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Combined measurements of tumor number and size helps estimate the outcome of resection of Barcelona clinic liver cancer stage B hepatocellular carcinoma.

Wang X, Wang Z, Wu L - BMC Surg (2016)

Bottom Line: However, the portion of patients with stage B that will achieve better outcomes from surgical treatment remains unclear.Cumulative tumor size >5.0 cm and tumor number ≥4 were independent prognostic risk factors for DFS.The 1-, 2-, and 5- year DFS rates and OS rates of patients with at least one of these two factors were 49.0, 17.2, and 7.4% (for DFS), and 78.6, 54.8, and 13.4% (for OS), respectively, which were significantly lower than patients without these two factors (77.8, 58.3, and 27.2% for DFS, and 94.4, 83.3,and 51.8% for OS, respectively, P < 0.01).

View Article: PubMed Central - PubMed

Affiliation: Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Qingdao University, Qingdao, 266000, China.

ABSTRACT

Background: Although the Barcelona Clinic Liver Cancer (BCLC) staging system suggests that patients with stage B hepatocellular carcinoma (HCC) should be treated with transcatheter arterial chemoembolization instead of surgical treatment, recent studies indicated that the prognosis of surgical resection for patients with BCLC stage B HCC was better than that of TACE. However, the portion of patients with stage B that will achieve better outcomes from surgical treatment remains unclear. In this study, we identified risk factors that influence the prognosis of BCLC stage B HCC after R0 surgical resection to determine whether some patients with stage B HCC may benefit more from R0 resection than other patients and to provide a guideline to estimate the tendency.

Methods: The clinical data of 78 patients with BCLC stage B HCC after R0 surgical treatment within 11 years were analyzed retrospectively, using relapse or death as the endpoint. Kaplan-Meier survival and Cox regression analyses were used to study prognosis (disease-free survival, DFS and overall survival, OS) and independent risk factors.

Results: For all stage B patients, 1-, 2-, and 5-year DFS rates were 62.5, 36.4, and 16.6%, respectively. Cumulative tumor size >5.0 cm and tumor number ≥4 were independent prognostic risk factors for DFS. The 1-, 2-, and 5- year DFS rates and OS rates of patients with at least one of these two factors were 49.0, 17.2, and 7.4% (for DFS), and 78.6, 54.8, and 13.4% (for OS), respectively, which were significantly lower than patients without these two factors (77.8, 58.3, and 27.2% for DFS, and 94.4, 83.3,and 51.8% for OS, respectively, P < 0.01).

Conclusions: The analyses indicated that the outcomes of R0 resection were much better for patients with BCLC stage B HCC with two or three tumors and cumulative tumor sizes of ≤5.0 but >3.0 cm than other patients with stage B.

No MeSH data available.


Related in: MedlinePlus

Disease-free survival (DFS) curves of tumor number ≤3 and ≥4. The upper curve represents DFS of patients with ≤3 tumors, while the lower curve represents DFS of patients with ≥4 tumors
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Fig2: Disease-free survival (DFS) curves of tumor number ≤3 and ≥4. The upper curve represents DFS of patients with ≤3 tumors, while the lower curve represents DFS of patients with ≥4 tumors

Mentions: Then, the receiver operating characteristic (ROC) curve was applied for further analysis. The tumor number was regarded as a test variable while the recurrence a state variable. The area under the curve was 69.4 % (P = 0.024) and the Youden index was 2.5 (specificity = 78.6 %, sensitivity = 56.3 %) (Fig. 1). We took the tumor number of 3 as the critical value according to the Youden index. The 1-, 2-, and 5-year DFS rates for the patients with tumor number ≤ 3 (56 cases) and ≥4 (22 cases) were 71.4, 48.2, and 23 % (for number ≤3), and 38.5, 4.8 and 0 % (for number ≥4), respectively (P = 0.000) (Fig. 2). These analytic data clearly indicate that the patients with 2 to 3 tumor number survived better with much lower recurrence rates than those with tumor number ≥4.Fig. 1


Combined measurements of tumor number and size helps estimate the outcome of resection of Barcelona clinic liver cancer stage B hepatocellular carcinoma.

