) on the surgical edge rather than a distant recurrence (DR) in other liver segments after surgery for hepatocarcinoma (HCC). The purpose of this study was to assess the risk factors for both patterns of recurrence.
Methods: An international, multicentre, retrospective study was conducted by collecting data on all consecutive patients with a first diagnosis of HCC who were treated between 2010 and 2017. The presence of macrovascular invasion was an exclusion criteria.
Results: About 376 patients were enrolled, and, among them, 62 presented LR, while 90 had DR. Baseline characteristics were comparable between the two groups, but the DR group had a much higher rate of HCV infection (48.9% vs 29%, p 0.014) and a higher median nodule size (3.40 cm IQR 2.2-5.5 versus 3.0 cm IQR 2.0-5.0 in the LR group, p 0.025). A positive surgical margin (R1, HR 4.721; 95% CI 1.83-12.17; p 0.001) was the only independent risk factor for LR, while MVI (HR 1.837; 95% CI 1.03-3.77; p 0.039) and satellitosis (HR 2.440, 95% CI 1.43-3.77, p 0.001) were the only predictive factors for DR.
Conclusion: MVI and satellitosis are predictive factors of intrahepatic distant recurrence, configuring a probable hallmark of advanced systemic disease, regardless of the treatment. LR has to be considered the expression of surgical failure.
Databáze: MEDLINE
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