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Conticchio M, Inchingolo R, Delvecchio A, Ratti F, Gelli M, Anelli MF, Laurent A, Vitali GC, Magistri P, Assirati G, Felli E, Wakabayashi T, Pessaux P, Piardi T, di Benedetto F, de'Angelis N, Briceño J, Rampoldi A, Adam R, Cherqui D, Aldrighetti LA, Memeo R. Peri-operative score for elderly patients with resectable hepatocellular carcinoma. World J Hepatol 2023; 15:1307-1314. [PMID: 38223412 PMCID: PMC10784806 DOI: 10.4254/wjh.v15.i12.1307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/25/2023] [Accepted: 12/04/2023] [Indexed: 12/25/2023] Open
Abstract
BACKGROUND Liver resection is the mainstay for a curative treatment for patients with resectable hepatocellular carcinoma (HCC), also in elderly population. Despite this, the evaluation of patient condition, liver function and extent of disease remains a demanding process with the aim to reduce postoperative morbidity and mortality. AIM To identify new perioperative risk factors that could be associated with higher 90- and 180-d mortality in elderly patients eligible for liver resection for HCC considering traditional perioperative risk scores and to develop a risk score. METHODS A multicentric, retrospective study was performed by reviewing the medical records of patients aged 70 years or older who electively underwent liver resection for HCC; several independent variables correlated with death from all causes at 90 and 180 d were studied. The coefficients of Cox regression proportional-hazards model for six-month mortality were rounded to the nearest integer to assign risk factors' weights and derive the scoring algorithm. RESULTS Multivariate analysis found variables (American Society of Anesthesiology score, high rate of comorbidities, Mayo end stage liver disease score and size of biggest lesion) that had independent correlations with increased 90- and 180-d mortality. A clinical risk score was developed with survival profiles. CONCLUSION This score can aid in stratifying this population in order to assess who can benefit from surgical treatment in terms of postoperative mortality.
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Affiliation(s)
- Maria Conticchio
- Unit of Hepato-Pancreatic-Biliary Surgery, "F. Miulli" Regional General Hospital, Acquaviva Delle Fonti 70021, Italy
| | - Riccardo Inchingolo
- Interventional Radiology Unit, Department of Radiology, "F. Miulli" Regional General Hospital, Acquaviva Delle Fonti 75100, Italy
| | - Antonella Delvecchio
- Unit of Hepato-Pancreatic-Biliary Surgery, "F. Miulli" Regional General Hospital, Acquaviva Delle Fonti 70021, Italy
| | - Francesca Ratti
- Hepatobiliary Surgery Division, IRCSS San Raffaele Scientific Institute, Milan 20132, Italy
- Hepatobiliary Surgery Division, Vita-Salute San Raffaele University, Milan 20132, Italy
| | - Maximiliano Gelli
- Département de Chirurgie Viscérale, Gustave Roussy Cancer Campus Grand Paris, Paris 94800, France
| | | | - Alexis Laurent
- Department of Digestive and Hepatobiliary Surgery, Assistance Publique-Hôpitaux de Paris, Créteil 94000, France
| | | | - Paolo Magistri
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena 41121, Italy
| | - Giacomo Assirati
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena 41121, Italy
| | - Emanuele Felli
- Department of Surgery, Institut de Recherche Contre les Cancers de l'Appareil Digestif (IRCAD), Strasbourg 67000, France
| | - Taiga Wakabayashi
- Department of Surgery, Institut de Recherche Contre les Cancers de l'Appareil Digestif (IRCAD), Strasbourg 67000, France
| | - Patrick Pessaux
- Service de Chirurgie Viscérale et Digestive, Nouvel Hôpital Civil, Unité INSERM U1110, Strasbourg 67000, France
| | - Tullio Piardi
- Department of Surgery, Hôpital Robert Debré, Reims 51092, France
| | - Fabrizio di Benedetto
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena 41121, Italy
| | - Nicola de'Angelis
- Assistance Publique-Hôpitaux de Paris, Centre Hospitalier Universitaire Henri Mondor, Paris 94000, France
| | - Javier Briceño
- Unit of Hepatobiliary Surgery and Liver Transplantation, Hospital University Reina Sofía, Cordoba 14004, Spain
| | - Antonio Rampoldi
- Interventional Radiology Unit, Niguarda Hospital, Milan 20162, Italy
| | - Renè Adam
- Department of Surgery, Centre Hepatobiliaire, Hopital Paul Brousse, Paris 94000, France
| | - Daniel Cherqui
- Department of Surgery, Centre Hepatobiliaire, Hopital Paul Brousse, Paris 94000, France
| | - Luca Antonio Aldrighetti
- Hepatobiliary Surgery Division, IRCSS San Raffaele Scientific Institute, Milan 20132, Italy
- Hepatobiliary Surgery Division, Vita-Salute San Raffaele University, Milan 20132, Italy
| | - Riccardo Memeo
- Unit of Hepato-Pancreatic-Biliary Surgery, "F. Miulli" Regional General Hospital, Acquaviva Delle Fonti 70021, Italy.
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Liu D, Fang JM, Chen XQ. Clinical significance of half-hepatic blood flow occlusion technology in patients with hepatocellular carcinoma with cirrhosis. World J Clin Cases 2022; 10:8547-8555. [PMID: 36157815 PMCID: PMC9453380 DOI: 10.12998/wjcc.v10.i24.8547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/23/2022] [Accepted: 07/22/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Most patients with primary hepatocellular carcinoma (HCC) have a history of chronic hepatitis B and usually present with varying degrees of cirrhosis. Owing to the special nature of liver anatomy, the blood vessel wall in the liver parenchyma is thin and prone to bleeding. Heavy bleeding and blood transfusion during hepatectomy are independent risk factors for liver cancer recurrence and death. Various clinical methods have been used to reduce intraoperative bleeding, and the Pringle method is most widely used to prevent blood flow to the liver.
AIM To investigate the effect of half-hepatic blood flow occlusion after patients with HCC and cirrhosis undergo hepatectomy.
