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Objective To investigate the magnetic resonance multimodal function imaging characteristics of small hepa-tocellular carcinoma and evaluate its diagnostic value in small liver cancer. Methods Thirty-nine patients with small hepato-cellular carcinoma were selected in the First Affiliated Hospital of Xinxiang Medical University from January 2016 to January 2018. The magnetic resonance plain scan data,dynamic enhance data and diffusion imaging data of all patients were analyzed. Results Forty-five lesions were found by plain scan,and 48 lesions(37 lesions were rapid rise and rapid descent type,6 le-sions were flatbed type,3 lesions were slow ascent and rapid descent type,2 lesions were not obvious strengthening type)were found by dynamic enhancement. The lesions were hyperintense or slightly hyperintense on the diffusion weighted imaging (DWI)image. The lesions were hyperintense or slightly hyperintense on the DWI. The main shape of lesions was round,irregu-lar ring and nodositas. The apparent diffusion coefficient(ADC)value of cancer tissue and normal liver tissue gradually de-creased with the increase of b value. Under the same b value,the ADC values of small hepatocellular carcinoma was significant-ly lower than that in the normal liver tissue(P < 0. 05). Conclusion Magnetic resonance multimodality functional imaging (magnetic resonance imaging dynamic enhanced combine with multi-b value DWI)can effectively improve the diagnostic effi-cacy of small hepatocellular carcinoma.
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Objective To evaluate the efficacy of microwave ablation in the treatment of small hepatic carcinoma with liver cirrhosis.Methods Altogether 50 patients with small hepatic carcinoma with liver cirrhosis from April 2009 to June 2013 were divided into microwave ablation group (n =26) or resection group (n =24).The microwave ablation group was treated by laparoscopic microwave ablation while the resection group was treated by laparoscopic resection.The time of operation,intraoperative blood loss,length of hospital stay,postoperative complications,postoperative liver functions,and 1-year,2-year,3-year survival rate of each group were observed.Results The alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were increased and the albumin (ALB) was decreased postoperatively in both groups,and all recovered in 7 days after operation.The ALT and AST in microwave ablation group were lower than resection group,and the ALB was higher than resection group,with statistical significances (P ＜ 0.05).The operation time in microwave ablation group was (53.5 ± 8.5) min,significantly less than the resection group [(92.9 ± 19.8) min,t =-9.019,P =0.000].The intraoperative blood loss in microwave ablation group was (41.9 ± 17.2) ml,significantly less than the resection group [(131.3 ± 66.0) ml,t =-6.663,P =0.000].The length of hospital stay in microwave ablation group was (7.8 ± 1.0) d,significantly less than the resection group [(10.4 ± 1.3) d,t =-7.742,P =0.000].The rate of postoperative complication in microwave ablation group was 19.2％ (5/26),significantly less than the resection group [45.8％ (11/24),x2 =4.059,P =0.044].The 1-year,2-year,and 3-year survival rates in microwave ablation group were 100％,88.5％,80.8％,respectively,and those in resection group were 100％,91.7％,83.3％,respectively.There were no statistical differences between the two groups (log-rank x2 =0.077,P =0.792).Conclusions Microwave ablation therapy is feasible in the treatment of small hepatocellular carcinoma with cirrhosis that located in the special area and endoscopic surgery is not easy to remove.Microwave ablation has advantages of less trauma,simple performance and less complications.
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Objective To compare the long-term efficacy between laparoscopic liver resection and open liver resection to treat small hepatocellular carcinoma.Methods The clinical data of 52 patients with small hepatocellular carcinoma treated from August 2011 to November 2012 were reviewed.Twenty patients underwent laparoscopic liver resection (the laparoscopic group),while the remaining 32 patients underwent open liver resection (the laparotomy group).The preoperative,postoperative and overall survival data between the two groups were compared.Results The data between the two groups before surgery were comparable (all P ＞ 0.05).The differences in tumor size and pathologic type between the two groups did not reach statistical significance (t =1.087,x2 =0.738,all P ＞ 0.05).However,the length of hospital stay in the laparoscopic group was significantly shorter than in the laparotomy group (t =3.363,P ＜ 0.05).Post-procedural complications occurred in no patients in the laparoscopic group,but in 8 patients in the laparotomy group (x2 =5.909,P ＜ 0.05).The cumulative survival rates in the two groups were not statistically signifi cant (P ＞ 0.05),but the recurrence-free survival of the laparoscopic group was significantly longer than the laparotomy group (P ＜ 0.05).The postoperative 1-year disease-free survival was not significantly different (P ＞ 0.05),though the 3-and 5-year recurrence-free survival rates were significantly different (all P ＜ 0.05).Conclusion The long-term overall survival rate of laparoscopic treatment for small liver cancer was similar to open operation,but the recurrence free survival rate was greatly improved.
