This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (52)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Oncology  • Oncology, Other  • Surgery  • Surgical Interventions  • Surgical Oncology  • Hepatobiliary Surgery  • Gastroenterology  • Liver/ Biliary Tract/ Pancreatic Diseases  • Alert me on articles by topic  Social Bookmarking   What's this?

Analysis by Disease-Free Survival Curves

Masato Sakon, MD; Koji Umeshita, MD; Hiroaki Nagano, MD; Hidetoshi Eguchi, MD; Shinichi Kishimoto, MD; Atsushi Miyamoto, MD; Satoshi Ohshima, MD; Keizo Dono, MD; Shozo Nakamori, MD; Mitsukazu Gotoh, MD; Morito Monden, MD

Arch Surg. 2000;135:1456-1459.

Hypothesis  The clinical significance of hepatectomy for hepatocellular carcinoma (HCC) is still controversial because of frequent intrahepatic recurrence, which results from either recurrence due to residual intrahepatic metastasis (Rim) or recurrence due to metachronous, multicentric liver carcinogenesis (Rmc).

Design  Retrospective review. Disease-free survival curves were obtained by the Kaplan-Meier method and the rates of Rim and Rmc were analyzed using 2 regression lines, based on the evidence that Rmc occurs at a constant rate throughout follow-up, whereas Rim occurs only in the early postoperative period.

Setting  University hospital.

Patients  From 1980 to 1996, 241 patients with HCC who underwent curative hepatic resection.

Main Outcome Measure  Intrahepatic recurrence.

Results  Disease-free survival curves for all patients in the early (within 2 years) and late (4 years after surgery) follow-up were approximated by 2 regression lines, which represent both Rim and Rmc (Y₁ = -3.4X + 48) and only Rmc (Y₂ = -23.1X + 98). Using this approximation, the annual incidence of Rim within 2 years (a₁-a₂) was calculated as 19.7% and that of Rmc (a₂) was 3.4%. The ratio of Rim in tumor recurrence (b₁-b₂) was 50%, and that of Rmc (b₁) was 48%. The ratios of Rmc in patients with stages I and II HCC were 60% and 64%, respectively. In contrast, the values could not be calculated in patients with stages III and IVA because all but 2 patients showed recurrence within 4 years after surgery.

Conclusion  Tumor recurrence is estimated to result from metachronous liver carcinogenesis in 48% of hepatectomized patients with HCC.

From the Department of Surgery and Clinical Oncology, Graduate School of Medicine, Osaka University, Osaka, Japan.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Visceral fat accumulation is an independent risk factor for hepatocellular carcinoma recurrence after curative treatment in patients with suspected NASH
Ohki et al.
Gut 2009;58:839-844.
ABSTRACT | FULL TEXT  

Molecular Prediction of Response to 5-Fluorouracil and Interferon-{alpha} Combination Chemotherapy in Advanced Hepatocellular Carcinoma
Kurokawa et al.
Clin. Cancer Res. 2004;10:6029-6038.
ABSTRACT | FULL TEXT  

Intrahepatic Recurrences of Hepatocellular Carcinoma After Hepatectomy: Analysis Based on Tumor Hemodynamics
Sakon et al.
Arch Surg 2002;137:94-99.
ABSTRACT | FULL TEXT