Redefining Hepatocellular Carcinoma Staging Systems Based on the Bile Duct Invasion Status: A Multicenter Study
Background and AimsThe prognostic value of bile duct invasion (BDI) remains controversial. We aimed to investigate the prognostic value of BDI and the stage of BDI in different staging systems.MethodsPatients with hepatocellular carcinoma (HCC) from nine hepatobiliary medical centers who underwent R...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-10-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.673285/full |
| _version_ | 1819025003539070976 |
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| author | Qizhen Huang Yufeng Chen Kongying Lin Chuandong Sun Shuguo Zheng Jinhong Chen Yifan Wang Yanming Zhou Weiping Zhou Jingfeng Liu Jingfeng Liu Yongyi Zeng Yongyi Zeng |
| author_facet | Qizhen Huang Yufeng Chen Kongying Lin Chuandong Sun Shuguo Zheng Jinhong Chen Yifan Wang Yanming Zhou Weiping Zhou Jingfeng Liu Jingfeng Liu Yongyi Zeng Yongyi Zeng |
| author_sort | Qizhen Huang |
| collection | DOAJ |
| description | Background and AimsThe prognostic value of bile duct invasion (BDI) remains controversial. We aimed to investigate the prognostic value of BDI and the stage of BDI in different staging systems.MethodsPatients with hepatocellular carcinoma (HCC) from nine hepatobiliary medical centers who underwent R0 resection were included. Overall survival (OS) was assessed using the Kaplan–Meier method and tested using the log-rank test. The prognostic effect of BDI was analyzed using univariate and multivariate Cox proportional hazard regression analyses. The predictive performance of these models was evaluated using the concordance index and time-dependent receiver operating characteristic curve (tdAUC).ResultsOf 1021 patients with HCC, 177 had BDI. OS was worse in the HCC with BDI group than in the HCC without BDI group (p<0.001); multivariate analysis identified BDI as an independent risk factor for OS. After adjustment for interference of confounding factors using the Cox proportional hazard regression model, HCC with BDI and without macrovascular invasion was classified as Barcelona Clinic Liver Cancer (BCLC) B, eighth edition American Joint Committee on Cancer (AJCC) IIIA, and China Liver Cancer (CNLC) IIb, respectively, whereas HCC with BDI and macrovascular was classified as BCLC C, AJCC IIIB, and CNLC IIIA, respectively. C-indexes and tdAUCs of the adjusted staging systems were superior to those of the corresponding current staging systems.ConclusionWe constructed adjusted staging systems with the BDI status, improved their predictive performance and facilitate clinical use. |
| first_indexed | 2024-12-21T05:03:46Z |
| format | Article |
| id | doaj.art-2041dfa5aa1d435db3e622046b01f3ac |
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| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-21T05:03:46Z |
| publishDate | 2021-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-2041dfa5aa1d435db3e622046b01f3ac2022-12-21T19:15:10ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-10-011110.3389/fonc.2021.673285673285Redefining Hepatocellular Carcinoma Staging Systems Based on the Bile Duct Invasion Status: A Multicenter StudyQizhen Huang0Yufeng Chen1Kongying Lin2Chuandong Sun3Shuguo Zheng4Jinhong Chen5Yifan Wang6Yanming Zhou7Weiping Zhou8Jingfeng Liu9Jingfeng Liu10Yongyi Zeng11Yongyi Zeng12Department of Radiation Oncology, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, ChinaDepartment of Hepatopancreatobiliary Surgery, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, ChinaDepartment of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, ChinaDepartment of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Qingdao University, Qingdao, ChinaInstitute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Chongqing, ChinaDepartment of General Surgery, Huashan Hospital, Fudan University, Shanghai, ChinaDepartment of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, ChinaDepartment of Hepato-Biliary-Pancreato-Vascular Surgery, First Affiliated Hospital of Xiamen University, Xiamen, ChinaThe Third Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, ChinaDepartment of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China0Department of Hepatopancreatobiliary Surgery, First Affiliated Hospital of Fujian Medical University, Fuzhou, ChinaDepartment of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China0Department of Hepatopancreatobiliary Surgery, First Affiliated Hospital of Fujian Medical University, Fuzhou, ChinaBackground and AimsThe prognostic value of bile duct invasion (BDI) remains controversial. We aimed to investigate the prognostic value of BDI and the stage of BDI in different staging systems.MethodsPatients with hepatocellular carcinoma (HCC) from nine hepatobiliary medical centers who underwent R0 resection were included. Overall survival (OS) was assessed using the Kaplan–Meier method and tested using the log-rank test. The prognostic effect of BDI was analyzed using univariate and multivariate Cox proportional hazard regression analyses. The predictive performance of these models was evaluated using the concordance index and time-dependent receiver operating characteristic curve (tdAUC).ResultsOf 1021 patients with HCC, 177 had BDI. OS was worse in the HCC with BDI group than in the HCC without BDI group (p<0.001); multivariate analysis identified BDI as an independent risk factor for OS. After adjustment for interference of confounding factors using the Cox proportional hazard regression model, HCC with BDI and without macrovascular invasion was classified as Barcelona Clinic Liver Cancer (BCLC) B, eighth edition American Joint Committee on Cancer (AJCC) IIIA, and China Liver Cancer (CNLC) IIb, respectively, whereas HCC with BDI and macrovascular was classified as BCLC C, AJCC IIIB, and CNLC IIIA, respectively. C-indexes and tdAUCs of the adjusted staging systems were superior to those of the corresponding current staging systems.ConclusionWe constructed adjusted staging systems with the BDI status, improved their predictive performance and facilitate clinical use.https://www.frontiersin.org/articles/10.3389/fonc.2021.673285/fullhepatocellular carcinomabile duct invasionstaging systemsurvivalprognosis |
| spellingShingle | Qizhen Huang Yufeng Chen Kongying Lin Chuandong Sun Shuguo Zheng Jinhong Chen Yifan Wang Yanming Zhou Weiping Zhou Jingfeng Liu Jingfeng Liu Yongyi Zeng Yongyi Zeng Redefining Hepatocellular Carcinoma Staging Systems Based on the Bile Duct Invasion Status: A Multicenter Study Frontiers in Oncology hepatocellular carcinoma bile duct invasion staging system survival prognosis |
| title | Redefining Hepatocellular Carcinoma Staging Systems Based on the Bile Duct Invasion Status: A Multicenter Study |
| title_full | Redefining Hepatocellular Carcinoma Staging Systems Based on the Bile Duct Invasion Status: A Multicenter Study |
| title_fullStr | Redefining Hepatocellular Carcinoma Staging Systems Based on the Bile Duct Invasion Status: A Multicenter Study |
| title_full_unstemmed | Redefining Hepatocellular Carcinoma Staging Systems Based on the Bile Duct Invasion Status: A Multicenter Study |
| title_short | Redefining Hepatocellular Carcinoma Staging Systems Based on the Bile Duct Invasion Status: A Multicenter Study |
| title_sort | redefining hepatocellular carcinoma staging systems based on the bile duct invasion status a multicenter study |
| topic | hepatocellular carcinoma bile duct invasion staging system survival prognosis |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2021.673285/full |
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