METHODS This retrospective study included 88 patients with HCC and liver cirrhosis who underwent hepatectomy in our hospital from January 2017 to September 2020. Patients were divided into two groups based on the following treatment methods: the research group (n = 44), treated with half-hepatic blood flow occlusion technology and the control group (n = 44), treated with total hepatic occlusion. Differences in operation procedure, blood transfusion, liver function, tumor markers, serum inflammatory response, and incidence of surgical complications were compared between the groups.
RESULTS The operation lasted longer in the research group than in the control group (273.0 ± 24.8 min vs 256.3 ± 28.5 min, P < 0.05), and the postoperative anal exhaust time was shorter in the research group than in the control group (50.0 ± 9.7 min vs 55.1 ± 10.4 min, P < 0.05). There was no statistically significant difference in incision length, surgical bleeding, portal block time, drainage tube indwelling time, and hospital stay between the research and control groups (P > 0.05). Before surgery, there were no significant differences in serum alanine transaminase (ALT), aspartate aminotransferase (AST), total bilirubin, and prealbumin levels between the research and control groups (P > 0.05). Conversely, 24 and 72 h after the operation the respective serum ALT (378.61 ± 77.49 U/L and 246.13 ± 54.06 U/L) and AST (355.30 ± 69.50 U/L and 223.47 ± 48.64 U/L) levels in the research group were significantly lower (P < 0.05) than those in the control group (ALT, 430.58 ± 83.67 U/L and 281.35 ± 59.61 U/L; AST, 416.49 ± 73.03 U/L and 248.62 ± 50.10 U/L). The operation complication rate did not significantly differ between the research group (15.91%) and the control group (22.73%; P > 0.05).
CONCLUSION Half-hepatic blood flow occlusion technology is more beneficial than total hepatic occlusion in reducing liver function injury in hepatectomy for patients with HCC and cirrhosis.
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Affiliation(s)
- Dong Liu
- Department of General Surgery, Yongkang First People’s Hospital of Zhejiang Province, Yongkang 321300, Zhejiang Province, China
| | - Jian-Ming Fang
- Department of Hepatopancreatobiliary Surgery, Jinhua Guangfu Oncology Hospital, Jinhua 321000, Zhejiang Province, China
| | - Xian-Qi Chen
- Department of Hepatopancreatobiliary Surgery, Jinhua Guangfu Oncology Hospital, Jinhua 321000, Zhejiang Province, China
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Wang C, Shi J, Xu J, Fu Q, Ding Y, Yang J, Liu B, Gao Q, Qin J, Liang C. NLRC3 High Expression Represents a Novel Predictor for Positive Overall Survival Correlated With CCL5 and CXCL9 in HCC Patients. Front Oncol 2022; 12:815326. [PMID: 35145917 PMCID: PMC8821914 DOI: 10.3389/fonc.2022.815326] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 01/03/2022] [Indexed: 12/19/2022] Open
Abstract
NLRC3 (NLR family caspase recruitment domain containing 3) has been reported as a factor of inhibiting inflammatory responses. It’s role in HCC (hepatocellular carcinoma) is still unknown. In this study we firstly used the GEO (Gene Expression Omnibus) database and mIHC (multiple immunohistochemical analysis) with TMAs (tumor tissue microarrays) of HCC patients to evaluate NLRC3 levels. The tumor-bearing mouse models were also established with NLRC3 over-expressing and knock-down Hepal-6 cells to assess its effect. The data showed high NLRC3 expression was related with favorable overall survival (P=0.0386) and disease-free survival (P=0.0458). In addition, NLRC3 expression showed a positive correlation between CD8+ T cells infiltration. In vivo, NLRC3-overexpressing Hepal-6 tumors showed increased CD8+ T cell infiltration. NLRC3-knockdown Hepa1-6 tumors displayed decreased CD8+ T cell infiltration. At the same time, we also found the positive correlations between NLRC3 and CCL5 (C-C motif chemokine ligand 5, P<0.0001, R2 = 0.2372) as well as CXCL9 (C-X-C motif chemokine ligand 9, P<0.0001, R2 = 0.2338) expressions. So NLRC3 high expression represents a novel predictor for positive survival outcomes in HCC patients, and NLRC3 is involved in CD8+ T cell infiltration, which is correlated with increased CCL5 and CXCL9 in TME (tumor microenvironment). This study implies that boosting NLRC3 is a promising treatment to enhance survival in HCC patients.
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Affiliation(s)
- Chengpan Wang
- Lab of Tumor Immunology, Department of Human Anatomy, Histology and Embryology, Basic Medical School of Fudan University, Shanghai, China
| | - Jieyi Shi
- Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, and Key Laboratory of Carcinogenesis and Cancer Invasion of Ministry of Education, Shanghai, China
| | - Jietian Xu
- Lab of Tumor Immunology, Department of Human Anatomy, Histology and Embryology, Basic Medical School of Fudan University, Shanghai, China
| | - Qiaoyu Fu
- Lab of Tumor Immunology, Department of Human Anatomy, Histology and Embryology, Basic Medical School of Fudan University, Shanghai, China
| | - Youpeng Ding
- Lab of Tumor Immunology, Department of Human Anatomy, Histology and Embryology, Basic Medical School of Fudan University, Shanghai, China
| | - Jessie Yang
- Lab of Tumor Immunology, Department of Human Anatomy, Histology and Embryology, Basic Medical School of Fudan University, Shanghai, China
| | - Binbin Liu
- Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, and Key Laboratory of Carcinogenesis and Cancer Invasion of Ministry of Education, Shanghai, China
| | - Qiang Gao
- Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, and Key Laboratory of Carcinogenesis and Cancer Invasion of Ministry of Education, Shanghai, China
| | - Jie Qin
- Lab of Tumor Immunology, Department of Human Anatomy, Histology and Embryology, Basic Medical School of Fudan University, Shanghai, China
| | - Chunmin Liang
- Lab of Tumor Immunology, Department of Human Anatomy, Histology and Embryology, Basic Medical School of Fudan University, Shanghai, China
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Zheng Ms B, Wang Ms H, Wang Ms JX, Liu Ms ZH, Zhang Md P, Zhang Md D. The Clinical Significance of RMI2 in Hepatocellular Carcinoma. Technol Cancer Res Treat 2021; 20:15330338211045496. [PMID: 34634948 PMCID: PMC8516379 DOI: 10.1177/15330338211045496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background: Hepatocellular carcinoma (HCC), which is the most common type of primary liver cancer, often presents at advanced stage with a dismal prognosis. Novel tumor biomarkers are needed to aid in HCC early detection and prognostication. Methods: Immunohistochemical staining for RecQ-mediated genome instability protein 2 (RMI2) was performed in 330 surgically resected HCC specimens and 190 adjacent normal tissues. Univariate and multivariate regression analysis were applied to identify prognostic indicators of HCC outcomes. Patient's survival was assessed with the Kaplan-Meier method. Results: RMI2 in HCC tissue was significantly higher than that in adjacent normal tissues, and was positively correlated with HCC histological grade and stage (P < .05) but negatively correlated with the survival period. RIM2 was identified to be an independent prognostic indicator for HCC. Conclusion: The abnormal expression of RMI2 may be related to the occurrence and development of HCC. RIM2 could potentially serve as a novel tumor-specific biomarker for HCC diagnosis and prognosis prediction.
