Long-Term Outcomes and Prognostic Factors with Reductive Hepatectomy and Sequential Percutaneous Isolated Hepatic Perfusion for Multiple Bilobar Hepatocellular Carcinoma

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• 作者：Takumi Fukumoto MD (1)
  Masahiro Tominaga MD (1)
  Masahiro Kido MD (1)
  Atsushi Takebe MD (1)
  Motofumi Tanaka MD (1)
  Kaori Kuramitsu MD (1)
  Ippei Matsumoto MD (1)
  Tetsuo Ajiki MD (1)
  Yonson Ku MD (1)
  
• 刊名：Annals of Surgical Oncology
• 出版年：2014
• 出版时间：March 2014
• 年：2014
• 卷：21
• 期：3
• 页码：971-978
• 全文大小：295 KB
• 参考文献：1. Llovet JM, Bruix J, Gores GJ. Surgical resection versus transplantation for early hepatocellular carcinoma: clues for the best strategy. / Hepatology. 2000;31:1019-1. CrossRef
  2. Yao FY, Ferrell L, Bass NM, Watson JJ, Bacchetti P, Venook A, et al. Liver transplantation for hepatocellular carcinoma: expansion of the tumor size limits does not adversely impact survival. / Hepatology. 2001;33:1394-03. CrossRef
  3. Poon RT, Fan ST, Lo CM, Liu CL, Wong J. Long-term survival and pattern of recurrence after resection of small hepatocellular carcinoma in patients with preserved liver function: implications for a strategy of salvage transplantation. / Ann Surg. 2002;235:373-2. CrossRef
  4. Kim WR, Gores GJ, Benson JT, Therneau TM, Melton LJ 3rd. Mortality and hospital utilization for hepatocellular carcinoma in the United States. / Gastroenterology. 2005;129:486-3.
  5. Llovet JM, Bru C, Bruix J. Prognosis of hepatocellular carcinoma: the BCLC staging classification. / Semin Liver Dis. 1999;19:329-8. CrossRef
  6. Bruix J, Sherman M. Management of hepatocellular carcinoma. / Hepatology. 2005;42:1208-6. CrossRef
  7. Llovet JM, Ricci S, Mazzaferro V, Hilgard P, Gane E, Blanc JF, et al. Sorafenib in advanced hepatocellular carcinoma. / N Engl J Med. 2008;359:378-0. CrossRef
  8. Shimamura Y, Gunven P, Ishii M, Ono M, Abe K. Debulking surgery and arterial embolization for unresectable liver cancer. / Hepatogastroenterology. 1993;40:10-.
  9. Yamamoto M, Iizuka H, Matsuda M, Nagahori K, Miura K, Itakura J. The indications for tumor mass reduction surgery and subsequent multidisciplinary treatments in stage IV hepatocellular carcinoma. / Surg Today. 1993;23:675-1. CrossRef
  10. Yamamoto K, Takenaka K, Kawahara N, Shimada M, Shirabe K, Itasaka H, et al. Indications for palliative reduction surgery in advanced hepatocellular carcinoma. The use of a remnant tumor index. / Arch Surg. 1997;132:120-. CrossRef
  11. Wakabayashi H, Ushiyama T, Ishimura K, Izuishi K, Karasawa Y, Masaki T, et al. Significance of reduction surgery in multidisciplinary treatment of advanced hepatocellular carcinoma with multiple intrahepatic lesions. / J Surg Oncol. 2003;82:98-03. CrossRef
  12. Inoue K, Nakamura T, Kinoshita T, Konishi M, Nakagohri T, Oda T, et al. Volume reduction surgery for advanced hepatocellular carcinoma. / J Cancer Res Clin Oncol. 2004;130:362-. CrossRef
  13. Kobayashi A, Takahashi S, Ishii H, Konishi M, Nakagohri T, Gotohda N, et al. Factors predicting survival in advanced T-staged hepatocellular carcinoma patients treated with reduction hepatectomy followed by transcatheter arterial chemoembolization. / Eur J Surg Oncol. 2007;33:1019-4. CrossRef
  14. Nagano H, Miyamoto A, Wada H, Ota H, Marubashi S, Takeda Y, et al. Interferon-alpha and 5-fluorouracil combination therapy after palliative hepatic resection in patients with advanced hepatocellular carcinoma, portal venous tumor thrombus in the major trunk, and multiple nodules. / Cancer. 2007;110:2493-01. CrossRef
  15. Taniai N, Yoshida H, Mamada Y, Kawano Y, Mizuguchi Y, Akimaru K, et al. Is intraoperative adjuvant therapy effective for satellite lesions in patients undergoing reduction surgery for advanced hepatocellular carcinoma? / Hepatogastroenterology. 2006;53:258-1.
  16. Konishi M, Ryu M, Kinoshita T, Inoue K. Surgical treatment of hepatocellular carcinoma with direct removal of the tumor thrombus in the main portal vein. / Hepatogastroenterology. 2001;48:1421-.
  17. Gotohda N, Kinoshita T, Konishi M, Nakagohri T, Takahashi S, Furuse J, et al. New indication for reduction surgery in patients with advanced hepatocellular carcinoma with major vascular involvement. / World J Surg. 2006;30:431-. CrossRef
