Arima Kota, Nitta Hidetoshi, Beppu Toru, Nakagawa Shigeki, Okabe Hirohisa, Imai Katsunori, Chikamoto Akira, Yamashita Yo-Ichi, Yamashita Yasuyuki, Baba Hideo
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Anticancer Res. 2019 Feb;39(2):965-970. doi: 10.21873/anticanres.13200.
Repeated hepatectomy is one of the most curative treatments for recurrent hepatocellular carcinoma (HCC). However, it is not clear whether the remnant liver has the same regenerative ability in repeated hepatectomy. This study assessed the regenerative ability of remnant liver after primary and secondary hepatectomy.
This study retrospectively assessed 118 patients who underwent curative anatomical liver resection for HCC. The liver regeneration rate (LRR) was calculated by SYNAPSE-VINCENT based on dynamic computed tomography before and 1 month after liver resection. To reduce any bias, the patients were matched at a 2:1 ratio by propensity score matching (PSM) method.
Before PSM, the laparoscopic radiofrequency-assisted liver resection (LRR) was higher in secondary hepatectomy than in primary (p=0.027). After PSM, there was no significant difference in LRR between the two groups (p=0.088). Among 10 patients who underwent both primary and secondary hepatectomy, there was no significant difference in LRR at both hepatectomies (p=0.80).
Hepatic regenerative ability after secondary hepatectomy may not be inferior to that after primary hepatectomy.
重复肝切除术是复发性肝细胞癌（HCC）最具治愈性的治疗方法之一。然而，在重复肝切除术中，残余肝脏是否具有相同的再生能力尚不清楚。本研究评估了初次和二次肝切除术后残余肝脏的再生能力。
本研究回顾性评估了118例行HCC根治性解剖性肝切除术的患者。肝再生率（LRR）由SYNAPSE-VINCENT根据肝切除术前和术后1个月的动态计算机断层扫描计算得出。为减少任何偏倚，采用倾向评分匹配（PSM）方法以2:1的比例对患者进行匹配。
在PSM之前，二次肝切除术中腹腔镜射频辅助肝切除（LRR）高于初次肝切除术（p = 0.027）。PSM后，两组之间的LRR无显著差异（p = 0.088）。在10例行初次和二次肝切除术的患者中，两次肝切除术中的LRR无显著差异（p = 0.80）。
二次肝切除术后的肝再生能力可能并不逊于初次肝切除术后。