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Affiliation(s)
- Bin Zheng Ms
- 74678Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, China.,The Second Clinical Medical College, 70571Zhejiang Chinese Medical University, HangZhou, China
| | - Heng Wang Ms
- 74678Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, China
| | | | - Zheng-Hong Liu Ms
- The Second Clinical Medical College, 70571Zhejiang Chinese Medical University, HangZhou, China
| | - Pu Zhang Md
- 74678Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Dahong Zhang Md
- 74678Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, China.,The Second Clinical Medical College, 70571Zhejiang Chinese Medical University, HangZhou, China
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Li Q, Xiong DL, Wang H, Jin WL, Ma YY, Fan XM. High Expression of SLC41A3 Correlates with Poor Prognosis in Hepatocellular Carcinoma. Onco Targets Ther 2021; 14:2975-2988. [PMID: 33981147 PMCID: PMC8107057 DOI: 10.2147/ott.s296187] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/16/2021] [Indexed: 12/16/2022] Open
Abstract
Purpose SLC41A3 is a member of the solute carrier family 41 (SLC41) and is involved in many cellular processes as a magnesium ion transporter. Although it plays an important role in cancer formation and development, the correlation between the expression of SLC41A3 and the occurrence and prognosis of hepatocellular carcinoma (HCC) remains unclear. Therefore, this study was focused on the evaluation of the relationship between SLC41A3 and the development and prognosis of HCC. Patients and Methods Firstly, we collected the mRNA expression of SLC41A3 in HCC through the platform of Oncomine. Then, the subgroups of HCC were performed by the UALCAN website and the prognosis of HCC was analyzed by Kaplan-Meier Plotter database. Subsequently, immunohistochemistry (IHC) method was used to detect SLC41A3 expression in 323 clinically confirmed HCC samples and 184 non-cancerous liver tissues. Finally, function enrichment analysis was done using the LinkInterpreter module in LinkedOmics, and gene set enrichment analysis (GSEA) was performed using TCGA data set. Results The Oncomine database and immunohistochemical (IHC) showed higher SLC41A3 expression in HCC tissue compared to normal tissue. The expression of SLC41A3 was significantly correlated with tumor metastasis, Edmondson grade, microvascular invasion, and AFP level. Kaplan-Meier and Cox regression analyses verified that high SLC41A3 expression is a significant prognostic factor for reduced overall survival in HCC patients. Conclusion Our results demonstrated that high expression of SLC41A3 was the predictor of poor prognosis in HCC patients, suggesting that this protein may be a potential target for HCC therapy.
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Affiliation(s)
- Qian Li
- Graduate Department, Bengbu Medical College, Bengbu, Anhui, 233000, People's Republic of China.,Department of Ultrasound, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Dan-Lei Xiong
- School of Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, 310018, People's Republic of China
| | - Heng Wang
- Graduate Department, Bengbu Medical College, Bengbu, Anhui, 233000, People's Republic of China
| | - Wei-Li Jin
- Department of Gastroenterology, Nanxun People's Hospital (Zhejiang Provincial People's Hospital Nanxun Branch), Huzhou, 313009, Zhejiang Province, People's Republic of China
| | - Ying-Yu Ma
- Key Laboratory of Gastroenterology of Zhejiang Province, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Xiao-Ming Fan
- Graduate Department, Bengbu Medical College, Bengbu, Anhui, 233000, People's Republic of China.,Department of Ultrasound, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People's Republic of China
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6
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Mai RY, Zeng J, Meng WD, Lu HZ, Liang R, Lin Y, Wu GB, Li LQ, Ma L, Ye JZ, Bai T. Artificial neural network model to predict post-hepatectomy early recurrence of hepatocellular carcinoma without macroscopic vascular invasion. BMC Cancer 2021; 21:283. [PMID: 33726693 PMCID: PMC7962237 DOI: 10.1186/s12885-021-07969-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 02/24/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The accurate prediction of post-hepatectomy early recurrence (PHER) of hepatocellular carcinoma (HCC) is vital in determining postoperative adjuvant treatment and monitoring. This study aimed to develop and validate an artificial neural network (ANN) model to predict PHER in HCC patients without macroscopic vascular invasion. METHODS Nine hundred and three patients who underwent curative liver resection for HCC participated in this study. They were randomly divided into derivation (n = 679) and validation (n = 224) cohorts. The ANN model was developed in the derivation cohort and subsequently verified in the validation cohort. RESULTS PHER morbidity in the derivation and validation cohorts was 34.8 and 39.2%, respectively. A multivariable analysis revealed that hepatitis B virus deoxyribonucleic acid load, γ-glutamyl transpeptidase level, α-fetoprotein level, tumor size, tumor differentiation, microvascular invasion, satellite nodules, and blood loss were significantly associated with PHER. These factors were incorporated into an ANN model, which displayed greater discriminatory abilities than a Cox's proportional hazards model, preexisting recurrence models, and commonly used staging systems for predicting PHER. The recurrence-free survival curves were significantly different between patients that had been stratified into two risk groups. CONCLUSION When compared to other models and staging systems, the ANN model has a significant advantage in predicting PHER for HCC patients without macroscopic vascular invasion.