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Objective To determine the effectiveness and safety of patients treated with stereotactic body radiotherapy ( SBRT ) - CyberKnife for small hepatocellular carcinoma. Methods A prospective analysis of treatment details and outcomes for 33 patients with small hepatocellular carcinoma treated by CyberKnife at CyberKnife center of Shanghai Changhai Hospital from June 2014 to December 2016 was presented. Patients were followed every 3 months. WHO modified response evaluation criteria in solid Tumors( mRECIST) was used to evaluate efficacy, Common Terminology Criteria for Adverse Events Version 4. 0(CTCAE 4. 0) to evaluate treatment response, Kaplan-Meier method to calculate survival rate and local control rate and plot survival curves. Results There were 33 patients, 33 targets included in the study at the date of the last follow-up. 18 lesions (54. 5%) showed complete remission response, 7 lesions (21. 2%) showed partial remission response, 5 lesions (15. 2%) showed stable, and 3 lesions (9. 1%) progressed. Response rate was 75. 8%, and disease control rate was 90. 9%. 1- and 2-year local control rate was 100% and 83. 6%, respectively. The median disease progression free survival ( DPFS) was 15. 0 months. Non irradiated liver volume more than 100 ml, prior AFP less than 100 ng/ml, post-treatment CTCAE less than grade 2 could improve overall survival ( OS ) . V5 was a factor in grades 2 -4 hepatic toxicity ( P=0. 015 ) . All patients tolerated the radiosurgery, with grade 1 and grade 2 fatigue, and the gastrointestinal reactions and liver injury was the main side effect. 1 patient with grade 3 liver damage relieved at 6 months after treatment and 1 patient with grade 4 liver damage cured at 12 months after treatment. No grade 5 toxicity was encountered. Conclusions CyberKnife seems to be a safe and effective treatment measure with tolerated adverse reaction and good local control rate for patients with small hepatocellular carcinoma.
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Background and purpose:Liver cancer resection and splenectomy are the main methods to treat hepatocellular carcinoma and hypersplenism. The aim of this study was to discuss the safety and feasibility of simultaneous radiofrequency ablation (RFA) and laparoscopic splenectomy (LS) for the treatment of small hepatocellular carcinoma with hypersplenism.Methods:Twenty-seven patients with small hepatocellular carcinoma and cirrhotic hypersplenism underwent RFA and LS. The clinical data were also analyzed.Results:The surgery was converted to an open surgery in 1 patient, while laparoscopic splenectomy in a hand-assisted manner was performed in 2 patients. There were 31 liver tumors treated with RFA. Blood loss were 110-900 mL (mean=320 mL). Operation time were 72-127 min (mean=107 min). Subcutaneous emphysema occurred in 1 patient, and pancreatic leakage in another patient. Nine patients developed ascites. one patient suffered from massive haemorrhage, and emergency operation was adopted to stop bleeding. This patient recovered well after operation. No death was found during the hospitalization. Conclusion:Combining RFA with LS for the treatment of liver cancer and hypersplenism is minimally invasive, safe, and feasible.
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Objective To study the influence of microvascular invasion (MVI) on progression-free survival (PFS) in patients with a solitary small hepatocellular carcinoma,and to analyze the risk factors of MVI.Methods 126 patients with a solitary small hepatocellular carcinoma who underwent liver resection at Tianjin Medical University Cancer Hospital from January 2010 to December 2012 were retrospectively studied.Their demographic and clinicopathological characteristics including age,gender,HBV infection,HCV infection,alcohol consumption,comorbidity,liver cirrhosis,ascites,tumor size,tumor differentiation,MVI,satellite lesion,AFP,CA19-9,ALT and TBil were analyzed.Results The 1-,2-and 3-year PFS rates of patients with a solitary small hepatocellular carcinoma were 81.0％,60.3％ and 47.3％ after surgical resection,respectively.Univariate analysis revealed that MVI,comorbidity,non-well-differentiated tumor,tumor size ＞4 cm were risk factors of PFS.Multivariate analysis demonstrated that only MVI and comorbidity were independent factors of PFS.MVI occurred in 43.7％ of the patients.The median PFS of patients without MVI was 45 months,and the 1-,2-and 3-year PFS rates of these patients were 91.5％,67.6％ and 56.0％,respectively.The median PFS of patients with MVI was 30 months,and the 1-,2-and 3-year PFS rates were 67.3％,50.9％ and 35.4％,respectively.On univariate analysis,AFP ＞ 100 μg/L,non-well-differentiated tumor and satellite lesions were significantly associated with MVI.On multivariate analysis only non-well-differentiated tumor was independently associated with MVI.Conclusions MVI was an important factor affecting PFS in patients with a solitary small hepatocellular carcinoma.AFP ＞ 100 μg/L,non-well-differentiated tumor and satellite lesions were risk factors of MVI.
