GS칼텍스의 지속가능 성장을 위한 최적전략 연구

Thesis(master`s)--서울대학교 경영전문대학원 :경영학과 Global MBA전공,2007.8Maste

Prognostic significance of microvascular invasion in tumor stage for hepatocellular carcinoma

Background: The presence of microvascular invasion (McVI) in hepatocellular carcinoma (HCC) has been proposed as a cause of recurrence and poor survival, although this has not been officially emphasized in staging systems. Thus, we conducted a retrospective study to investigate the prognostic importance of McVI in tumor staging in patients with HCC who underwent hepatic resection. Methods: A retrospective analysis was performed of patients who underwent hepatic resection for HCC at our center from 1994 to 2012. Patients with HCC were classified into four groups based on the presence of McVI and extent of gross vascular invasion (VI). Results: The 5-year overall and recurrence-free survival rates of 676 patients were 63.3 and 42.6%, respectively. There was no difference in tumor recurrence or survival rate between patients with HCC and McVI without gross VI and those with gross VI confined to segmental/sectional branches. Multivariate analysis revealed that the extent of VI based on the presence of McVI and gross VI was independently associated with tumor recurrence and overall survival. Conclusions: McVI was revealed to be an important risk factor similar to gross VI confined to a segmental/sectional branch in patients with HCC who underwent hepatic resection. This finding should be considered when estimating the stage for prognosis

Conditional Survival Analysis Demonstrates that Recurrence Risk of Surgically Treated Hepatocellular Carcinoma Evolves with Time

Objective The study aim was to investigate long-term change in tumor recurrence risk in patients with hepatocellular carcinoma(HCC) after hepatic resection. Recurrence probability over time was estimated by conditional survival (CS) analysis.Patients and Methods Early-stage HCC patients with hepatic resection were selected for inclusion from our surgery database.Variables predictive of tumor recurrence were identified by univariate and multivariate analyses. Five-year recurrence-free CSprobability was calculated for all patients and for risk groups stratified by independent predictors.Results In this series of 436 patients, tumor size >5 cm, microvascular invasion, positive resection margin, liver cirrhosis, and aindocyanine green retention ratio at 15 min (ICG-R15) >20% were independently predictive of tumor recurrence. The estimated5-year recurrence-free CS probability improved with each additional year of recurrence-free survival, and the improvement wassignificantly greater in the high-risk than in the low- or intermediate-risk groups.Conclusion CS provides added value during follow-up of early-stage HCC patients treated by surgical resection