Satellite lesions in patients with small hepatocellular carcinoma with reference to clinicopathologic features

Takuji Okusaka, Shuichi Okada, Hideki Ueno, Masafumi Ikeda, Kazuaki Shimada, Junji Yamamoto, Tomoo Kosuge, Susumu Yamasaki, Noriyoshi Fukushima, Michiie Sakamoto

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150 Citations (Scopus)

Abstract

BACKGROUND. It is not rare to find satellite lesions in patients with small hepatocellular carcinoma (HCC). The purpose of this study was to elucidate the factors associated with satellite lesions in these patients. METHODS. We investigated the prevalence of satellite lesions, the relationship of clinicopathologic factors to satellite lesions, and the distance from the main tumor to the satellite lesion in 149 patients. Patients, who had a solitary HCC of 3.0 cm or less in diameter but no satellite lesions on preoperative imaging procedures, underwent potentially curative resection. The main tumors were macroscopically classified into four groups: early HCC, a vaguely nodular type showing preservation of the preexisting liver structure; single nodular type; single nodular type with extranodular growth; and confluent multinodular type. RESULTS. Of 149 resected specimens, 28 (19%) showed satellite lesions. Of the clinicopathologic factors investigated, the macroscopic type and tumor differentiation were significantly associated with the prevalence of satellite lesions. Both the single nodular type with extranodular growth and the confluent multinodular type showed satellite lesions more frequently than the early HCC and the single nodular type. A significantly higher prevalence of satellite lesions was observed in poorly differentiated HCC than in well and moderately differentiated HCC. The satellite lesions were located 0.5 cm or less from the main tumor in 8 (33%) specimens, 0.6-1.0 cm in 12 (50%), and 1.1-2.0 cm in 4 (17%). No identifiable factors were significantly related to the distance from the main tumor to the satellite lesion. However, all satellite lesions located more than 1.0 cm from the main tumor coexisted with poorly differentiated HCC, which were the single nodular type with extranodular growth or the confluent multinodular type. CONCLUSION. In the single nodular type with extranodular growth, confluent multinodular type, and poorly differentiated HCC, extensive treatment achieving a large safety margin and/or frequent posttreatment follow-up examinations may be needed because of the high prevalence of satellite lesions.

Original languageEnglish
Pages (from-to)1931-1937
Number of pages7
JournalCancer
Volume95
Issue number9
DOIs
Publication statusPublished - 2002 Nov 1
Externally publishedYes

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Keywords

  • Clinicopathologic factors
  • Hepatocellular carcinoma
  • Local ablation therapy
  • Satellite lesions

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Okusaka, T., Okada, S., Ueno, H., Ikeda, M., Shimada, K., Yamamoto, J., Kosuge, T., Yamasaki, S., Fukushima, N., & Sakamoto, M. (2002). Satellite lesions in patients with small hepatocellular carcinoma with reference to clinicopathologic features. Cancer, 95(9), 1931-1937. https://doi.org/10.1002/cncr.10892