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Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy
Published on: March 10, 2023
Surgical Resection for Lymph Node Metastasis After Liver Transplantation for Hepatocellular Carcinoma
Toru Ikegami1, Tomoharu Yoshizumi2, Jyunji Kawasaki2
1Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan tikesurg@surg2.med.kyushu-u.ac.jp.
Background:
Treatment strategies for lymph node (LN) metastasis after liver transplantation (LT) for hepatocellular carcinoma (HCC) have not been studied.
Patients And Methods:
The treatment modes and outcomes in patients with LN metastasis after LT (n=6) for HCC were reviewed.
Results:
The mean time from LT to LN recurrence was 2.0±1.3 years, and the locations of the LNs recurrences included the phrenic (n=2), common hepatic artery (n=2), inferior vena cava (n=1) and gastric (n=1) regions. Treatments included surgery alone (n=3), surgery followed by chemoradiation (n=1), radiation followed by chemotherapy (n=1), and chemotherapy, radiation and sorafenib (n=1). Although the patients receiving non-surgical treatments (n=3) died within 1.2 years, those who underwent surgical removal of the metastatic LNs survived 11.2 years, 4.5 years and 0.8 years, respectively, without any signs of re-recurrence.
Conclusion:
Surgical resection is the only feasible and potentially curative treatment for LN metastasis after LT for HCC.
