Long-term survival and prognosis for primary clear cell carcinoma of the liver after hepatectomy

OncoTargets and Therapy long-term survival and prognosis for primary clear cell carcinoma of the liver after hepatectomy 8 1 0 2 - l u J - 2 1 n o 4 1 2 . 6 1 . 4 5 2 . 1 5 y b / m o c . s s rvpee l.yno PowerdbyTCPDF(ww.tcpdf.org) O r i g i n a l r e s e a r c h Background: The aim of this study was to investigate the long-term survival and prognosis for primary clear cell carcinoma of the liver (PCCCL) of the liver after hepatectomy. Methods: Our study retrospectively analyzed the clinicopathological data of 64 patients with PCCCL (PCCCL group) and 247 with nonclear cell hepatocellular carcinoma (NHCC group) after hepatectomy between January 1996 and December 2006. The overall survival (OS) and disease-free survival of the two groups was compared using the Kaplan-Meier method. Prognostic factors of survival were identified by multivariate analysis. Results: The 1-, 3-, and 5-year OS (P=0.016) and disease-free survival (P,0.001) of the PCCCL group were significantly higher than that of the NHCC group. In mutivariate analysis, tumor size .5 cm, presence of portal vein tumor thrombosis and proportion of clear cells #70% were risk factors for OS of the PCCCL group. The prognosis of a subgroup with higher proportion of clear cells was markedly better than that of the subgroup with a lower proportion of clear cells. Conclusion: Our results suggested that the prognosis of patients with PCCCL was better than that of the patients with NHCC. The higher the proportion of clear cells, the better the prognosis. - Zu-shun chen* shao-liang Zhu* lu-n an Qi* le-Qun li Department of hepatobiliary surgery, a ffiliated Tumor h ospital of g uangxi Medical University, n anning, People’s republic of china *These authors contributed equally to this work Therefore in the present study, we investigated the long-term survival and prognosis for primary clear cell carcinoma of the liver after hepatectomy. In addition, the long-term survival and prognosis of cases with different proportion of clear cells were also analyzed. Materials and methods 8 Patients -102 From January 1996 to December 2006, a total of 975 HCC l-Ju patients with newly diagnosed HCC in the department of 2n1 hepatobiliary surgery at our Hospital were enrolled and o41 retrospectively analyzed (Figure 1). Of these, 392 patients .621 who received other treatment such as transarterial chemoem..25145 sboorlaizfeantiiobnt,hleorcaaplya,bolartsiuopnptohretriavpeyc,asryeswteemreateixccclhuedmedo.tAhemraopnyg, /yb the remaining 483 patients who underwent hepatectomy, .com 46 were excluded because of incomplete data or extrahess patic metastasis. Of the remaining 308 patients, 64 patients rvpee l.yno with proportions of clear cells .30% were postoperatively .dow lsue diagnosed as PCCCL (PCCCL group, Figure 2A–C) and we /ww ano diagnosed PCCCL when it contained .30% of clear cells.12,13 / ttp pe The other 244 patients were diagnosed as NHCC group :s rs h ro (Figure 3). HCC and PCCCL diagnosis was confirmed after from F hepatectomy by histopathological examination of surgical dade samples. HCC and PCCCL diagnosis were confirmed by at lno least two pathologists. The clinicopathological characteristics dow of the two groups were compared (Table 1). y p a r e h T d n a s t e g r a T o c n O hepatectomy Liver resection was the treatment proposed to all patients with a Child–Pugh class A or B, a Model for End-stage Liver Disease score ,8 points. Intraoperative ultrasound was routinely performed to determine tumor location and assess the vascular anatomy of the liver. A decision was then made on the type of liver resection that would allow a clear margin around the tumor with maximum preservation of remnant liver volume. Hepatic resection was performed following the techniques described previously.17,18 In almost all hepatic resections, intermittent Pringle’s maneuvers consisting of clamping the portal triad for ,20 minutes and then releasing the clamp at 5-minute intervals or hemivascular occlusions were applied.19 Encountered large vessels and bile ducts were ligated separately during liver dissection. Liver parenchyma was transected gradually from front to back, from shallow to deep, and the tumor was cutoff eventually. Follow-up After treatment, follow-up of all surviving patients included a liver function test, estimation of serum α-fetoprotein (AFP) levels, dynamic liver CT, MRI, liver ultrasonography, and chest radiography at an interval of 2–3 months, especially during the first 2 years. The overall survival (OS) was defined as the period from the date of hepatectomy. Disease-free survival (DFS) was defined as the period from the date of hepatectomy until imaging study detected recurrence. When recurrence was confirmed, secondary hepatectomy, radiofrequency ablation, or transcatheter arterial chemoembolization was the treatment of choice. statistical analysis Continuous variables were expressed as mean ± standard deviation (SD) and compared using the t-test. Catego (...truncated)