BACKGROUND: Small hepatocellular carcinoma (HCC) affects millions of individuals worldwide. Surveillance of high-risk patients increases the early detection of small HCC. OBJECTIVE: To identify prognostic factors affecting the overall survival (OS) and recurrence-free survival (RFS) of patients with small HCC. METHODS: The present prospective study enrolled 140 Taiwanese patients with stage I or stage II small HCC. Clinical parameters of interest included operation type, tumour size, tumour histology, Child- Pugh class, presence of hepatitis B surface antigen and liver cirrhosis, hepatitis C status, alpha-fetoprotein, total bilirubin and serum albumin levels, and administration of antiviral and salvage therapies. RESULTS: Tumour size correlated significantly with poorer OS in patients with stage I small HCC (P=0.014); however, patients with stage II small HCC experienced a significantly poorer RFS (P=0.033). OS rates did not differ significantly between patients with stage I and stage II small HCC. Tumour margins, tumour histology and cirrhosis did not significantly affect OS or RFS (P>0.05). DISCUSSION: Increasing tumour size has generally been associated with poorer prognoses in cases of HCC. The present study verified the relationship between small HCC tumour size and OS; however, a reduction in OS with increasing tumour size was demonstrated for patients with stage I - but not for stage II - small HCC. CONCLUSION: Patients with stage II small HCC may benefit from aggressive surveillance for tumour recurrence and appropriate salvage treatment. Further studies are needed for additional stratification of stage I patients to identify those at increased risk of death.
BACKGROUND:Small hepatocellular carcinoma (HCC) affects millions of individuals worldwide. Surveillance of high-risk patients increases the early detection of small HCC. OBJECTIVE: To identify prognostic factors affecting the overall survival (OS) and recurrence-free survival (RFS) of patients with small HCC. METHODS: The present prospective study enrolled 140 Taiwanese patients with stage I or stage II small HCC. Clinical parameters of interest included operation type, tumour size, tumour histology, Child- Pugh class, presence of hepatitis B surface antigen and liver cirrhosis, hepatitis C status, alpha-fetoprotein, total bilirubin and serum albumin levels, and administration of antiviral and salvage therapies. RESULTS:Tumour size correlated significantly with poorer OS in patients with stage I small HCC (P=0.014); however, patients with stage II small HCC experienced a significantly poorer RFS (P=0.033). OS rates did not differ significantly between patients with stage I and stage II small HCC. Tumour margins, tumour histology and cirrhosis did not significantly affect OS or RFS (P>0.05). DISCUSSION: Increasing tumour size has generally been associated with poorer prognoses in cases of HCC. The present study verified the relationship between small HCC tumour size and OS; however, a reduction in OS with increasing tumour size was demonstrated for patients with stage I - but not for stage II - small HCC. CONCLUSION:Patients with stage II small HCC may benefit from aggressive surveillance for tumour recurrence and appropriate salvage treatment. Further studies are needed for additional stratification of stage I patients to identify those at increased risk of death.
Authors: Timothy M Pawlik; Keith A Delman; Jean-Nicolas Vauthey; David M Nagorney; Irene Oi-Lin Ng; Iwao Ikai; Yoshio Yamaoka; Jacques Belghiti; Gregory Y Lauwers; Ronnie T Poon; Eddie K Abdalla Journal: Liver Transpl Date: 2005-09 Impact factor: 5.799
Authors: J Fuster; J C García-Valdecasas; L Grande; J Tabet; J Bruix; T Anglada; P Taurá; A M Lacy; X González; R Vilana; C Bru; M Solé; J Visa Journal: Ann Surg Date: 1996-03 Impact factor: 12.969