Surgical treatment of fibrolamellar hepatocellular carcinoma:an underestimated malignant tumor?

查看全文 作　　者：Paulo [1]Herman;Aline Lopes [1]Chagas;Marcos Vinicius [1]Perini;Fabricio Ferreira [2]Coelho;Gilton Marques [2]Fonseca;Venancio Avancini Ferreira [3]Alves;Flair José [1]Carrilho;Ivan [4]Cecconello 机构地区：[1]Digestive Surgery Division,Department of Gastroenterology,University of Sao Paulo School of Medicine,Avenida Doutor Enéas de Carvalho Aguiar,255,Instituto Central,9°andar,Sala 9074,CEP:05403-900,Cerqueira Cesar-Sao Paulo,SP,Brazil;[2]Digestive Surgery Division,Department of Gastroenterology,University of Sao Paulo School of Medicine,Avenida Doutor Enéas de Carvalho Aguiar,255,Instituto Central,9°andar,Sala 9074,CEP:05403-900,Cerqueira Cesar-Sao Paulo,SP,Brazil;[3]Department of Pathology,University of Sao Paulo School of Medicine,Avenida Doutor Enéas de Carvalho Aguiar,255,Instituto Central,9°andar,Sala 9074,CEP:05403-900,Cerqueira Cesar-Sao Paulo,SP,Brazil;[4]Digestive Surgery Division,Department of Gastroenterology,University of Sao Paulo School of Medicine,Avenida Doutor Enéas de Carvalho Aguiar,255,Instituto Central,9°andar,Sala 9074,CEP:05403-900,Cerqueira Cesar-Sao Paulo,SP,Brazil 出　　处：《Hepatobiliary & Pancreatic Diseases International》索引2014年第13卷第6期,共4页 摘　　要：BACKGROUND: Fibrolamellar hepatocellular carcinoma (FLHCC) is a rare disease with an indolent behavior. Its prognosis is better than that of patients with hepatocellular carcinoma. The authors present their experience with resection of FLHCC.METHODS: Twenty-one patients with FLHCC were treated at our institution between 1990 and 2012. Of these patients, 14 were subjected to resection of the tumor. Patient demographics,medical history, results of imaging studies and laboratory tests,surgical data, and pathologic findings were evaluated.RESULTS: The median age of the patients at the diagnosis of the tumor was 20 years and 14 patients were female. None of the patients had tumor-associated chronic liver disease or cirrhosis.The mean tumor size was 12.8 cm (range 6-19) and 18 patients had a single liver nodule. Fourteen patients were subjected to hepatectomy and six of them had lymph node metastases resected. Pathologic evaluation revealed that 5 (35.7%) patients had major vascular invasion. Tumor recurrence was seen in 8 patients (66.7%), during a follow-up. The median survival time for patients who were subjected to resection was 36 months. The 5-year overall survival rate and disease free survival rate were 28.0% and 8.5%, respectively. Univariate analysis showed that vascular invasion was the only variable associated with the disease free survival rate.CONCLUSIONS: Despite an aggressive treatment, patients with FLHCC presented unexpected low survival rates. It seems that an underestimated malignant behavior is attributed to this disease, and that the forms of adjuvant treatment should be urgently evaluated. 关 键 词：fibrolamellar hepatocellular carcinoma HEPATECTOMY hepatocellular carcinoma lymph node excision SURVIVAL