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Objective:To study the impact of repeat hepatectomy for patients with post-hepatectomy recurrent hepatocellular carcinoma (HCC).Methods:The data of patients who developed post-hepatecotmy recurrent HCC and underwent repeat hepatectomy at the General Surgery Department of Beijing Tongren Hospital from May 2013 to May 2016 (the Recurrence Group), were retrospectively compared with the data from patients who underwent initial hepatectomy for HCC during the same study period (the Primary Group). The general data, perioperative data, postoperative complications and survival of the two groups were compared.Results:The primary group included 179 patients, consisting of 133 males and 46 females, aged (57.3±11.7) years, with a range from 14.0 to 84.0 years. The recurrence group included 36 patients, consisting of 30 males and 6 females, aged (55.9±11.4) years, with a range from 40.0 to 77.0 years. There were no statistically significant differences between the two groups in gender, age, hepatitis virus infection status, preoperative alpha fetoprotein, Child-Pugh score and indocyanine green retention rate at 15 min ( P>0.05). However, there were statistically significant differences ( P<0.05) between the two groups in operative time [(244.2±84.3)min vs. (283.4±66.8)min], intraoperative blood loss[(428.5±151.6)ml vs. (756.2±187.4)ml], anatomic or nonanatomic hepatectomy, single tumor or multiple tumors, and maximum tumor diameter[(5.81±2.24)cm vs. (3.69±1.55)cm]. There were no statistically significant differences between the two groups in incidences of tumor capsular invasion, tumor thrombus and degrees of tumor differentiation ( P>0.05). There were no statistically significant differences in surgical complication rates ( P>0.05), and in 1-year and 3-year overall and disease free survival rates between the two groups ( P>0.05). Conclusions:Repeat hepatectomy for recurrent HCC after hepatectomy was safe and effective. Its long-term survival outcomes were similar to first hepatectomy for HCC.
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Objective To explore the relationship between CXCL1 expression level and prognosis of HBV-associated hepatocellular carcinoma (HCC) after liver transplantation.Methods From 2000 to 2010,127 recipients of liver transplantation for HBV-associated HCC in our hospital were enrolled.General hematoxylin-eosin staining and CXCL1 immunohistochemical staining were applied in formalin-fixed paraffinembedded sections,and the Cohort's adverse prognostic factors were analyzed retrospectively.Neutrophil migration assay and Transwell invasion assay were used to verify its mechanism.Results CXCL1 expression level is an independent prognostic factor for 5-year overall survival (OS) and disease-free survival (DFS) (P ＜ 0.05);Neutrophil migration assay and Transwell invasion assay suggested that HCC cells can secrete CXCL1 recruiting neutrophils to hepatic carcinoma tissues,and neutrophils secrete vascular endothelial growth factor A (VEGFA) promoting the invasion of HCC cells through vascular endothelial growth factor receptor 2 (VRGFR2).Conclusion High CXCL1 level in HCC tissues is an independent prognostic factor for HCC recurrence and long-term survival of patients with HBV-associated HCC after liver transplantation.CXCL1-neutrophil-VEGFA-VEGFR2 may be a mechanisms leading to HCC recurrence in patients with HBV-associated HCC after liver transplantation.