{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T19:06:20Z","timestamp":1760295980013},"reference-count":0,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2014,4,19]],"date-time":"2014-04-19T00:00:00Z","timestamp":1397865600000},"content-version":"vor","delay-in-days":4887,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2000,12,1]],"date-time":"2000-12-01T00:00:00Z","timestamp":975628800000},"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":[[2000,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The presence of small additional hepatocellular carcinomas (HCCs) undetectable before hepatic resection is a crucial topic for hepatic surgeons. We assessed the incidence of pathologically diagnosed multiple HCCs in 267 patients who underwent hepatic resection for HCC. Ninety\u2010five additional HCC nodules were detected in 72 of the patients (27%). The survival rate of these 72 patients was significant worse than for the 195 with single nodular HCC (<jats:italic>p<\/jats:italic>= 0.0013). Twenty\u2010one (22%) were detected before surgery, 29 (31%) during surgery, and 45 (47%) on pathologic examination after surgery. The mean nodule diameters for each group were 2.1, 1.0, and 0.9\u00a0cm, respectively (<jats:italic>p<\/jats:italic> &lt; 0.0001). None of the 21\u00a0nodules detected before surgery was well differentiated, whereas 30 of the 74\u00a0nodules in the other two groups were well\u2010differentiated. Although the mean nodule diameter of the well\u2010differentiated HCC group was the smallest, there was no significant difference among the three groups assigned according to tumor differentiation (<jats:italic>p<\/jats:italic>= 0.2355). Altogether, 9 of 16 patients with additional nodules detected before surgery (56%) and 49 of 59 with additional nodules detected during or after surgery (88%) had cirrhosis of the liver. The odds ratio for detecting a new HCC nodule during or after surgery in the presence of cirrhosis was 5.444 (<jats:italic>p<\/jats:italic>= 0.0087). Improvement in the detection of small additional HCC nodules before and during surgery and meticulous follow\u2010up after surgery are necessary for patients with cirrhosis. For patients without cirrhosis, surgical treatment may be performed according to the results of preoperative imaging studies.<\/jats:p>","DOI":"10.1007\/s002680010278","type":"journal-article","created":{"date-parts":[[2002,8,25]],"date-time":"2002-08-25T05:57:49Z","timestamp":1030255069000},"page":"1566-1569","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Additional Hepatocellular Carcinomas Undetectable before Surgery"],"prefix":"10.1002","volume":"24","author":[{"given":"Taichi","family":"Shuto","sequence":"first","affiliation":[{"name":"Second Department of Surgery Osaka City University Medical School 1\u20104\u20103 Asahi\u2010machi, Abeno\u2010ku, Osaka 545\u20108585 Japan<!--<country1>JP<\/country1>-->"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuhiro","family":"Hirohashi","sequence":"additional","affiliation":[{"name":"Second Department of Surgery Osaka City University Medical School 1\u20104\u20103 Asahi\u2010machi, Abeno\u2010ku, Osaka 545\u20108585 Japan<!--<country1>JP<\/country1>-->"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Ikebe","sequence":"additional","affiliation":[{"name":"Second Department of Pathology Osaka City University Medical School 1\u20104\u20103 Asahi\u2010machi, Abeno\u2010ku, Osaka 545\u20108585 Japan<!--<country1>JP<\/country1>-->"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinichi","family":"Mikami","sequence":"additional","affiliation":[{"name":"Second Department of Surgery Osaka City University Medical School 1\u20104\u20103 Asahi\u2010machi, Abeno\u2010ku, Osaka 545\u20108585 Japan<!--<country1>JP<\/country1>-->"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takatsugu","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Second Department of Pathology Osaka City University Medical School 1\u20104\u20103 Asahi\u2010machi, Abeno\u2010ku, Osaka 545\u20108585 Japan<!--<country1>JP<\/country1>-->"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shoji","family":"Kubo","sequence":"additional","affiliation":[{"name":"Second Department of Surgery Osaka City University Medical School 1\u20104\u20103 Asahi\u2010machi, Abeno\u2010ku, Osaka 545\u20108585 Japan<!--<country1>JP<\/country1>-->"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenichi","family":"Wakasa","sequence":"additional","affiliation":[{"name":"Department of Pathology Osaka City University Hospital 1\u20104\u20103 Asahi\u2010machi, Abeno\u2010ku, Osaka 545\u20108585 Japan<!--<country1>JP<\/country1>-->"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroaki","family":"Kinoshita","sequence":"additional","affiliation":[{"name":"Second Department of Surgery Osaka City University Medical School 1\u20104\u20103 Asahi\u2010machi, Abeno\u2010ku, Osaka 545\u20108585 Japan<!--<country1>JP<\/country1>-->"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,4,19]]},"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s002680010278.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s002680010278\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s002680010278","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T19:32:56Z","timestamp":1705001576000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s002680010278"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,12]]},"references-count":0,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2000,12]]}},"alternative-id":["10.1007\/s002680010278"],"URL":"https:\/\/doi.org\/10.1007\/s002680010278","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2000,12]]}}}