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OBJECTIVE: To assess the lesion conspicuity and image quality in CT evaluation of small (< or = 3 cm) hepatocellular carcinomas (HCCs) using automatic tube voltage selection (ATVS) and automatic tube current modulation (ATCM) with or without iterative reconstruction. MATERIALS AND METHODS: One hundred and five patients with 123 HCC lesions were included. Fifty-seven patients were scanned using both ATVS and ATCM and images were reconstructed using either filtered back-projection (FBP) (group A1) or sinogram-affirmed iterative reconstruction (SAFIRE) (group A2). Forty-eight patients were imaged using only ATCM, with a fixed tube potential of 120 kVp and FBP reconstruction (group B). Quantitative parameters (image noise in Hounsfield unit and contrast-to-noise ratio of the aorta, the liver, and the hepatic tumors) and qualitative visual parameters (image noise, overall image quality, and lesion conspicuity as graded on a 5-point scale) were compared among the groups. RESULTS: Group A2 scanned with the automatically chosen 80 kVp and 100 kVp tube voltages ranked the best in lesion conspicuity and subjective and objective image quality (p values ranging from < 0.001 to 0.004) among the three groups, except for overall image quality between group A2 and group B (p = 0.022). Group A1 showed higher image noise (p = 0.005) but similar lesion conspicuity and overall image quality as compared with group B. The radiation dose in group A was 19% lower than that in group B (p = 0.022). CONCLUSION: CT scanning with combined use of ATVS and ATCM and image reconstruction with SAFIRE algorithm provides higher lesion conspicuity and better image quality for evaluating small hepatic HCCs with radiation dose reduction.
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Algorithms , Carcinoma, Hepatocellular/diagnostic imaging , Contrast Media , Fluoroscopy , Image Enhancement/methods , Liver Neoplasms/diagnostic imaging , Prospective Studies , Radiation Dosage , Radiographic Image Interpretation, Computer-Assisted/methods , Tomography, X-Ray Computed/methodsABSTRACT
Background and purpose:The incidence of liver cancer is high in China. Primary liver cancers usually occur in patients with liver cirrhosis, which is a challenge for the early diagnosis of liver cancer. Our purpose is to investigate the efifcacy of contrast-enhanced ultrasonography (CEUS) in the early identiifcation and diagnosis of small hepatocellular carcinoma (HCC) by regularly tracking and supervising the high risk population. Methods:A total of 320 high risk patients of HCC admitted in our hospital from February 2011 to November 2013 were enrolled in this prospective study. All patients underwent conventional ultrasound and hepatic CEUS. The differential diagnosis of malignant HCCs from benign ones was based on the enhancement patterns of hepatic lesions in different phases on CEUS. Results:Twenty patients were diagnosed as small HCC among 320 HCC high risk patients who were under regular surveillance using CEUS and all were pathologically conifrmed. Seven of the 20 HCC cases were smaller than 1.0 cm and 13 measured 1.1-2.0 cm. There were 6 (30.0%) HCCs presented as“early wash-in and slow wash-out”atypical pattern of HCC. The small size of the lesion and iso-echogenicity were the main factors of atypical pattern of HCC on CEUS.Conclusion:Ultrasonography and CEUS surveillance is a useful strategy for the early detection of small HCCs in high risk patients, which can help them to receive proper therapeutic management in time.