  18. Bruix J, Llovet JM, Castells A, Monta?á X, Brú C, Ayuso MC, et al. Transarterial embolization versus symptomatic treatment in patients with advanced hepatocellular carcinoma: results of a randomized, controlled trial in a single institution. / Hepatology. 1998;27:1578-3. CrossRef
  19. Ku Y, Iwasaki T, Tominaga M, Fukumoto T, Takahashi T, Kido M, et al. Reductive surgery plus percutaneous isolated hepatic perfusion for multiple advanced hepatocellular carcinoma. / Ann Surg. 2004;239:53-0. CrossRef
  20. Ku Y, Saitoh M, Iwasaki T, Tominaga M, Maekawa Y, Shiki H, et al. Intraarterial infusion of high-dose adriamycin for unresectable hepatocellular carcinoma using direct hemoperfusion under hepatic venous isolation. / Eur J Surg Oncol. 1993;19:387-2.
  21. Ku Y, Fukumoto T, Iwasaki T, Tominaga M, Samizo M, Nishida T, et al. Clinical pilot study on high-dose intraarterial chemotherapy with direct hemoperfusion under hepatic venous isolation in patients with advanced hepatocellular carcinoma. / Surgery. 1995;117:510-. CrossRef
  22. Ku Y, Fukumoto T, Tominaga M, Iwasaki T, Maeda I, Kusunoki N, et al. Single catheter technique of hepatic venous isolation and extracorporeal charcoal hemoperfusion for malignant liver tumors. / Am J Surg. 1997;173:103-. CrossRef
  23. Ku Y, Iwasaki T, Fukumoto T, Tominaga M, Muramatsu S, Kusunoki N, et al. Induction of long-term remission in advanced hepatocellular carcinoma with percutaneous isolated liver chemoperfusion. / Ann Surg. 1998;227:519-6. CrossRef
  24. Group d’Etude et de Traitement du Carcinoma Hepatocellulaire. A comparison of lipiodol chemoembolization and conservative treatment for unresectable hepatocellular carcinoma. / N Engl J Med. 1995;332:1256-1. CrossRef
  25. Liver Cancer Study Group of Japan. General rules for the clinical and pathological study of primary liver cancer. 3rd English ed. Tokyo: Kanehara; 2010.
  26. Sobin LH, Gospodarowicz MK, Wittekind C. TNM classification of malignant tumours. International Union against Cancer. 7th ed. Oxford: Wiley; 2009.
  27. Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. / J Natl Cancer Inst. 2000;92:205-6. CrossRef
  28. Cheng AL, Kang YK, Chen Z, Tsao CJ, Qin S, Kim JS, et al. Efficacy and safety of sorafenib in patients in the Asia-Pacific region with advanced hepatocellular carcinoma: a phase III randomised, double-blind, placebo-controlled trial. / Lancet Oncol. 2009;10:25-4. CrossRef
  29. Villa E, Moles A, Ferretti I, Buttafoco P, Grottola A, Del Buono M, et al. Natural history of inoperable hepatocellular carcinoma: estrogen receptors-status in the tumor is the strongest prognostic factor for survival. / Hepatology. 2000;32:233-. CrossRef
  30. Friedman MA. Primary hepatocellular cancer—present results and future prospects. / Int J Radiat Oncol Biol Phys. 1983;9:1841-0. CrossRef
  31. Lai CL, Wu PC, Chan GC, Lok AS, Lin HJ. Doxorubicin versus no antitumor therapy in inoperable hepatocellular carcinoma. A prospective randomized trial. / Cancer. 1988;62:479-3. CrossRef
  32. Llovet JM, Bustamante J, Castells A, Vilana R, Ayuso Mdel C, Sala M, et al. Natural history of untreated nonsurgical hepatocellular carcinoma: rationale for the design and evaluation of therapeutic trials. / Hepatology. 1999;29:62-. CrossRef
  33. Fujikawa T, Shiraha H, Ueda N, Takaoka N, Nakanishi Y, Matsuo N, et al. Des-gamma-carboxyl prothrombin-promoted vascular endothelial cell proliferation and migration. / J Biol Chem. 2007;282:8741-. CrossRef
  34. Ikai I, Hatano E, Hasegawa S, Fujii H, Taura K, Uyama N, et al. Prognostic index for patients with hepatocellular carcinoma combined with tumor thrombosis in the major portal vein. / J Am Coll Surg. 2006;202:431-. CrossRef
  35. Pawlik TM, Poon RT, Abdalla EK, Ikai I, Nagorney DM, Belghiti J, et al. Hepatectomy for hepatocellular carcinoma with major portal or hepatic vein invasion: results of a multicenter study. / Surgery. 2005;137:403-0. CrossRef
  36. Zhou J, Tang ZY, Wu ZQ, Zhou XD, Ma ZC, Tan CJ, et al. Factors influencing survival in hepatocellular carcinoma patients with macroscopic portal vein tumor thrombosis after surgery, with special reference to time dependency: a single-center experience of 381 cases. / Hepatogastroenterology. 2006;53:275-0.
  37. Minagawa M, Makuuchi M, Takayama T, Ohtomo K. Selection criteria for hepatectomy in patients with hepatocellular carcinoma and portal vein tumor thrombus. / Ann Surg. 2001;233:379-4. CrossRef
  
