Histological Severity of Cirrhosis Influences Surgical Outcomes of Hepatocellular Carcinoma After Curative Hepatectomy
Bin-Yong Liang,1,* Jin Gu,2,* Min Xiong,3 Er-Lei Zhang,1 Zun-Yi Zhang,1 Wan-Yee Lau,4 Shao-Fa Wang,5 Yan Guan,1 Xiao-Ping Chen,1 Zhi-Yong Huang1 1Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic o...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2022-07-01
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| Series: | Journal of Hepatocellular Carcinoma |
| Subjects: | |
| Online Access: | https://www.dovepress.com/histological-severity-of-cirrhosis-influences-surgical-outcomes-of-hep-peer-reviewed-fulltext-article-JHC |
| _version_ | 1828451671478370304 |
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| author | Liang BY Gu J Xiong M Zhang EL Zhang ZY Lau WY Wang SF Guan Y Chen XP Huang ZY |
| author_facet | Liang BY Gu J Xiong M Zhang EL Zhang ZY Lau WY Wang SF Guan Y Chen XP Huang ZY |
| author_sort | Liang BY |
| collection | DOAJ |
| description | Bin-Yong Liang,1,* Jin Gu,2,* Min Xiong,3 Er-Lei Zhang,1 Zun-Yi Zhang,1 Wan-Yee Lau,4 Shao-Fa Wang,5 Yan Guan,1 Xiao-Ping Chen,1 Zhi-Yong Huang1 1Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 2Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China; 3Department of Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 4Faculty of Medicine, the Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, People’s Republic of China; 5Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhi-Yong Huang, Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie Fang Da Dao, Wuhan, People’s Republic of China, Tel +86-27-83665392, Fax +86-27-83663432, Email huangzy@tjh.tjmu.edu.cnBackground: Hepatocellular carcinoma (HCC) is frequently associated with cirrhosis. The present study investigated the impact of histological severity of cirrhosis on surgical outcomes for HCC and further developed novel nomograms to predict postoperative recurrence and survival.Methods: A total of 1524 consecutive patients undergoing curative hepatectomy for HCC between 1999 and 2015 were retrospectively studied. Cirrhotic severity was histologically staged according to the Laennec staging system. Short- and long-term outcomes were investigated. Recurrence-free survival (RFS) and overall survival (OS) predictive nomograms were constructed based on the results of multivariate analysis. The predictive accuracy of the nomograms was measured by the concordance index (C-index) and calibration.Results: Patients in the severe cirrhosis group had significantly higher morbidity and mortality rates than patients in the no, mild, and moderate cirrhosis groups. The 5-year RFS and OS rates were 36.8% and 64.5%, respectively, in the no cirrhosis group, compared to 34.8% and 60.4% in the mild cirrhosis group, 17.3% and 43.4% in the moderate cirrhosis group, and 6.1% and 20.1% in the severe cirrhosis group. Long-term survival outcomes were significantly worse as cirrhotic severity was increased. The C-index was 0.727 for the RFS nomogram and 0.746 for the OS nomogram. Calibration curves showed good agreement between actual observations and nomogram predictions. The 2 nomograms had a superior discriminatory ability to predict RFS and OS compared to other staging systems.Conclusion: Histological severity of cirrhosis significantly affected surgical outcomes in HCC patients undergoing curative hepatectomy. The novel nomograms, including histological severity of cirrhosis, showed an accurate prediction of postoperative recurrence and survival.Keywords: hepatocellular carcinoma, Laennec staging system, prognosis, nomogram, hepatectomy |
| first_indexed | 2024-12-10T23:40:59Z |
| format | Article |
| id | doaj.art-350bc42f0ac64922a59176b29a2b0149 |
| institution | Directory Open Access Journal |
| issn | 2253-5969 |
| language | English |
| last_indexed | 2024-12-10T23:40:59Z |
| publishDate | 2022-07-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Hepatocellular Carcinoma |
