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간암에서 좋은 결과를 예상하고 치료를(TACE, RFA, OP/LT, Cyber knife 등) 하였으나 조기 재발한 간암 증례 : 좋은 결과를 예상하고 수술을 하였으나 조기 재발한 간세포암종 1예

A Case of Early Recurred Hepatocellular Carcinoma with Initial Expectation of Good outcome by Surgical Resection

대한간암연구학회지 2009년 9권 1호 p.41 ~ 44
이정민, 박준용, 김도영, 김경식, 박영년, 김명진, 전재윤, 한광협,
소속 상세정보
이정민 ( Lee Jung-Min ) - 연세대학교 의과대학 내과학교실
박준용 ( Park Jun-Yong ) - 연세대학교 의과대학 내과학교실
김도영 ( Kim Do-Young ) - 연세대학교 의과대학 내과학교실
김경식 ( Kim Kyung-Sik ) - 연세대학교 의과대학 외과학교실
박영년 ( Park Young-Nyun ) - 연세대학교 의과대학 병리학교실
김명진 ( Kim Myung-Jin ) - 연세대학교 의과대학 영상의학교실
전재윤 ( Chon Chae-Yoon ) - 연세대학교 의과대학 내과학교실
한광협 ( Han Kwang-Hyub ) - 연세대학교 의과대학 내과학교실

Abstract


Hepatocellular carcinoma (HCC) is one of the cancers with poor prognosis as HCC develops on base of cirrhosis in
majority cases, which requires multidisciplinary approach. If feasible, however, surgical resection is the choice of treatment, and many previous studies and guidelines offered appropriate indications for surgical resection; firstly, preservation of liver function should be confirmed with traditional Child-Pugh classification or more recently with Indocyanine Green retention test or absence of portal hypertension. Secondly, several variables about the size, number, and vascular invasion of tumor should be taken into consideration. It is suggested that to lessen the risk of recurrence gross vascular invasion be absent and the number of tumor be single. Regarding the size of tumor, although risk of dissemination increases with size, some tumors may grow as a single mass and thus the size of tumor is not a clear-cut limiting factor. Based on above suggestions, we herein offer our experience of a patient with initial hopeful expectation of good outcome with surgical resection, but who eventually turned out to result in disseminated tumor recurrence. Further study, maybe regarding a combination of adjuvant or neoadjuvant transarterial chemoembolization/chemotherapy or radiotherapy, is necessary on how to manage such patient.

키워드

Hepatocellular carcinoma;Hepatic Lobectomy;Recurrence

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