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Objective To investigate the clinical application of CT perfusion imaging in assessing the hemodynamic changes in patients with small hepatocellular carcinoma (<5 cm) before and after transcatheter arterial chemoembolization (TACE). Methods Twelve patients with small hepatocellular carcinoma were enrolled in this study. CT perfusion imaging of the liver was performed 1 - 2 days before and 3 - 4 weeks after TACE. By using the perfusion parameters the hemodynamics of the preoperative and postoperative tumor tissue, the hemodynamics of the preoperative tumor tissue and the normal tissue, and the hemodynamics of the postoperative active tumor tissue and the normal tissue were determined , and the results were compared between each other. Results Before TACE, the blood flow (BF), hepatic arterial fraction (HAF), hepatic arterial perfusion (HAP) and permeability of surface (PS) in the tumor tissue were significantly higher than those in the normal tissue (P < 0.01), while after TACE all the perfusion parameters except blood volume (BV) were significantly decreased in the tumor tissue (P < 0.01). After TACE, BF, PS, HAF and HAP in the activity tumor tissue were increased more than those in the normal tissue (P < 0.05). Conclusion CT perfusion imaging is of great clinical value in diagnosing < 5 cm hepatocellular carcinoma , in evaluating the hemodynamic changes after TACE and in demonstrating the activity of the residual tumor tissue.
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Primovist is a newly developed hepatocytespecific agent that is transported into the hepatocyte through organic anion transporting polypeptides (OATPs) and excre ted into bile through canalicular multiorganic anion trans porters.Primovist uptake is usually reduced in HCC cells that present hypointensity on the hepatobiliary phase,there fore this agent may help differentiate HCC from other neoplasms and improve histological grading.This article will further explore the use of Primovist in liver cirrhosis and small hepatocellular carcinoma.
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In recent years,the incidence of hepatocellular carcinoma (HCC) has increased with a higher mortality rate.Early detection and early treatment are essential to improving the patients' survival rate. Imaging is widely used HCC and is advantageous because it is non-invasive. The rapid development of imaging calls for higher standards in order to diagnosis hepatocarcinoma at an earlier stage so as to achieve complete treatment.This review describes the scientific progress on imaging differential diagnosis and application on pre-cancerous nodules (dysplastic nodule,DN) and small hepatocellular carcinoma (sHCC) related to hepatocarcinogenesis in cirrhotic livers.
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BACKGROUNDS/AIMS: Surveillance programs and imaging modality developments have increased the detection rate of small hepatocellular carcinoma (HCC). In particular, liver transplantation produces good results and is now regarded an alternative to liver resection. However, optimal treatment for small HCC is still debated, and thus, the authors designed this study to document clinicopathological characteristics, to identify the prognostic factors of small HCC, and to determine the effectiveness of surgery. METHODS: A total of 507 patients underwent curative liver resection for HCC between January 1996 and August 2006 in our institution. One hundred and thirty four of these patients with a single HCC of less than 3 cm and no gross vascular invasion were enrolled. RESULTS: Major resection was performed in 32 (23.9%) patients; there was no postoperative mortality. Fifty-eight (43.3%) patients experienced recurrence, 53 developed intrahepatic recurrence alone, and 50 (94.3%) of 53 had tumors within the Milan criteria. Five-year disease-free and overall survival rates were 51.0% and 77.3%, respectively. Microscopic vascular invasion, positivity for hepatitis B surface antigen or antibody to hepatitis C, and an indocyanine green retention test at 15 minutes of more than 10% were found to be significantly correlated with disease-free overall survival. A platelet count of less than 100,000/mm3 was the only independent prognostic factors of overall survival identified. CONCLUSIONS: This study showed favorable outcome comparable to the survival after liver transplantation, thus that liver resection appears to be the primary treatment option for small HCC, even in cases with poor prognostic factors.
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Humans , Carcinoma, Hepatocellular , Hepatitis B Surface Antigens , Hepatitis C , Indocyanine Green , Liver , Liver Transplantation , Platelet Count , Recurrence , Retention, Psychology , Survival RateABSTRACT
Early detection and treatment of hepatocellular carcinoma (HCC) is one of the most direct and effective ways to improve the long-term outcome of patients with HCC. The comparative study on clinicopathological characteristics of surgically resected micro HCC (≤1 cm), small HCC(≤3 cm), middle HCC (3-5 cm), and large HCC (>5 cm) showed that ≤3 cm small HCC had the features of DNA diploidy, well differentiation, relatively slow growth, encapsulation, rare long-distance metastatic foci and thrombosis, easy to be radically resected and long-term postoperative survival. It is suggested that HCC growing to about ≤3 cm is an important growth phase when the change of pathobiological characteristics of HCC from a relatively benign to a more malignant behavior would occur. This is also the important time to carry out radical treatment to get better results. Therefore,further research on the early diagnosis and treatment as well as the pathobiological features of small HCC ≤3 cm should be undertaken as one of the key clinical and pathological studies in the future.
