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Actual 10-Year Survivors After Resection of Hepatocellular Carcinoma.

Publication ,  Journal Article
Zheng, J; Kuk, D; Gönen, M; Balachandran, VP; Kingham, TP; Allen, PJ; D'Angelica, MI; Jarnagin, WR; DeMatteo, RP
Published in: Ann Surg Oncol
May 2017

BACKGROUND: Resection of hepatocellular carcinoma (HCC) offers a chance of cure, but recurrence is common and survival is often limited. The clinical and pathological characteristics of long-term survivors have not been well studied. METHODS: We retrospectively reviewed 212 patients who underwent partial hepatectomy for HCC with curative intent from 1992 to 2006. Fifty patients who survived beyond 10 years were compared with 109 patients who died of recurrence within 10 years. RESULTS: Multivariate analysis showed that tumors <5 cm (odds ratio [OR] 2.3, p = 0.04), solitary tumors (OR 3.2, p = 0.01), and absence of vascular invasion (OR 2.3, p = 0.04) were independently associated with actual 10-year survival. However, more than 20% of long-term survivors also possessed established poor prognostic factors, including α-fetoprotein >1000 ng/mL, unfavorable serum inflammatory indices, tumor size >10 cm, microvascular invasion, poor tumor differentiation, cirrhosis, and metabolic syndrome. None of the 10-year survivors had an R1 resection. While 77% of the short-term survivors developed recurrence within 2 years, 42% of the 10-year survivors developed recurrence during their decade of follow-up, although most of the recurrences among 10-year survivors were intrahepatic and amenable to further treatment. Among patients who survived beyond 10 years, 42% remained alive without recurrence. CONCLUSIONS: In this largest Western series of actual 10-year survivors after HCC resection, almost one in four patients survived over a decade, even though nearly half of this subset had developed recurrence. While many well-known variables were associated with a poor outcome, only a positive microscopic margin precluded long-term survival.

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Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

May 2017

Volume

24

Issue

5

Start / End Page

1358 / 1366

Location

United States

Related Subject Headings

  • alpha-Fetoproteins
  • Tumor Burden
  • Survivors
  • Survival Rate
  • Retrospective Studies
  • Respiratory Tract Neoplasms
  • Oncology & Carcinogenesis
  • Neoplasm Recurrence, Local
  • Neoplasm Invasiveness
  • Neoplasm Grading
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Zheng, J., Kuk, D., Gönen, M., Balachandran, V. P., Kingham, T. P., Allen, P. J., … DeMatteo, R. P. (2017). Actual 10-Year Survivors After Resection of Hepatocellular Carcinoma. Ann Surg Oncol, 24(5), 1358–1366. https://doi.org/10.1245/s10434-016-5713-2
Zheng, Jian, Deborah Kuk, Mithat Gönen, Vinod P. Balachandran, T Peter Kingham, Peter J. Allen, Michael I. D’Angelica, William R. Jarnagin, and Ronald P. DeMatteo. “Actual 10-Year Survivors After Resection of Hepatocellular Carcinoma.Ann Surg Oncol 24, no. 5 (May 2017): 1358–66. https://doi.org/10.1245/s10434-016-5713-2.
Zheng J, Kuk D, Gönen M, Balachandran VP, Kingham TP, Allen PJ, et al. Actual 10-Year Survivors After Resection of Hepatocellular Carcinoma. Ann Surg Oncol. 2017 May;24(5):1358–66.
Zheng, Jian, et al. “Actual 10-Year Survivors After Resection of Hepatocellular Carcinoma.Ann Surg Oncol, vol. 24, no. 5, May 2017, pp. 1358–66. Pubmed, doi:10.1245/s10434-016-5713-2.
Zheng J, Kuk D, Gönen M, Balachandran VP, Kingham TP, Allen PJ, D’Angelica MI, Jarnagin WR, DeMatteo RP. Actual 10-Year Survivors After Resection of Hepatocellular Carcinoma. Ann Surg Oncol. 2017 May;24(5):1358–1366.
Journal cover image

Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

May 2017

Volume

24

Issue

5

Start / End Page

1358 / 1366

Location

United States

Related Subject Headings

  • alpha-Fetoproteins
  • Tumor Burden
  • Survivors
  • Survival Rate
  • Retrospective Studies
  • Respiratory Tract Neoplasms
  • Oncology & Carcinogenesis
  • Neoplasm Recurrence, Local
  • Neoplasm Invasiveness
  • Neoplasm Grading