Kaibori Masaki, Ishizaki Morihiko, Saito Takamichi, Matsui Kosuke, Kwon A-Hon, Kamiyama Yasuo
Department of Surgery, Hirakata Hospital, Kansai Medical University, Hirakata, Osaka, Japan.
Am J Surg. 2009 Jul;198(1):39-45. doi: 10.1016/j.amjsurg.2008.07.051. Epub 2009 Jan 29.
This study aimed to clarify risk factors for early recurrence and examine the subsequent outcome in patients undergoing potentially R0 resection of small hepatocellular carcinomas (HCCs) (<or=2 cm in greatest dimension).
Eighty-nine patients were divided into 2 groups as follows: 26 patients suffering from recurrence within 2 years of surgery (early recurrence group) and 63 patients who were disease-free for at least 2 years (disease-free 2Y group).
Only 7 of 63 patients (11%) from the group that was disease-free for at least 2 years died during the 5-year period after surgery, whereas 13 of 26 patients (50%) from the early recurrence group died. Multivariate analysis showed that the preoperative maximum removal rate of technetium-99m-diethylenetriamine pentaacetic acid-galactosyl human serum albumin and microscopic vascular invasion were independent predictors of the early recurrence of small HCC.
Early recurrence of small HCC is the leading cause of death within 5 years after R0 resection. The preoperative hepatic functional reserve influences early recurrence, even in patients with small tumors.
本研究旨在阐明小肝细胞癌（最大直径≤2 cm）行潜在R0切除术后早期复发的危险因素，并探讨其后续转归。
89例患者分为以下两组：26例术后2年内复发的患者（早期复发组）和63例无病生存至少2年的患者（无病生存2年组）。
无病生存至少2年组的63例患者中仅7例（11%）在术后5年内死亡，而早期复发组的26例患者中有13例（50%）死亡。多因素分析显示，术前99m锝-二乙烯三胺五乙酸-半乳糖基人血清白蛋白最大清除率和微血管侵犯是小肝癌早期复发的独立预测因素。
小肝癌早期复发是R0切除术后5年内死亡的主要原因。即使是小肿瘤患者，术前肝功能储备也会影响早期复发。
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