title: Long-term outcomes after curative resection for patients with macroscopically solitary hepatocellular carcinoma without macrovascular invasion and an analysis of prognostic factors.
abstract: The long-term outcome and prognostic factors after curative in patients with single hepatocellular carcinoma (HCC) without macrovascular invasion are still unclear. The objective of this study is to evaluate the effect of curative resection on survival and analyze the prognostic clinicopathologic factors, especially the presence of microvascular invasion (MVI), in these patients. Two hundred and sixty consecutive patients with single HCC without macrovascular invasion who underwent curative resection from December 2004 to December 2007 were retrospectively reviewed in this study. Survival rates were calculated by using the Kaplan-Meier method. Univariate and multivariate analyses of 14 clinicopathologic factors were performed to determine the significant prognostic factors. No patient died within 1 month after the operation. The 1-, 3-, and 5-year overall survival rates after curative resection were 96.54, 83.46, and 74.01%, respectively. Multivariate analysis revealed that only the presence of MVI was an independent negative prognostic factor affecting overall survival. The 1-, 3-, and 5-year disease-free survival rates were 79.62, 62.69, and 56.01%, respectively. The presence of MVI was the only independent unfavorable prognostic factor for disease-free survival. According to our analysis, patients with single HCC without macrovascular invasion after curative resection can be expected to have considerable long-term survival. The presence of MVI was an independent negative prognostic factor for both overall survival and disease-free survival. To improve the prognosis, these patients should be followed up more carefully and might be good candidates for adjuvant therapy.
authors: Department of Hepatobiliary Oncology, Cancer Center, Sun Yat-sen University, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.
authors: Shu-Hong
authors: SH
authors: Li
authors: Wei
authors: W
authors: Wei
authors: Rong-Ping
authors: RP
authors: Guo
authors: Ming
authors: M
authors: Shi
authors: Zhi-Xing
authors: ZX
authors: Guo
authors: Zhi-Yuan
authors: ZY
authors: Chen
authors: Cheng-Zuo
authors: CZ
authors: Xiao
authors: Mu-Yan
authors: MY
authors: Cai
authors: Lie
authors: L
authors: Zheng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D008297:Male; D055806:Microvessels / Q000473:pathology; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
references: Cancer. 2004 Aug 15;101(4):796-802
references: 15305412
references: Ann Surg Oncol. 2008 May;15(5):1375-82
references: 18324443
references: Ann Surg. 2007 Jan;245(1):36-43
references: 17197963
references: Ann Surg Oncol. 2009 Jul;16(7):1832-42
references: 19365625
references: J Am Coll Surg. 2006 Feb;202(2):275-83
references: 16427553
references: Am J Surg. 2012 Jun;203(6):741-50
references: 22177551
references: N Engl J Med. 1999 Mar 11;340(10):745-50
references: 10072408
references: World J Surg. 1993 Nov-Dec;17(6):786-90; discussion 791
references: 8109119
references: J Surg Oncol. 2013 Mar;107(4):408-13
references: 22903402
references: Ann Surg Oncol. 2006 Jul;13(7):940-6
references: 16788755
references: Ann Surg. 2001 Jul;234(1):63-70
references: 11420484
references: World J Surg. 2004 Apr;28(4):376-81
references: 15022021
references: Ann Surg Oncol. 2005 May;12(5):364-73
references: 15915370
references: J Hepatol. 2007 Nov;47(5):684-90
references: 17854945
references: Ann Surg. 2011 Dec;254(6):984-91
references: 21606837
references: Br J Surg. 2011 Sep;98(9):1292-300
references: 21656513
references: Ann Surg. 2000 Apr;231(4):544-51
references: 10749616
references: J Surg Oncol. 2011 Feb;103(2):148-51
references: 21259248
references: Eur J Surg Oncol. 2011 Jun;37(6):521-5
references: 21531111
references: Semin Liver Dis. 1999;19(3):271-85
references: 10518307
references: J Hepatobiliary Pancreat Sci. 2010 May;17(3):291-5
references: 19787285
references: J Am Coll Surg. 2012 Aug;215(2):244-54
references: 22634119
references: J Clin Oncol. 2002 Mar 15;20(6):1527-36
references: 11896101
references: Ann Surg Oncol. 2012 Feb;19(2):426-34
references: 21732145
references: J Surg Oncol. 2007 Mar 1;95(3):235-40
references: 17323337
references: World J Surg. 2010 Oct;34(10):2434-41
references: 20523993
references: Ann Surg Oncol. 2010 Aug;17(8):2073-80
references: 20131013
references: World J Surg. 2007 Apr;31(4):795-801
references: 17345125
references: Ann Surg. 2009 Jan;249(1):118-23
references: 19106686
references: Cancer. 2000 Aug 1;89(3):500-7
references: 10931448