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Affiliation(s)
- Rong-Yun Mai
- Department of Hepatobilliary & Pancreatic Surgery, Guangxi Medical University Cancer Hospital, 71 He Di Road, Nanning, China
- Department of Experimental Research, Guangxi Medical University Cancer Hospital, Nanning, 530021, China
- Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning, 530021, China
| | - Jie Zeng
- Department of Experimental Research, Guangxi Medical University Cancer Hospital, Nanning, 530021, China
- Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning, 530021, China
| | - Wei-da Meng
- Department of Hepatobilliary & Pancreatic Surgery, Guangxi Medical University Cancer Hospital, 71 He Di Road, Nanning, China
- Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning, 530021, China
| | - Hua-Ze Lu
- Department of Hepatobilliary & Pancreatic Surgery, Guangxi Medical University Cancer Hospital, 71 He Di Road, Nanning, China
- Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning, 530021, China
| | - Rong Liang
- Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning, 530021, China
- Department of First Chemotherapy, Guangxi Medical University Cancer Hospital, Nanning, 530021, China
| | - Yan Lin
- Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning, 530021, China
- Department of First Chemotherapy, Guangxi Medical University Cancer Hospital, Nanning, 530021, China
| | - Guo-Bin Wu
- Department of Hepatobilliary & Pancreatic Surgery, Guangxi Medical University Cancer Hospital, 71 He Di Road, Nanning, China
- Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning, 530021, China
| | - Le-Qun Li
- Department of Hepatobilliary & Pancreatic Surgery, Guangxi Medical University Cancer Hospital, 71 He Di Road, Nanning, China
- Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning, 530021, China
| | - Liang Ma
- Department of Hepatobilliary & Pancreatic Surgery, Guangxi Medical University Cancer Hospital, 71 He Di Road, Nanning, China
- Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning, 530021, China
| | - Jia-Zhou Ye
- Department of Hepatobilliary & Pancreatic Surgery, Guangxi Medical University Cancer Hospital, 71 He Di Road, Nanning, China.
- Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning, 530021, China.
| | - Tao Bai
- Department of Hepatobilliary & Pancreatic Surgery, Guangxi Medical University Cancer Hospital, 71 He Di Road, Nanning, China.
- Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning, 530021, China.
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7
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Nakajima M, Kobayashi S, Wada H, Tomokuni A, Takahashi H, Noda T, Matsui H, Matsukuma S, Kanekiyo S, Shindo Y, Tokumitsu Y, Nakagami Y, Suzuki N, Takeda S, Tanabe M, Ito K, Hoshii Y, Eguchi H, Nagano H. Viral elimination is essential for improving surgical outcomes of hepatitis C virus-related hepatocellular carcinoma: Multicenter retrospective analysis. Ann Gastroenterol Surg 2020; 4:710-720. [PMID: 33319162 PMCID: PMC7726693 DOI: 10.1002/ags3.12377] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 06/19/2020] [Accepted: 06/24/2020] [Indexed: 01/27/2023] Open
Abstract
AIM The impact of sustained virologic response (SVR) on surgical outcomes for patients with hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) remains controversial. This study aimed to evaluate the influence of SVR on long-term surgical outcomes after hepatectomy. METHODS This multicenter study included 504 patients who underwent curative resection for HCV-related HCC. Patients with a history of HCC treatment, HBV infection, poor liver function, and tumor with major vascular invasion were excluded. Long-term surgical outcomes (overall survival [OS] and recurrence-free survival [RFS]) among patients who achieved SVR before hepatectomy (Pre-SVR group: 58 patients), after hepatectomy (Post-SVR group: 54 patients), and without SVR (Non-SVR group: 186 patients) were compared after adjusting for 13 confounding factors. Using the surgically resected specimens, comparison of the pathological changes in liver fibrosis between the first and second hepatectomy were analyzed. RESULTS Patients with SVR were younger, had better liver function, and less liver fibrosis compared to patients without SVR. Propensity score-matched OS and RFS were significantly better in Pre-SVR group than Non-SVR group (P = .029 and P = .009, respectively). Inverse probability-weighted OS and RFS were also significantly better in the Post-SVR group (P = .001 and P = .021, respectively) than in the Non-SVR group. Histopathological evaluation revealed that only the patients with SVR had regression of liver fibrosis (P < .05). CONCLUSION Achievement of SVR before or after hepatectomy is essential for improving long-term surgical outcomes in patients with HCV-related HCC.