• 作者单位：Takumi Fukumoto MD (1)
  Masahiro Tominaga MD (1)
  Masahiro Kido MD (1)
  Atsushi Takebe MD (1)
  Motofumi Tanaka MD (1)
  Kaori Kuramitsu MD (1)
  Ippei Matsumoto MD (1)
  Tetsuo Ajiki MD (1)
  Yonson Ku MD (1)
  
  1. Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan
  
• ISSN：1534-4681

文摘

Background Sorafenib is currently recommended as first-line therapy for patients with intermediate or advanced hepatocellular carcinoma (HCC) per Barcelona Clinic Liver Cancer staging. However, the median overall survival (OS) with sorafenib in these patients is 10.7?months with an overall response rate of 2?%. We retrospectively investigated the long-term outcomes and prognostic factors with reductive hepatectomy and sequential percutaneous isolated hepatic perfusion (PIHP) for refractory intermediate or advanced HCC. Methods A total of 68 patients who had intermediate or advanced stage HCC without extrahepatic metastases were scheduled for reductive hepatectomy plus PIHP. All patients underwent reductive hepatectomy and PIHP with mitomycin C 20-0?mg/m2 and/or doxorubicin 60-20?mg/m2 1-?months after surgery (mean, 1.51 times/patient). Results The objective response rate of PIHP was 70.6?% (complete plus partial response). The median OS of all 68 patients was 25?months, and the 5-year OS rate was 27.6?%. Univariate and multivariate analyses indicated that tumor response to PIHP and normalization of serum des-γ-carboxy prothrombin concentrations after PIHP were independent prognostic factors for OS. Conclusions The median OS of the study population treated by reductive hepatectomy and sequential PIHP was 25?months. This treatment strategy can offer a possible curative treatment to patients with refractory intermediate and advanced HCC.