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KMID : 0365720010170000029
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Journal of Pusan Surgical Society
2001 Volume.17 No. 0 p.29 ~ p.38
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Risk Factors of Portal Vein Invasion in Hepatocellular Carcinoma
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Abstract
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Background : The postoperative intrahepatic recurrence of hepatocellular carcinoma(HCC) is high. Among many factors, portal vein invasion is considered to be the most important risk factors leading to recurrence, and it is thought to be the direct evidence of tumor invasiveness. In clinical aspects, it seems to be more practical to determine the factors associated with portal vein invasion.
Method : One hundred and five patients who underwent curative hepatic resection for hepatocelluar carcinomas between 1996 and 2000 at Pusan National University Hospital were included in this study, Portal vein invasion was identified histopathologically. The prognostic factors of hepatocellular carcinoma and the risk factors linked to portal vein invasion were analyzed by both uninvariated and multivariate analyses.
Results : Portal vein invasion was detected in fifteen(14.2%), and the 5 year overall and disease-free survival rates in this group were 37.5% and 6.7%, respectively. The 5-year overall and disease-free survival rates of patients without portal vein invasion were 61.3% and 37.4%, respectively. In multivariate analysis using Cox's proportional hazards model portal vein invasion was proven to be the most important risk factor in both overall and disease-free survival. In a multiple stepwise logistic regression analysis, the size and the number of the tumors were strong independent predictors of portal vein invasion by a hepatocellular carcinoma.
Conclusions : Intrahepatic recurrence and patient survival in cases of hepatocellular carcinomas were closely related to portal vein invasion. Patients with tumor sizes larger than 4 cm or with multiple tumors should be monitored closely for early recurrence.
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