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KMID : 0870420130170040157
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Korean Journal of Hepato-Biliary-Pancreatic Surgery
2013 Volume.17 No. 4 p.157 ~ p.161
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Role of the 1-month protocol transarterial chemoinfusion in detecting intrahepatic metastasis after resection of large hepatocellular carcinoma greater than 10 cm
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Shin Hae-Na
Hwang Shin
Kim Ki-Hun
Ahn Chul-Soo
Moon Deok-Bog
Ha Tae-Yong
Song Gi-Won
Lee Young-Joo
Lee Sung-Gyu
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Abstract
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Backgrounds/Aims: Tumor recurrence is very common after hepatic resection of hepatocellular carcinoma (HCC) ≥10 cm. The purpose of this study was to validate the prognostic significance of the preoperative alkaline phosphatase (ALP) level and early intrahepatic metastasis in HCC patients who underwent resection of large HCC.
Methods: Clinical data of 100 large HCC patients who underwent liver resection were retrospectively reviewed. All of them underwent protocol transarterial chemoinfusion (TACI) at 1 month.
Results: Median tumor diameter was 13.8 cm, and 94% were single lesions. Systematic and non-systematic resections were performed in 91% and 9%, respectively, with R0 re-section achieved in 84%. Overall 1-, 3- and 5-year survival rates were 76%, 38.5%, and 30.4%, respectively. Univariate analyses on patient survival revealed that intrahepatic metastasis on 1-month protocol TACI was the only significant risk factor (p=0.002). Mean ALP values according to the intrahepatic metastasis on 1-month protocol TACI were 124.6±76.9 IU/L and 145.1±92.6 IU/L, which did not show a statistical difference (p=0.23).
Conclusions: In patients with large HCC, 1-month protocol TACI combined with hepatic resection may contribute to the early detection and timely treatment of potentially preexisting metastatic lesions.
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KEYWORD
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Intrahepatic metastasis, Hepatocellular carcinoma, Recurrence, Transarterial chemoinfusion
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