The guiding value of microvascular invasion for treating early recurrent small hepatocellular carcinoma,International Journal of Hyperthermia

当前位置： X-MOL 学术 › Int. J. Hyperth. › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

The guiding value of microvascular invasion for treating early recurrent small hepatocellular carcinoma
International Journal of Hyperthermia ( IF 3.0 ) Pub Date : 2021-06-13 , DOI: 10.1080/02656736.2021.1937715
Xuqi Sun _{1,

2,

3} , Ziliang Yang _{1,

2} , Jie Mei _{1,

2} , Ning Lyu _{1,

4} , Jinfa Lai _{1,

4} , Minshan Chen _{1,

2} , Ming Zhao _{1,

4}

Affiliation

Abstract

Introduction

Hepatocellular carcinoma (HCC) patients with microvascular invasion (MVI) have worse survival. Whether the presence of MVI indicates the necessity of more aggressive locoregional treatments for recurrences remains to be elucidated.

Methods

We reviewed patients who underwent curative hepatectomy for primary HCC in our institution, and 379 patients with recurrent HCC up to three nodules smaller than 3 cm were enrolled. The Kaplan–Meier method was adopted to compare the secondary recurrence-free survival (sRFS) and post-recurrence survival (PRS) among patients undergoing hepatectomy, RFA and transarterial chemoembolization plus RFA (TACE-RFA). Cox regression analyses were performed to identify independent prognostic factors.

Results

Both the sRFS and PRS of the MVI (−) group were significantly longer than those of the MVI (+) group (p = 0.001 and 0.011). For patients with MVI (−), no significant difference was found in sRFS or PRS among recurrent HCC patients receiving hepatectomy, RFA or TACE-RFA (p = 0.149 and 0.821). A similar trend was found in patients with MVI (+) (p = 0.851 and 0.960). Further analysis found that TACE-RFA provided better sRFS than hepatectomy or RFA alone in patients with MVI (+) and early recurrence within two years (p = 0.036 and 0.044).

Conclusion

For HCC patients with MVI (+) and early small recurrence, TACE-RFA could achieve better prognosis than hepatectomy or RFA alone, while RFA alone provided comparable survival benefits compared with hepatectomy or TACE-RFA in other HCC patients with small recurrence.

中文翻译：

微血管浸润治疗早期复发性小肝细胞癌的指导价值

摘要

介绍

伴有微血管侵犯 (MVI) 的肝细胞癌 (HCC) 患者的生存期较差。MVI 的存在是否表明需要对复发进行更积极的局部治疗仍有待阐明。

方法

我们回顾了我们机构中因原发性 HCC 接受根治性肝切除术的患者，并纳入了 379 名复发性 HCC 患者多达三个小于 3 cm 的结节。采用 Kaplan-Meier 方法比较接受肝切除术、RFA 和经动脉化疗栓塞加 RFA（TACE-RFA）的患者的二次无复发生存率（sRFS）和复发后生存率（PRS）。进行Cox回归分析以确定独立的预后因素。

结果

MVI（-）组的sRFS和PRS均显着长于MVI（+）组（p = 0.001和0.011）。对于 MVI (-) 患者，在接受肝切除术、RFA 或 TACE-RFA 的复发性 HCC 患者中，sRFS 或 PRS 没有显着差异（p = 0.149 和 0.821）。在 MVI (+) 患者中发现了类似的趋势（p = 0.851 和 0.960）。进一步分析发现，对于 MVI（+）和两年内早期复发的患者，TACE-RFA 比单独肝切除术或 RFA 提供更好的 sRFS（p = 0.036 和 0.044）。