Korean J Radiol.  2000 Mar;1(1):38-42. 10.3348/kjr.2000.1.1.38.

Early Recurring Hepato cellular Carcinoma after Partial Hepatic Resection: Preoperative CT Findings

• Lim JH
• Jang HJ
• Kim EY
• Park CK
• Joh JW
• Kim YI

• KMID: 1777294
• DOI: http://doi.org/10.3348/kjr.2000.1.1.38

Abstract

OBJECTIVE
The purpose of this study was to determine the utility of preoperative CT in predicting early recurrence of hepatocellular carcinoma after partial hepatic resection. MATERIALS AND METHODS: Preoperative three-phase helical CT scans in 53 patients with hepatocellular carcinoma were retrospectively reviewed by two radiologists. In 27 patients (group I), HCC had recurred within six months, while 26 (group II) had remained disease free for at least two years. In each group, preoperative CT findings were evaluated in each group for the tumor size and number, the presence or absence of capsule, distinctness of tumor margin, perinodular extension, and the presence or absence of portal vein thrombosis. RESULTS: In group I, a tumor capsule of tumor was seen in five of 27 patients (19%), and in group II, in 16 of 26 (62%) (p = .001). The tumor margin was distinct in eight patients (30%) in group I and in 20 (77%) in group II (p = .001). Multiple tumors, perinodular extension, and portal vein thrombosis were more frequently seen in group I but the differences were not statistically significant (p > .05). Tumor size was similar in each group (p > .05). CONCLUSION: Preoperative CT findings that may help predict the early recurrence of hepatocellular carcinoma after surgical resection are an absence of capsule of tumors and an indistinct margin. Reference to these findings during preop-erative CT can guide clinicians in their choice of treatment.

Keyword

Liver, CT, Liver neoplasms, CT; Liver neoplasms, CT

MeSH Terms

Carcinoma, Hepatocellular/*radiography/surgery
Case-Control Studies
Female
*Hepatectomy
Human
Liver Neoplasms/*radiography/surgery
Male
Middle Age
Neoplasm Recurrence, Local/*radiography/surgery
Preoperative Care
Retrospective Studies
Time Factors
*Tomography, X-Ray Computed

Figure

• 

  Fig. 1 A 31-year-old man with a large hepatocellular carcinoma in the right lobe who underwent right hepatic lobectomy (group I). A. CT scan obtained during the delayed phase shows ill-defined hepatocellular carcinoma without capsule. B. CT scan obtained 2 months after surgery reveals that multiple nodular hepatocellular carcinoma in the entire liver had replaced about 70-80% of parenchyma.

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  Fig. 2 A 59-year-old man with nodular hepatocellular carcinoma in the right lobe who underwent right hepatic lobectomy 2 years and 6 months ago. Since this time he has been well, with no evidence of recurrence (group II). A CT scan obtained during the delayed phase shows a well-defined, thin, enhancing capsule around the mass (arrowheads).

• 

  Fig. 3 A 45-year-old man with a large hepatocellular carcinoma in the right lobe who underwent right hepatic lobectomy 2 years and 6 months ago. Since this time he has been well, with no evidence of recurrence (group I). CT Scan obtained during the delayed phase shows a low attenuating mass with an irregular but sharply circumscribed border. The central irregular area of low attenuation represents necrosis.

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  Fig. 4 A 60-year-old man with hepatocellular carcinoma in the right lobe who underwent posterior segmentectomy (group I). CT Scan obtained during the delayed phase shows an oval hepatocellular carcinoma measuring 5 × 7 cm and two small perinodular extensions (straight arrows). Note disruption of the enhancing capsule (curved arrow).

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