title: Distant metastatic recurrence after hepatic resection for hepatocellular carcinoma.
abstract: To identify clinicopathologic features of distant metastatic recurrence (DMR) after hepatic resection for hepatocellular carcinoma, we investigated 352 recurrent patients. Of them, 261 with only intrahepatic recurrence were compared with 91 with DMR. Between two groups, there was significantly difference with respect to preoperative liver function, positive tests for protein induced by vitamin K absence or antagonist-II (PIVKA-II), major resection, tumor-free interval, tumor diameter, extrahepatic progression of the tumor, single nodular configuration, and portal vein invasion. Survival rates at 1 and 5 years after intrahepatic recurrence were 73% and 17%, while these were 57% and 18% when recurrences were DMR (p = .0362). DMR was frequent when a resected tumor was large, extrahepatic, ill defined or multinodular or associated with portal vein invasion, good preoperative liver function, or PIVKA-II positivity. Such patients should receive particularly careful follow-up during the first 2 years after hepatic resection focusing on early detection of DMR.
authors.affiliation: Department of Gastrointestinal & Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan. shutou@med.osaka-cu.ac.jp
authors.forename: Taichi
authors.initials: T
authors.lastname: Shuto
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hirohashi
authors.forename: Shoji
authors.initials: S
authors.lastname: Kubo
authors.forename: Hiromu
authors.initials: H
authors.lastname: Tanaka
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Takemura
authors.forename: Takahiro
authors.initials: T
authors.lastname: Uenishi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kinoshita
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D015996:Survival Rate