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Objective To evaluate the value of radiofrequency ablation and Percutaneous Ethanol Injection in the treatment of small hepatocellular carcinoma (HCC). Methods We searched MED-LINE (1966-2009), EMBASE (1966-2009), CBMdisc (1978-2009), The Cochrane Library, Evidence Base Medicine Reviews (Ovid Edition), and Cancerlit (1993-2009). Date of last search: 30Jun 2009. There were no restrictions in language. Randomized controlled trials (RCTs) and nonRCTs (NRCT) were both included in this study, and the quality of each study included was assessed.Meta-analysis was performed using RevMan 4.2 software. Results Four RCTs and one NRCT met the inclusion criteria on RFA versus PEI in the treatment of small HCCs. Meta-analysis showed the following: complete tumor response rate, 3-year survival rate, 1-, 3-year tumor-free survival rates and 1-, 3-year local recurrence rates showed statistically significant difference in the RFA group than the PEI group(P＜0.05). The 1-year survival rate and the main complications of the two groups of patients were similar and they were not significantly different (P＞0. 055). Conclusions The results show that RFA resulted in better clinical outcomes than PEI in the treatment of small HCC larger than 2 cm, and no difference small HCC of 2 cm or less. The two modalities were safe and there were vey few adverse effects of the treatments.
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PURPOSE: There has been controversy concerning which is the best treatment method for small hepatocellular carcinoma between anatomical resection (AR) and non-anatomical resection (NAR). In this retrospective study, we investigated the outcomes of surgical resection for small hepatocellular carcinoma and the clinical results depending on the type of hepatectomy. METHODS: We performed an analysis of the clinicopathologic factors of forty eight patients who underwent hepatectomy for a small (<2 cm) hepatocellular carcinoma between 1990 and 2005. The AR was defined as the resection based on the segment or lobe, as proposed by Couinaud. NAR was defined as the resection of a lesion without regard to the segmental or lobar anatomy, as proposed by Couinaud. The patients were divided into 2 groups base on the hepatectomy procedure: AR (n=24) and NAR (n=24). RESULTS: There were no significant difference between the two groups for the general characteristics of the patients and the clinicopathologic findings, except for ICG R15. The mean ICG R15 in the AR and NAR groups was 11.8+/-6.9 and 22.4+/-15.6, respectively, The NAR group had significantly higher ICG R15 values. The cumulative 1, 3 and 5 year overall survival rates in the AR and NAR groups were 95.8%, 68.2% and 61.3%, and 76.6%, 59.0% and 52.5%, respectively. The cumulative overall survival rate and the mean 5 year disease free survival rate in the AR group (69.8%) were higher than those of the NAR group (45.8%). However, there was no statistically significant difference. CONCLUSION: Depending on the surgical results of this study, there was no statistically significant difference in the outcomes between the AR and NAR groups.
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Humans , Carcinoma, Hepatocellular , Disease-Free Survival , Hepatectomy , Retrospective Studies , Survival RateABSTRACT
PURPOSE: There has been controversy concerning which is the best treatment method for small hepatocellular carcinoma between anatomical resection (AR) and non-anatomical resection (NAR). In this retrospective study, we investigated the outcomes of surgical resection for small hepatocellular carcinoma and the clinical results depending on the type of hepatectomy. METHODS: We performed an analysis of the clinicopathologic factors of forty eight patients who underwent hepatectomy for a small (<2 cm) hepatocellular carcinoma between 1990 and 2005. The AR was defined as the resection based on the segment or lobe, as proposed by Couinaud. NAR was defined as the resection of a lesion without regard to the segmental or lobar anatomy, as proposed by Couinaud. The patients were divided into 2 groups base on the hepatectomy procedure: AR (n=24) and NAR (n=24). RESULTS: There were no significant difference between the two groups for the general characteristics of the patients and the clinicopathologic findings, except for ICG R15. The mean ICG R15 in the AR and NAR groups was 11.8+/-6.9 and 22.4+/-15.6, respectively, The NAR group had significantly higher ICG R15 values. The cumulative 1, 3 and 5 year overall survival rates in the AR and NAR groups were 95.8%, 68.2% and 61.3%, and 76.6%, 59.0% and 52.5%, respectively. The cumulative overall survival rate and the mean 5 year disease free survival rate in the AR group (69.8%) were higher than those of the NAR group (45.8%). However, there was no statistically significant difference. CONCLUSION: Depending on the surgical results of this study, there was no statistically significant difference in the outcomes between the AR and NAR groups.