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Affiliation(s)
- Masao Nakajima
- Department of Gastroenterological, Breast and Endocrine SurgeryYamaguchi University Graduate School of MedicineYamaguchiJapan
| | - Shogo Kobayashi
- Department of Gastroenterological SurgeryGraduate School of MedicineOsaka UniversityOsakaJapan
| | - Hiroshi Wada
- Department of SurgeryOsaka International Cancer InstituteOsakaJapan
| | - Akira Tomokuni
- Department of Gastroenterological surgeryOsaka General Medical CenterOsakaJapan
| | | | - Takehiro Noda
- Department of Gastroenterological SurgeryGraduate School of MedicineOsaka UniversityOsakaJapan
| | - Hiroto Matsui
- Department of Gastroenterological, Breast and Endocrine SurgeryYamaguchi University Graduate School of MedicineYamaguchiJapan
| | - Satoshi Matsukuma
- Department of Gastroenterological, Breast and Endocrine SurgeryYamaguchi University Graduate School of MedicineYamaguchiJapan
| | - Shinsuke Kanekiyo
- Department of Gastroenterological, Breast and Endocrine SurgeryYamaguchi University Graduate School of MedicineYamaguchiJapan
| | - Yoshitaro Shindo
- Department of Gastroenterological, Breast and Endocrine SurgeryYamaguchi University Graduate School of MedicineYamaguchiJapan
| | - Yukio Tokumitsu
- Department of Gastroenterological, Breast and Endocrine SurgeryYamaguchi University Graduate School of MedicineYamaguchiJapan
| | - Yuki Nakagami
- Department of Gastroenterological, Breast and Endocrine SurgeryYamaguchi University Graduate School of MedicineYamaguchiJapan
| | - Nobuaki Suzuki
- Department of Gastroenterological, Breast and Endocrine SurgeryYamaguchi University Graduate School of MedicineYamaguchiJapan
| | - Shigeru Takeda
- Department of Gastroenterological, Breast and Endocrine SurgeryYamaguchi University Graduate School of MedicineYamaguchiJapan
| | - Masahiro Tanabe
- Department of RadiologyYamaguchi University Graduate School of MedicineYamaguchiJapan
| | - Katsuyoshi Ito
- Department of RadiologyYamaguchi University Graduate School of MedicineYamaguchiJapan
| | - Yoshinobu Hoshii
- Department of Diagnostic pathologyYamaguchi University HospitalYamaguchiJapan
| | - Hidetoshi Eguchi
- Department of Gastroenterological SurgeryGraduate School of MedicineOsaka UniversityOsakaJapan
| | - Hiroaki Nagano
- Department of Gastroenterological, Breast and Endocrine SurgeryYamaguchi University Graduate School of MedicineYamaguchiJapan
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Wu J, Yang Y, Song J. Expression of SLC17A9 in hepatocellular carcinoma and its clinical significance. Oncol Lett 2020; 20:182. [PMID: 32934749 PMCID: PMC7471742 DOI: 10.3892/ol.2020.12043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 06/24/2020] [Indexed: 12/16/2022] Open
Abstract
The present study aimed to investigate the expression and clinical significance of solute carrier family 17 member 9 (SLC17A9) in cancer tissues of patients with hepatocellular carcinoma (HCC). Ninety-eight patients with HCC were admitted to our hospital from January 2010 to December 2014. Their clinical data was retrospectively analyzed. The expression of SLC17A9 in HCC cancer tissues was detected by immunohistochemistry. Kaplan-Meier curve, log-rank test and Cox proportional hazard model analysis were used to analyze the tumor-free survival rate and overall survival rate. SLC17A9 expression was associated with Edmondson grade (P=0.04) and distant metastasis (P=0.03). The tumor-free survival (P=0.03) and overall survival (P=0.01) of SLC17A9-high expression patients were significantly lower than those in SLC17A9-low expression patients. Multivariate analysis revealed that SLC17A9 expression (HR, 0.77; 95% CI, 0.27–2.47, P=0.02) was an independent risk factor for tumor-free survival in patients with HCC, and the expression of SLC17A9 (HR, 1.81; 95% CI, 0.99–3.77, P=0.04) was an independent risk factor for overall survival in patients with HCC. In conclusion, SLC17A9 can be used as a new molecular marker to predict the poor prognosis of patients with HCC.
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Affiliation(s)
- Jingdong Wu
- Department of Emergency Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hebei 430010, P.R. China
| | - Yongfei Yang
- Department of Emergency Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hebei 430010, P.R. China
| | - Jiansheng Song
- Department of Emergency Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hebei 430010, P.R. China
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Chen X, Ding L, Kong D, Zhao X, Liao L, Zhang Y, Li F, Liu R. FXYD6 overexpression in HBV-related hepatocellular carcinoma with cirrhosis. Open Life Sci 2020; 15:259-266. [PMID: 33817214 PMCID: PMC7874599 DOI: 10.1515/biol-2020-0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 02/11/2020] [Accepted: 02/11/2020] [Indexed: 11/22/2022] Open
Abstract
Objective The aim of this study was to investigate the expression of FXYD domain-containing
ion transport regulator 6 (FXYD6) mRNA and protein in hepatitis B virus
(HBV)-related hepatocellular carcinoma (HCC) tissues with cirrhosis, the
corresponding paracancerous tissues and the normal liver tissues, and to explore
the clinical significance of FXYD6 expression in HBV-related HCC with
cirrhosis. Methods The FXYD6 mRNA and protein were examined by semi-quantitative reverse
transcription polymerase chain reaction and immunohistochemistry,
respectively. Results The FXYD6 mRNA in HBV-related HCC tissues was significantly higher than that in
the cirrhosis tissues or that in the normal liver tissues. The positive expression
rate of FXYD6 protein was statistically higher in HBV-related HCC tissues than
that in HBV-related cirrhosis or that in normal liver tissues. There was no
significant correlation between the expression of FXYD6 protein and gender, age,
histological differentiation, tumor diameter, tumor number, integrity of tumor
capsule or not and alpha fetoprotein (AFP) concentration in serum, but the protein
expression was associated with microvascular invasion, pathological stage, and
early recurrence after operation within 1 year. Conclusion FXYD6 might be involved in hepatocyte carcinogenesis and tumor progression in
HBV-related HCC with cirrhosis and indicated a poor prognosis.
