title: Risk factors for the Long-Term Efficacy, Recurrence, and Metastasis in Small Hepatocellular Carcinomas.
abstract: We tried to determine the risk factors for the long-term efficacy, recurrence, and metastasis of small hepatocellular carcinoma (HCC, diameter <5 cm). One hundred sixty-eight small liver cancer patients received percutaneous cryoablation therapy by argon-helium superconducting surgery system under the ultrasound guidance. Clinical parameter and the efficacy were analyzed after follow-up. After cryoablation treatment, the median follow-up time for the 168 patients was 36 (7-41) months. Liver functions were impaired as indicated by increased alanine aminotransferase, total bilirubin, total protein, albumin, and prothrombin activity. The difference of VEGF expression in liver cancer and the surrounding tissue is significant. 1-, 2-, and 3-year overall survival were 92.9, 83.9, and 65.5 %, respectively. Relapse-free survival was 76.8, 53.0, and 41.1 %. Less tumor number, higher tumor differentiation, and low VEGF expression predict higher metastasis-free and relapse-free survival rate. Lower Child-Pugh classification is correlated with the higher overall survival after cryoablation. There was no statistical significance in in situ intrahepatic recurrence patients, but VEGF changes were statistically significant for metastasis in other parts of liver or extrahepatic metastasis. Tumor number, differentiation, VEGF expression, large vessel invasion, lymph node, and extrahepatic metastasis all affect the overall and relapse-free survival. VEGF expression can be a predictable factor for liver cancer recurrence and metastasis.
authors: Department of Oncology Surgery, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, 471003, Henan, China.
authors: Ye
authors: Y
authors: Chen
authors: Department of Oncology Surgery, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, 471003, Henan, China.
authors: She-Gan
authors: SG
authors: Gao
authors: Department of Oncology Surgery, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, 471003, Henan, China.
authors: Jian-Min
authors: JM
authors: Chen
authors: Department of Oncology Surgery, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, 471003, Henan, China.
authors: Gong-Ping
authors: GP
authors: Wang
authors: Department of Oncology Surgery, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, 471003, Henan, China.
authors: Zeng-Fang
authors: ZF
authors: Wang
authors: Department of Oncology Surgery, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, 471003, Henan, China.
authors: Bo
authors: B
authors: Zhou
authors: Department of Oncology Surgery, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, 471003, Henan, China.
authors: Can-Hui
authors: CH
authors: Jin
authors: Department of Oncology Surgery, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, 471003, Henan, China.
authors: Yan-Tong
authors: YT
authors: Yang
authors: Department of Oncology Surgery, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, 471003, Henan, China. xiao_shanf88@163.com.
authors: Xiao-Shan
authors: XS
authors: Feng
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood / Q000378:metabolism; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D003452:Cryosurgery; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000453:epidemiology*; D009367:Neoplasm Staging; D012307:Risk Factors; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D042461:Vascular Endothelial Growth Factor A
keywords: Cryosurgical technique; Liver cancer; Prognostic factors; Tumor metastasis; Tumor recurrence; Vascular endothelial growth factor