{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:38:44Z","timestamp":1777523924815,"version":"3.51.4"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,10,7]],"date-time":"2014-10-07T00:00:00Z","timestamp":1412640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2014,10,7]],"date-time":"2014-10-07T00:00:00Z","timestamp":1412640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Small hepatocellular carcinomas (HCC) with poorly differentiated components (PDC) are reportedly at risk of dissemination and needle tract seeding after percutaneous radiofrequency ablation, although it is the preferred treatment for HCC \u2264 2\u00a0cm because of the low rate of vascular invasion. On the other hand, the clinical outcomes after hepatectomy for these tumors are still unclear because of their rarity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 233 cases of solitary HCC \u2264 2\u00a0cm were retrospectively reviewed and divided into two groups according to the presence of PDC: 199 without PDC (NP\u2010HCCs) and 34 with PDC (P\u2010HCCs). The clinicopathological characteristics and prognosis were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A comparison of clinicopathological characteristics showed that the elevation of the tumor markers alpha\u2010fetoprotein (AFP) (&gt;20\u00a0ng\/mL) and des\u2010gamma\u2010carboxyprothrombin (DCP) (&gt;40 AU\/L) was significantly frequent in P\u2010HCCs. The 3\u2010 and 5\u2010year recurrence\u2010free survival rates for P\u2010HCCS were 39 and 29 %, respectively, which were significantly worse than those for NP\u2010HCCs (64 and 50 %, respectively) (<jats:italic>p<\/jats:italic> &lt; 0.01). Initial recurrence of P\u2010HCCs was significantly more frequent, as well as extrahepatic recurrence and advanced recurrence in the early period after the operation. Recurrences with tumor dissemination were observed in 15 % of P\u2010HCCs and 4 % of NP\u2010HCCs (<jats:italic>p<\/jats:italic> = 0.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>PDC is present in 15 % of HCC &lt; 2\u00a0cm and should be suspected when the both tumor markers are elevated. Moreover, significantly worse post\u2010hepatectomy outcomes such as early advanced recurrence or recurrence with dissemination should be taken into account if PDC is present even in HCCs \u2264 2\u00a0cm.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-014-2806-6","type":"journal-article","created":{"date-parts":[[2014,10,6]],"date-time":"2014-10-06T14:57:37Z","timestamp":1412607457000},"page":"1134-1141","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["The Influence of Histological Differentiation Grade on the Outcome of Liver Resection for Hepatocellular Carcinomas 2\u00a0cm or Smaller in Size"],"prefix":"10.1002","volume":"39","author":[{"given":"Kazunari","family":"Sasaki","sequence":"first","affiliation":[{"name":"Department of Digestive Surgery, Hepatopancreatobiliary Surgery Unit Toranomon Hospital Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masamichi","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery, Hepatopancreatobiliary Surgery Unit Toranomon Hospital Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Ohkura","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery, Hepatopancreatobiliary Surgery Unit Toranomon Hospital Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Department of Hepatology Toranomon Hospital Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masafumi","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Pathology Toranomon Hospital Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaji","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery, Hepatopancreatobiliary Surgery Unit Toranomon Hospital Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Hepatology Toranomon Hospital Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiromitsu","family":"Kumada","sequence":"additional","affiliation":[{"name":"Department of Hepatology Toranomon Hospital Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Goro","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery, Hepatopancreatobiliary Surgery Unit Toranomon Hospital Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,10,7]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100676.1987.tb00310.x"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00535\u2010008\u20102274\u20106"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010007\u20109685\u20100"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4986"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572\u20100241.2008.02153.x"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010011\u20102066\u20108"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1159\/000327577"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1872\u2010034X.2010.00703.x"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20798"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v13.i33.4498"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.12079"},{"key":"e_1_2_9_13_2","volume-title":"The general rules for the clinical and pathological study of primary liver cancer","author":"Liver Cancer Study Group of Japan","year":"2010"},{"key":"e_1_2_9_14_2","first-page":"157","volume-title":"World Health Organisation Classification of Tumours: Pathology and genetics of tumours of the digestive system","author":"Hirohashi S","year":"2000"},{"key":"e_1_2_9_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2012.09.026"},{"key":"e_1_2_9_16_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010011\u20102195\u20100"},{"key":"e_1_2_9_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.25832"},{"key":"e_1_2_9_18_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010012\u20102739\u2010y"},{"key":"e_1_2_9_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20933"},{"key":"e_1_2_9_20_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.136.1.25"},{"key":"e_1_2_9_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31820508f1"},{"key":"e_1_2_9_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000171307.37401.db"},{"key":"e_1_2_9_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2007.12.003"},{"key":"e_1_2_9_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10620\u2010010\u20101482\u20100"},{"key":"e_1_2_9_25_2","doi-asserted-by":"publisher","DOI":"10.1159\/000320463"},{"key":"e_1_2_9_26_2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v17.i15.2037"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-014-2806-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-014-2806-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-014-2806-6","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T23:24:56Z","timestamp":1704929096000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-014-2806-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,10,7]]},"references-count":25,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2015,5]]}},"alternative-id":["10.1007\/s00268-014-2806-6"],"URL":"https:\/\/doi.org\/10.1007\/s00268-014-2806-6","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,10,7]]}}}