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Humans , Carcinoma, Hepatocellular , Disease-Free Survival , Hepatectomy , Retrospective Studies , Survival RateABSTRACT
PURPOSE: Hepatectomy has been regarded as the first treatment of choice for small hepatocellular carcinoma. However, hepatectomy for treatment of small hepatocellular carcinoma remains a critical issue. This study evaluates the role of treatment regarding the survival rate and clinicopathological features after resection of small hepatocellular carcinoma ((< or =2 cm) METHODS: This retrospective study was based on the medical records of 48 small hepatocellular carcinoma (< or =2 cm) patients who received surgical hepatectomy from 1990 to 2005. Patients who revealed on postoperative pathologic reports were enrolled. The survival rate was analyzed according to clinicopathologic and therapeutic factors and we analyzed the pathologic features of the recurrence group. RESULTS: The presence of liver cirrhosis, ICGR15 (Indocyanine green retension-15) was statistically significant in the univariate analysis. The vascular invasion rate and capsule formation rate was 90, 80% in the recurrence group. CONCLUSION: In the small hepatocellular carcinoma ((< or =2 cm), the presence of liver cirrhosis, ICGR15 (Indocyanine green retension-15) should be checked to predict prognosis. The small hepatocellular carcinoma ((< or =2 cm) is similar to advanced hepatocellular carcinoma so hepatectomy may play an important role in the small hepatocellular carcinoma ((< or =2 cm).
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Humans , Carcinoma, Hepatocellular , Hepatectomy , Liver Cirrhosis , Medical Records , Prognosis , Recurrence , Retrospective Studies , Survival RateABSTRACT
Objective:To retrospectively evaluate the safety,technical success rate,and effectiveness of ultratranscatheter tumor feeding arterial embolization with ethanol and lipidol for SHCC,and to explore the new therapy for SHCC. Methods:To 95 cases carry out hepatic selective arterial angiography for SHCC by CT or MRI be diagnosed and clinical very doubt be SHCC,after was diagnosed by DSA,to transcatheter ultraselective subsegmental feeding artery with microcatheter for tumor,employ ethanol and lipidol (1/1) to full fill embolized 143 tumors. Results:Technical success rate was 100% for the ultraselective subsegmental feeding artery transcatheter and embolizatoin in SHCC,There were no major complications in all cases.Before embolization ,the diameter of tumors were 0.5~3cm,average diameter 2.3 cm. after tumors were embolized,average diameter 1.2 cm. The 1,3and 5 year recurrence rates were 19%(18/95),27%(26/95),37%(35/95),and the survival rates were 100%(95/95),85%(81/95),67%(64/95) respectively. Conclusion:Its effectiveness was very notable,there were no major complications and recurrence rates was less than surgical resection in ultraselective transcatheter tumor feeding arterial embolization with ethanol and lipidol for SHCC,It should become the first selective therapy for SHCC.
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BACKGROUND/AIMS: We studied the patterns of recurrence after resection of relatively small hepatocellular carcinoma, defined as less than 5 cm in diameter, with tumor-free margin, and risk factor for recurrence were re-evaluated for these group. METHODS: The subjects were 25 patients who had undergone tumor removal with tumor-free margin for hepatocellular carcinoma at our department from 1995 to 1998. Tumor-free survival rates of patients with various risk factors were calculated and differences between groups were evaluated. RESULTS: The tumors recurred in 17 patients (68.0%), with 11 patients (64.7% of recurrences) recurring within 1 year of surgery. Recurrent disease was nearly intrahepatic. Univariate retrospective analysis in this study showed the absence of tumor capsule to be significant risk factor. But there is no significant difference in survival rate between capsule (+) groups and capsule (-) groups. CONCLUSION: It was concluded that small hepatocellular carcinoma has no significant difference in clinicopathologic variables except tumor capsule.
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Humans , Carcinoma, Hepatocellular , Recurrence , Retrospective Studies , Risk Factors , Survival RateABSTRACT
Objective The application of CTHA/CTAP in examination of liver cancer relapse after interventional therapy were retrospectively analyzed.Methods The CTHA/CTAP and DSA were performed on 19 patients with primary hepatic cancer after receiving TACE procedure followed by obvious rising of AFP.Results CTHA/CTAP discovered 14 recurrent lesions in the peripheral region of the embolized tumors,and 15 new lesions.In comparison,DSA only discovered 6 recurrent lesions and 8 new lesions.Conclusion Comparing with DSA,CTHA/CTAP is a more sensitive and reliable method in detection of liver cancer relapse after interventional therapy.