Prediction of recurrence after HCC resection. Faint oily deposits on preoperative Lipiodol-CT of remnant liver tissue.
In trying to clarify the high recurrence rate after removal of small hepatocellular carcinoma (HCC), we assessed the postoperative evolution of minute hepatic Lipiodol deposits which had been diagnosed as artifacts on the preoperative Lipiodol-CT. Of 27 patients with solitary HCC less than 5 cm in diameter, 14 had such Lipiodol deposits in the preoperative CT and 9 of them (64%) developed recurrent tumors. On the other hand, 6 of the 13 patients without deposits (46%) suffered recurrence, but in 5 of these 6 patients the HCC was metachronous multicentric. The cumulative survival rate of the non-deposit group was better than that of the deposit group (p < 0.1). The present study suggested that, even in patients with small HCC, minute concomitant tumors invisible by conventional imaging techniques may exist at the time of surgery. Some of these lesions without sufficient tumor vasculature showing a hypervascular blush on angiography appear to retain small, vague Lipiodol deposits.
First Department of Surgery, Yamanashi Medical College, Japan.
M
M
Yamamoto
Y
Y
Iimuro
M
M
Mogaki
K
K
Kachi
H
H
Fujii
Y
Y
Matsumoto
D000792:Angiography; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D016461:Chemoembolization, Therapeutic; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic; D000431:Ethanol / Q000627:therapeutic use; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D007269:Injections, Intra-Arterial; D007459:Iodized Oil / Q000008:administration & dosage; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000473:pathology*; D011300:Preoperative Care; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
D000431:Ethanol; D007459:Iodized Oil