title: Intrahepatic dissemination of hepatocellular carcinoma after local ablation therapy.
abstract: OBJECTIVE
  We aimed to clarify the histological features of and risk factors for intrahepatic dissemination after local ablation therapy (LAT) for hepatocellular carcinoma (HCC).
  
  
  METHODS
  Between April 1992 and December 2005, 192 HCC patients underwent hepatic resection at our department, among whom were 17 patients who had local recurrences after LAT. Eight of these 17 patients had intrahepatic dissemination. The clinical and histological characteristics of these 8 surgically treated patients with intrahepatic dissemination were investigated.
  
  
  RESULTS
  Histologically, numerous intrahepatic metastases were observed, mainly in the same section as the treated tumor, together with main or sectional portal vein tumor thrombi. Before the ablation therapy, the average tumor diameter was 2.1 cm, and 62.5% of the tumors were adjacent to the main or sectional portal vein. In terms of therapeutic factors, 25% of the patients had a prior needle biopsy and 62.5% had insufficient safety margins.
  
  
  CONCLUSIONS
  LAT for HCCs (even those less than 3 cm in diameter) adjacent less than 5 mm to the main or sectional portal vein possibly promotes intrahepatic dissemination.
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Masuda
authors.forename: Toru
authors.initials: T
authors.lastname: Beppu
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Ishiko
authors.forename: Kei
authors.initials: K
authors.lastname: Horino
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Baba
authors.forename: Takao
authors.initials: T
authors.lastname: Mizumoto
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Hayashi
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Okabe
authors.forename: Hasita
authors.initials: H
authors.lastname: Horlad
authors.forename: Koichi
authors.initials: K
authors.lastname: Doi
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Okabe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takamori
authors.forename: Masahiko
authors.initials: M
authors.lastname: Hirota
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Iyama
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000601:surgery*; D017115:Catheter Ablation; D018450:Disease Progression; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D012307:Risk Factors