Wang X, Wang Z, Wu L - BMC Surg (2016)

Disease-free survival (DFS) curves of tumor number ≤3 and ≥4. The upper curve represents DFS of patients with ≤3 tumors, while the lower curve represents DFS of patients with ≥4 tumors
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4837634&req=5

Fig2: Disease-free survival (DFS) curves of tumor number ≤3 and ≥4. The upper curve represents DFS of patients with ≤3 tumors, while the lower curve represents DFS of patients with ≥4 tumors
Mentions: Then, the receiver operating characteristic (ROC) curve was applied for further analysis. The tumor number was regarded as a test variable while the recurrence a state variable. The area under the curve was 69.4 % (P = 0.024) and the Youden index was 2.5 (specificity = 78.6 %, sensitivity = 56.3 %) (Fig. 1). We took the tumor number of 3 as the critical value according to the Youden index. The 1-, 2-, and 5-year DFS rates for the patients with tumor number ≤ 3 (56 cases) and ≥4 (22 cases) were 71.4, 48.2, and 23 % (for number ≤3), and 38.5, 4.8 and 0 % (for number ≥4), respectively (P = 0.000) (Fig. 2). These analytic data clearly indicate that the patients with 2 to 3 tumor number survived better with much lower recurrence rates than those with tumor number ≥4.Fig. 1

Bottom Line: However, the portion of patients with stage B that will achieve better outcomes from surgical treatment remains unclear.Cumulative tumor size >5.0 cm and tumor number ≥4 were independent prognostic risk factors for DFS.The 1-, 2-, and 5- year DFS rates and OS rates of patients with at least one of these two factors were 49.0, 17.2, and 7.4% (for DFS), and 78.6, 54.8, and 13.4% (for OS), respectively, which were significantly lower than patients without these two factors (77.8, 58.3, and 27.2% for DFS, and 94.4, 83.3,and 51.8% for OS, respectively, P < 0.01).

View Article: PubMed Central - PubMed

Affiliation: Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Qingdao University, Qingdao, 266000, China.

ABSTRACT

Background: Although the Barcelona Clinic Liver Cancer (BCLC) staging system suggests that patients with stage B hepatocellular carcinoma (HCC) should be treated with transcatheter arterial chemoembolization instead of surgical treatment, recent studies indicated that the prognosis of surgical resection for patients with BCLC stage B HCC was better than that of TACE. However, the portion of patients with stage B that will achieve better outcomes from surgical treatment remains unclear. In this study, we identified risk factors that influence the prognosis of BCLC stage B HCC after R0 surgical resection to determine whether some patients with stage B HCC may benefit more from R0 resection than other patients and to provide a guideline to estimate the tendency.

Methods: The clinical data of 78 patients with BCLC stage B HCC after R0 surgical treatment within 11 years were analyzed retrospectively, using relapse or death as the endpoint. Kaplan-Meier survival and Cox regression analyses were used to study prognosis (disease-free survival, DFS and overall survival, OS) and independent risk factors.

Results: For all stage B patients, 1-, 2-, and 5-year DFS rates were 62.5, 36.4, and 16.6%, respectively. Cumulative tumor size >5.0 cm and tumor number ≥4 were independent prognostic risk factors for DFS. The 1-, 2-, and 5- year DFS rates and OS rates of patients with at least one of these two factors were 49.0, 17.2, and 7.4% (for DFS), and 78.6, 54.8, and 13.4% (for OS), respectively, which were significantly lower than patients without these two factors (77.8, 58.3, and 27.2% for DFS, and 94.4, 83.3,and 51.8% for OS, respectively, P < 0.01).

Conclusions: The analyses indicated that the outcomes of R0 resection were much better for patients with BCLC stage B HCC with two or three tumors and cumulative tumor sizes of ≤5.0 but >3.0 cm than other patients with stage B.

No MeSH data available.


Related in: MedlinePlus