| spelling | doaj.art-350bc42f0ac64922a59176b29a2b01492022-12-22T01:29:03ZengDove Medical PressJournal of Hepatocellular Carcinoma2253-59692022-07-01Volume 963364776768Histological Severity of Cirrhosis Influences Surgical Outcomes of Hepatocellular Carcinoma After Curative HepatectomyLiang BYGu JXiong MZhang ELZhang ZYLau WYWang SFGuan YChen XPHuang ZYBin-Yong Liang,1,* Jin Gu,2,* Min Xiong,3 Er-Lei Zhang,1 Zun-Yi Zhang,1 Wan-Yee Lau,4 Shao-Fa Wang,5 Yan Guan,1 Xiao-Ping Chen,1 Zhi-Yong Huang1 1Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 2Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China; 3Department of Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 4Faculty of Medicine, the Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, People’s Republic of China; 5Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhi-Yong Huang, Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie Fang Da Dao, Wuhan, People’s Republic of China, Tel +86-27-83665392, Fax +86-27-83663432, Email huangzy@tjh.tjmu.edu.cnBackground: Hepatocellular carcinoma (HCC) is frequently associated with cirrhosis. The present study investigated the impact of histological severity of cirrhosis on surgical outcomes for HCC and further developed novel nomograms to predict postoperative recurrence and survival.Methods: A total of 1524 consecutive patients undergoing curative hepatectomy for HCC between 1999 and 2015 were retrospectively studied. Cirrhotic severity was histologically staged according to the Laennec staging system. Short- and long-term outcomes were investigated. Recurrence-free survival (RFS) and overall survival (OS) predictive nomograms were constructed based on the results of multivariate analysis. The predictive accuracy of the nomograms was measured by the concordance index (C-index) and calibration.Results: Patients in the severe cirrhosis group had significantly higher morbidity and mortality rates than patients in the no, mild, and moderate cirrhosis groups. The 5-year RFS and OS rates were 36.8% and 64.5%, respectively, in the no cirrhosis group, compared to 34.8% and 60.4% in the mild cirrhosis group, 17.3% and 43.4% in the moderate cirrhosis group, and 6.1% and 20.1% in the severe cirrhosis group. Long-term survival outcomes were significantly worse as cirrhotic severity was increased. The C-index was 0.727 for the RFS nomogram and 0.746 for the OS nomogram. Calibration curves showed good agreement between actual observations and nomogram predictions. The 2 nomograms had a superior discriminatory ability to predict RFS and OS compared to other staging systems.Conclusion: Histological severity of cirrhosis significantly affected surgical outcomes in HCC patients undergoing curative hepatectomy. The novel nomograms, including histological severity of cirrhosis, showed an accurate prediction of postoperative recurrence and survival.Keywords: hepatocellular carcinoma, Laennec staging system, prognosis, nomogram, hepatectomyhttps://www.dovepress.com/histological-severity-of-cirrhosis-influences-surgical-outcomes-of-hep-peer-reviewed-fulltext-article-JHChepatocellular carcinomalaennec staging systemprognosisnomogramhepatectomy |
| spellingShingle | Liang BY Gu J Xiong M Zhang EL Zhang ZY Lau WY Wang SF Guan Y Chen XP Huang ZY Histological Severity of Cirrhosis Influences Surgical Outcomes of Hepatocellular Carcinoma After Curative Hepatectomy Journal of Hepatocellular Carcinoma hepatocellular carcinoma laennec staging system prognosis nomogram hepatectomy |
| title | Histological Severity of Cirrhosis Influences Surgical Outcomes of Hepatocellular Carcinoma After Curative Hepatectomy |
| title_full | Histological Severity of Cirrhosis Influences Surgical Outcomes of Hepatocellular Carcinoma After Curative Hepatectomy |
| title_fullStr | Histological Severity of Cirrhosis Influences Surgical Outcomes of Hepatocellular Carcinoma After Curative Hepatectomy |
| title_full_unstemmed | Histological Severity of Cirrhosis Influences Surgical Outcomes of Hepatocellular Carcinoma After Curative Hepatectomy |
| title_short | Histological Severity of Cirrhosis Influences Surgical Outcomes of Hepatocellular Carcinoma After Curative Hepatectomy |
| title_sort | histological severity of cirrhosis influences surgical outcomes of hepatocellular carcinoma after curative hepatectomy |
| topic | hepatocellular carcinoma laennec staging system prognosis nomogram hepatectomy |
| url | https://www.dovepress.com/histological-severity-of-cirrhosis-influences-surgical-outcomes-of-hep-peer-reviewed-fulltext-article-JHC |
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