TY - JOUR
T1 - Tumor doubling time predicts recurrence after surgery and describes the histological pattern of hepatocellular carcinoma on cirrhosis
AU - Cucchetti, Alessandro
AU - Vivarelli, Marco
AU - Piscaglia, Fabio
AU - Nardo, Bruno
AU - Montalti, Roberto
AU - Grazi, Gian Luca
AU - Ravaioli, Matteo
AU - La Barba, Giuliano
AU - Cavallari, Antonino
AU - Bolondi, Luigi
AU - Pinna, Antonio Daniele
PY - 2005/8
Y1 - 2005/8
N2 - Background/Aims: Recurrence of hepatocellular carcinoma (HCC) following surgical resection is influenced by parameters detectable on the resection specimen or through a biopsy. The prognostic significance of HCC doubling time (DT) after surgery has never been investigated. Methods: We evaluated 62 patients who underwent curative resection of a single HCC on cirrhosis; tumors were assessed before surgery on two subsequent occasions with the same imaging technique allowing the calculation of DT. The influence of tumor DT, clinical and pathological parameters on recurrence-rate and patients survival was assessed with uni- and multivariate analysis. Relationship between DT and pathological features was also analyzed. Results: Three-year recurrence rate was 32.3% (20 patients): this was significantly higher in the presence of DT shorter than 100 days (58 versus 18% when equal to or longer; P=0.008), microvascular invasion (59 versus 17% when absent; P=0.008) or tumor undifferentiation (54 versus 25% when well/moderately differentiated; P=0.015). DT was the only independent predictor of recurrence (P=0.005). Patients survival was affected by Child-Pugh class only. DT was significantly shorter in tumors with microvascular invasion (P=0.007), undifferentiation (P=0.003) and high alpha-fetoprotein levels (P=0.011). Conclusions: DT is easy to estimate and indicates the prognosis of single HCCs prior to liver resection.
AB - Background/Aims: Recurrence of hepatocellular carcinoma (HCC) following surgical resection is influenced by parameters detectable on the resection specimen or through a biopsy. The prognostic significance of HCC doubling time (DT) after surgery has never been investigated. Methods: We evaluated 62 patients who underwent curative resection of a single HCC on cirrhosis; tumors were assessed before surgery on two subsequent occasions with the same imaging technique allowing the calculation of DT. The influence of tumor DT, clinical and pathological parameters on recurrence-rate and patients survival was assessed with uni- and multivariate analysis. Relationship between DT and pathological features was also analyzed. Results: Three-year recurrence rate was 32.3% (20 patients): this was significantly higher in the presence of DT shorter than 100 days (58 versus 18% when equal to or longer; P=0.008), microvascular invasion (59 versus 17% when absent; P=0.008) or tumor undifferentiation (54 versus 25% when well/moderately differentiated; P=0.015). DT was the only independent predictor of recurrence (P=0.005). Patients survival was affected by Child-Pugh class only. DT was significantly shorter in tumors with microvascular invasion (P=0.007), undifferentiation (P=0.003) and high alpha-fetoprotein levels (P=0.011). Conclusions: DT is easy to estimate and indicates the prognosis of single HCCs prior to liver resection.
KW - Diagnostic imaging
KW - Liver neoplasm diagnosis
KW - Liver neoplasm surgery
KW - Liver neoplasms
KW - Neoplasm recurrence
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U2 - 10.1016/j.jhep.2005.03.014
DO - 10.1016/j.jhep.2005.03.014
M3 - Article
C2 - 15970351
AN - SCOPUS:21844444583
VL - 43
SP - 310
EP - 316
JO - Journal of Hepatology
JF - Journal of Hepatology
SN - 0168-8278
IS - 2
ER -