Outcome of Oligonodular Hepatocellular Carcinoma after Hepatectomy

Authors

  • SM Shakhwat Hossain Diploma in Hepatobiliary Surgery (China), Advanced Training in HBPS (Singapore), Classified Specialist in Surgery & Head of the Department of Hepatobiliary Surgery, CMH, Dhaka, Bangladesh
  • Md Mahboob Hasan Diploma in Hepatobiliary Surgery (China), Classified Specialist in Surgery and Hepatobiliary Surgeon, CMH, Dhaka, Bangladesh
  • Md Mahbubur Rahman Fellow Colorectal Surgery (France), Consultant Surgeon General, Directorate General of Medical Services, Ministry of Defence, Dhaka, Bangladesh

DOI:

https://doi.org/10.3329/jafmc.v15i1.48643

Keywords:

Hepatocellular carcinoma, Oligonodular, Intrahepatic metastasis and Recurrence

Abstract

Introduction: Hepatocellular carcinoma (HCC) is a common cancer and is the third most common cause of cancer-related death worldwide. Frequent recurrence of HCC after resection is a major surgical limitation. Early recurrence is the most disappointing outcome after surgery for multinodular HCC. Several studies found good results after hepatectomy for oligonodular (2 or 3 nodules) HCC.

Objectives: To observe the recurrence rate three months after hepatectomy for oligonodular HCC and study the possible risk factors.

Materials and Methods: The study population consisted of 102 patients with oligonodular HCC and received hepatectomy in Combined Military Hospital (CMH) between July 2011 and July 2017 according to the following criteria: (1) numbers of tumour nodules determined by preoperative imaging (computed tomography or magnetic resonance imaging) and intraoperative exploration; (2) diagnosis of HCC confirmed by postoperative histopathology; (3) incision margins negative; (4) complete clinicopathologic data; (5) adjuvant chemotherapy advised one month after operation. Multicentric occurrence (MO) and intrahepatic metastasis (IM) were determined in each patient according to the histopathologic examination.

Results: Among 102 patients, 43(42.2%) had small tumor stain three months after surgery, 22(21.6%) and 21(20.6%) were definded as single and multiple recurrence respectively. The recurrence rate of patients with microvascular involvement was higher (64.3%) than those without (33.8%), (p<0.05). IM or MO, complete tumor capsule or not, number of tumors (2 versus 3), liver condition (cirrhosis versus chronic hepatitis) showed no significant difference.

Conclusion: There was a high rate of very early recurrence for patients with oligonodular HCC three months ater hepatectomy, and the hepatic resection seems no-account for these patients regardless of very early recurrence or not a curative resection. Microvascular involvement was a risk factor while IM or MO is not.

Journal of Armed Forces Medical College Bangladesh Vol.15 (1) 2019: 55-57

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Published

2020-08-20

How to Cite

Hossain, S. S., Hasan, M. M., & Rahman, M. M. (2020). Outcome of Oligonodular Hepatocellular Carcinoma after Hepatectomy. Journal of Armed Forces Medical College, Bangladesh, 15(1), 55–57. https://doi.org/10.3329/jafmc.v15i1.48643

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Section

Original Papers