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Affiliation(s)
- Xiongfei Chen
- Department of Hepatobiliary and Pancreatic Surgery, Cangzhou Central Hospital, 16 Xinhuaxi Road, Yunhe District, Cangzhou, 061001, P. R. China
| | - Lishuang Ding
- Department of Hepatobiliary and Pancreatic Surgery, Cangzhou Central Hospital, 16 Xinhuaxi Road, Yunhe District, Cangzhou, 061001, P. R. China
| | - Deshuai Kong
- Department of Hepatobiliary and Pancreatic Surgery, Cangzhou Central Hospital, 16 Xinhuaxi Road, Yunhe District, Cangzhou, 061001, P. R. China
| | - Xiulei Zhao
- Department of Hepatobiliary and Pancreatic Surgery, Cangzhou Central Hospital, 16 Xinhuaxi Road, Yunhe District, Cangzhou, 061001, P. R. China
| | - Lili Liao
- Department of Hepatobiliary and Pancreatic Surgery, Cangzhou Central Hospital, 16 Xinhuaxi Road, Yunhe District, Cangzhou, 061001, P. R. China
| | - Yaomin Zhang
- Department of Hepatobiliary and Pancreatic Surgery, Cangzhou Central Hospital, 16 Xinhuaxi Road, Yunhe District, Cangzhou, 061001, P. R. China
| | - Fengshan Li
- Department of Hepatobiliary and Pancreatic Surgery, Cangzhou Central Hospital, 16 Xinhuaxi Road, Yunhe District, Cangzhou, 061001, P. R. China
| | - Ruhai Liu
- Department of Hepatobiliary and Pancreatic Surgery, Cangzhou Central Hospital, 16 Xinhuaxi Road, Yunhe District, Cangzhou, 061001, P. R. China
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10
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Xu W, Li R, Liu F. Novel Prognostic Nomograms for Predicting Early and Late Recurrence of Hepatocellular Carcinoma After Curative Hepatectomy. Cancer Manag Res 2020; 12:1693-1712. [PMID: 32214844 PMCID: PMC7082541 DOI: 10.2147/cmar.s241959] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 02/25/2020] [Indexed: 01/27/2023] Open
Abstract
Aim Hepatectomy is the main curative method for patients with hepatocellular carcinoma (HCC) in China. Unfortunately, high recurrence rate after hepatectomy poses negative impact on the prognosis of patients. This study aimed to develop prognostic nomograms to predict early recurrence (ER) and late recurrence (LR) of HCC after curative hepatectomy. Patients and Methods Total of 318 HCC patients undergoing curative hepatectomy from January 2012 to January 2018 were retrospectively recruited. Potential risk factors that were significant for predicting ER and LR in univariate analysis were selected for multivariate survival model analysis using the backward stepwise method. Risk factors identified in multivariate analysis were used to develop nomograms to predict ER and LR. The nomogram was internally validated using 2,000 bootstrap samples from 75% of the original data. Results Among 318 patients, 164 showed postoperative recurrence, of which 140 and 24 had ER (≤2 years) and LR (>2 years), respectively. Multivariate analysis showed that age, Hong Kong Liver Cancer Stage, albumin-bilirubin, METAVIR fibrosis grade, and microvascular invasion were risk factors of ER for HCC after curative hepatectomy. The AUC of the ROC curve for ER in the development set (D-set) was 0.888 while that in the validation set (V-set) was 0.812. Neutrophil/lymphocyte ratio and glypican-3 (+) were risk factors for LR in HCC patients after curative hepatectomy. The AUC of the ROC curve for LR predictive nomogram that integrated all independent predictors was 0.831. The AUC of the ROC curve for LR in the D-set was 0.833, while that for LR in the V-set was 0.733. The C-index and AUC of ROC for the proposed nomograms were more satisfactory than three conventional HCC staging systems used in this study. Conclusion We developed novel nomograms to predict ER and LR of HCC patients after curative hepatectomy for clinical use to individualize follow-up and therapeutic strategies.
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Affiliation(s)
- Wei Xu
- Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital, The First Hospital Affiliated with Hunan Normal University, Changsha 410005, People's Republic of China
| | - Ruineng Li
- Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital, The First Hospital Affiliated with Hunan Normal University, Changsha 410005, People's Republic of China
| | - Fei Liu
- Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital, The First Hospital Affiliated with Hunan Normal University, Changsha 410005, People's Republic of China
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11
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Wang J, Huang A, Wang YP, Yin Y, Fu PY, Zhang X, Zhou J. Circulating tumor DNA correlates with microvascular invasion and predicts tumor recurrence of hepatocellular carcinoma. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:237. [PMID: 32309384 PMCID: PMC7154404 DOI: 10.21037/atm.2019.12.154] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background To evaluate the feasibility of predicting tumor recurrence of hepatocellular carcinoma (HCC) patients after curative hepatectomy by detection of circulating tumor DNA (ctDNA) through droplet digital PCR (ddPCR). Methods HCC patients receiving surgical treatment were enrolled and peripheral blood samples before and after hepatectomy were collected. Four hotspot mutants, TP53-rs28934571 (c.747G>T), TRET-rs1242535815 (c.1-124C>T), CTNNB1-rs121913412 (c.121A>G) and CTNNB1-rs121913407 (c.133T>C) were selected to detect ctDNA and the mutant allele frequency (MAF) was calculated accordingly. The matched peripheral blood mononuclear cells (PBMCs) were used for Sanger sequencing. The clinicopathologic information of the patients was retrospectively analyzed and the predictive abilities for postoperative recurrence of different clinicopathologic parameters and ctDNA were compared. Results Eighty-one patients were enrolled and 70.4% (57/81) of them had detectable ctDNA before hepatectomy. Positive preoperative ctDNA status was related to larger tumor size (P=0.001), multiple tumor lesions (P=0.001), microvascular invasion (MVI) (P<0.001), advanced BCLC stages (P<0.001) and shorter disease free survival (DFS) (P<<0.001) and overall survival (OS) (P<<0.001). Multivariate analysis showed that detectable ctDNA was the independent risk factor for postoperative recurrence. Moreover, receiver operating characteristic (ROC) curves proved that ctDNA possessed the second largest area under the curve (AUC) in foretelling postoperative recurrence right after BCLC stage. For patients after surgery, the alterations of MAF were also correlated to postsurgical recurrence. Patients with increased MAF had more incidences of MVI (P=0.016) and recurrence (P<0.001). At the same time, Kaplan-Meier curves revealed a significant shorter DFS and OS in the patients with increased MAF compared to the patients with decreased MAF (P<0.001 and P=0.0045, respectively) and ROC curves showed MAF to possess the greatest AUC among all the indices for postoperative recurrence. Conclusions Digital droplets PCR assessment of specific gene combination through ctDNA possesses potential prognostic value in HCC patients undergoing surgical treatment.
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Affiliation(s)
- Jian Wang
- Department of Liver Surgery & Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University; Key Laboratory of Carcinogenesis and Cancer Invasion (Fudan University), Ministry of Education, Shanghai 200032, China
| | - Ao Huang
- Department of Liver Surgery & Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University; Key Laboratory of Carcinogenesis and Cancer Invasion (Fudan University), Ministry of Education, Shanghai 200032, China
| | - Yu-Peng Wang
- Department of Liver Surgery & Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University; Key Laboratory of Carcinogenesis and Cancer Invasion (Fudan University), Ministry of Education, Shanghai 200032, China
| | - Yue Yin
- Department of Liver Surgery & Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University; Key Laboratory of Carcinogenesis and Cancer Invasion (Fudan University), Ministry of Education, Shanghai 200032, China
| | - Pei-Yao Fu
- Department of Liver Surgery & Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University; Key Laboratory of Carcinogenesis and Cancer Invasion (Fudan University), Ministry of Education, Shanghai 200032, China
| | - Xin Zhang
- Department of Liver Surgery & Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University; Key Laboratory of Carcinogenesis and Cancer Invasion (Fudan University), Ministry of Education, Shanghai 200032, China
| | - Jian Zhou
- Department of Liver Surgery & Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University; Key Laboratory of Carcinogenesis and Cancer Invasion (Fudan University), Ministry of Education, Shanghai 200032, China.,Institute of Biomedical Sciences, Fudan University, Shanghai 200032, China.,State Key Laboratory of Genetic Engineering Fudan University, Shanghai 200433, China
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12
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Tokumitsu Y, Shindo Y, Matsui H, Matsukuma S, Nakajima M, Suzuki N, Takeda S, Wada H, Kobayashi S, Eguchi H, Ueno T, Nagano H. Utility of scoring systems combining the product of tumor number and size with liver function for predicting the prognosis of patients with hepatocellular carcinoma after hepatectomy. Oncol Lett 2019; 18:3903-3913. [PMID: 31516601 DOI: 10.3892/ol.2019.10688] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 07/02/2019] [Indexed: 12/13/2022] Open
Abstract
Our previous study reported the effectiveness of the product of tumor number and size (NxS factor) as a predictor of the prognosis of patients with hepatocellular carcinoma (HCC) following hepatectomy. The aim of the present study was to validate the prognostic value of scoring systems based on the NxS factor for HCC. The records of 940 patients who underwent hepatectomy for HCC at Osaka University Graduate School of Medicine and Osaka International Cancer Institute were analyzed. The discriminatory abilities of the mathematical integrated model for tumor staging (MITS) score, which combines the NxS factor with liver function, and known prognostic systems, including the Japan Integrated Staging system, the Barcelona Clinic Liver Cancer, Cancer of the Liver Italian Program and the Tokyo system, were compared. Firstly, the present study demonstrated that a higher NxS factor was associated with decreased disease-free survival (DFS) and overall survival (OS) in patients with HCC (P<0.05). Subsequently, univariate analysis of DFS and OS curves revealed significant differences among all NxS factor and liver damage combinations (MITS-LD score; score 0 vs. score 1; score 1 vs. score 2; score 2 vs. score 3; all P<0.05) and all NxS factor and albumin-bilirubin (ALBI) score combinations (MITS-ALBI score; score 0 vs. score 1; score 1 vs. score 2; score 2 vs. score 3; all P<0.05). Furthermore, multivariate Cox proportional hazards model analysis demonstrated that there were significant differences in DFS [Hazard Ratio (HR); score 0 vs. score 1 (1.48); score 1 vs. score 2 (1.27); score 2 vs. score 3 (1.64); all P<0.05] and OS [HR; score 0 vs. score 1 (1.34); score 1 vs. score 2 (1.29); score 2 vs. score 3 (1.64); all P<0.05] among patients with different MITS-LD scores, and there were significant differences in DFS [HR; score 0 vs. score 1 (1.38); score 1 vs. score 2 (1.43); score 2 vs. score 3 (1.60); all P<0.05] among patients with different MITS-ALBI scores. The NxS factor may be a comprehensive measure of tumor burden for predicting the prognosis of patients with HCC following liver resection, and MITS scores could be an improved scoring system for predicting the prognosis of patients with HCC after hepatectomy.
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Affiliation(s)
- Yukio Tokumitsu
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan
| | - Yoshitaro Shindo
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan
| | - Hiroto Matsui
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan
| | - Satoshi Matsukuma
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan
| | - Masao Nakajima
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan
| | - Nobuaki Suzuki
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan
| | - Shigeru Takeda
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan
| | - Hiroshi Wada
- Department of Digestive Surgery, Osaka International Cancer Institute, Osaka 541-8567, Japan
| | - Shogo Kobayashi
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan
| | - Hidetoshi Eguchi
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan
| | - Tomio Ueno
- Department of Digestive Surgery, Kawasaki Medical School, Kurashiki, Okayama 701-0192, Japan
| | - Hiroaki Nagano
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan
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13
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Huang Y, Zhang Z, Zhou Y, Yang J, Hu K, Wang Z. Should we apply sorafenib in hepatocellular carcinoma patients with microvascular invasion after curative hepatectomy? Onco Targets Ther 2019; 12:541-548. [PMID: 30666133 PMCID: PMC6334782 DOI: 10.2147/ott.s187357] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Objective Microvascular invasion (MVI) has been proved to be an independent risk factor for the recurrence of HCC. If promptly treated, the recurrence rate can be reduced and the total survival time can be prolonged. The aim of this study is to analyze the effect of sorafenib on the clinical outcomes in HCC patients with MVI after curative hepatectomy. Methods HCC patients who underwent hepatectomy and were pathologically diagnosed with MVI were retrospectively analyzed. Patients were divided into sorafenib group and control group. Sorafenib 400 mg, twice daily, was administered orally after surgery in the sorafenib group. The recurrence-free survival (RFS) and overall survival (OS) were observed during follow-up, and associated factors were analyzed using univariate and multivariate COX regression. Results There was no significant difference in demographics, clinical staging, and tumor index between sorafenib group (16 patients) and control group (33 matched patients). The RFS and OS were both longer in the sorafenib group, and the 3-years RFS rates of the sorafenib group and control group were 56.3% (9 of 16) and 24.2% (8 of 33), respectively (P=0.027). The 3-year OS rate of the sorafenib group was 81.3% (13 of 16), which was significantly higher than that of the control group (39.4%, P=0.006). The results of multivariate COX regression indicated that treatment with sorafenib was an independent associated factor for RFS and OS. Conclusion We believe that using sorafenib therapy after curative hepatectomy in HCC patients with MVI is effective and beneficial as it can reduce recurrence and prolong the survival time.
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Affiliation(s)
- Yun Huang
- Department of Hepatobiliary Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China,
| | - Zeyu Zhang
- Department of Hepatobiliary Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China,
| | - Yufan Zhou
- Department of Hepatobiliary Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China,
| | - Jiajin Yang
- Department of Hepatobiliary Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China,
| | - Kuan Hu
- Department of Hepatobiliary Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China,
| | - Zhiming Wang
- Department of Hepatobiliary Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China,
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14
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Zhang Y, Chen SW, Liu LL, Yang X, Cai SH, Yun JP. A model combining TNM stage and tumor size shows utility in predicting recurrence among patients with hepatocellular carcinoma after resection. Cancer Manag Res 2018; 10:3707-3715. [PMID: 30288102 PMCID: PMC6159804 DOI: 10.2147/cmar.s175303] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Objective Hepatocellular carcinoma (HCC) recurrence is a clinical challenge. An accurate prediction system for patients with HCC is needed, since the choice of HCC treatment strategies is very important. Patients and methods A total of 804 patients with HCC who underwent curative resection at Sun Yat-sen University Cancer Center were included in this study. Demographics, clinicopathological data, and follow-up information were collected. Results A logistic regression analysis was conducted to investigate the relationships between clinical features and HCC recurrence. Tumor size (OR=1.454, 95% CI: 1.047–2.020, P=0.026) and TNM stage (OR=1.360, 95% CI: 1.021–1.813, P=0.036) were independent predictors of HCC recurrence after curative resection. Therefore, the following equation was established to predict HCC recurrence: 0.308×TNM+0.374×tumor size–0.639. The equation score was 0.53±0.23 in patients who experienced HCC recurrence compared with 0.47±0.24 in other patients. A similar trend was observed in patients who survived after the last follow-up, compared with those who did not, with scores of 0.37±0.26 vs 0.52±0.22, respectively (P<0.001). The Kaplan–Meier analysis showed that patients with HCC with equation values >0.5 had significantly worse outcomes than those with equation values ≤0.5 (P<0.001) for overall survival (OS) and recurrence (P=0.043). Multivariate Cox analyses showed that tumor multiplicity (P=0.039), involucrum (P=0.029), vascular invasion (P<0.001), and equation value (P<0.001) were independent prognostic variables for OS, whereas tumor multiplicity (P=0.01), tumor differentiation (P=0.007), vascular invasion (P<0.001), involucrum (P=0.01), and equation value (P<0.001) were independent prognostic variables for HCC recurrence. Conclusion We established a novel and effective equation for predicting the probability of recurrence and OS after curative resection. Patients with a high recurrence score, based on this equation, should undergo additional high-end imaging examinations.
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Affiliation(s)
- Yu Zhang
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China, .,Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China,
| | - Shu-Wei Chen
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China, .,Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Li-Li Liu
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China, .,Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China,
| | - Xia Yang
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China, .,Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China,
| | - Shao-Hang Cai
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China, .,Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China,
| | - Jing-Ping Yun
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China, .,Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China,
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15
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Jaruvongvanich V, Sempokuya T, Wong L. Is there an optimal staging system or liver reserve model that can predict outcome in hepatocellular carcinoma? J Gastrointest Oncol 2018; 9:750-761. [PMID: 30151272 DOI: 10.21037/jgo.2018.05.11] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Background Many staging systems and liver reserve models have been proposed to predict hepatocellular carcinoma (HCC) prognosis. However, there is no consensus as to which model provides the best prognostic value. We aimed to investigate the prognostic role of 8 noninvasive models including the albumin-bilirubin index (ALBI), AST to platelet ratio index (APRI), Barcelona Clinic Liver Cancer (BCLC), Cancer of the Liver Italian Program (CLIP) system, Child-Pugh (CP) class, Fibrosis-4 (FIB-4) score, model for end-stage liver disease (MELD) score, and platelet-albumin-bilirubin index (PALBI) in patients with HCC. Methods This is a retrospective study of 900 HCC patients. Patients who underwent transplantation were excluded. The Kaplan-Meier method was used to estimate the survival probabilities. Multivariate cox proportional hazard models were used to calculate the survival trend. P<0.05 was considered significant. The area under receiver operating characteristic curve (AUC) was calculated to test the discriminatory power over 1- and 3-year mortality and recurrence. Results For predicting 1- and 3-year mortality, the CLIP score provided the highest AUC value, followed by the BCLC stage and the PALBI grade. For predicting 3-year recurrence, the CLIP score demonstrated the highest discriminative power followed by the PALBI grade, ALBI grade and BCLC system. However, all included models were found to be poor predictors for recurrence. Conclusions The CLIP score is more accurate prognostic model to predict mortality and recurrence than the BCLC stage. Regarding the liver reserve models, the PALBI is the most accurate prognostic models among 6 models to predict mortality and recurrence.
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Affiliation(s)
| | - Tomoki Sempokuya
- Department of Internal Medicine, University of Hawaii, Honolulu, HI, USA
| | - Linda Wong
- Department of Surgery, University of Hawaii, Honolulu, HI, USA
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