Potential candidates for liver resection in liver-confined advanced HCC: a Chinese multicenter observational study
BackgroundAdvanced hepatocellular carcinoma (HCC) is characterized as symptomatic tumors [performance status (PS) score of 1-2], vascular invasion and extrahepatic spread, but patients with PS1 alone may be eliminated from this stage. Although liver resection is used for liver-confined HCC, its role...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-06-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1170923/full |
| _version_ | 1797795135273041920 |
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| author | Tingting Bai Enxin Wang Shoujie Zhao Dandan Han Yan Zhao Hui Chen Jun Zhu Tenghui Han Yang Bai Yanju Lou Yongchao Zhang Man Yang Luo Zuo Jiahao Fan Xing Chen Jia Jia Wenbin Wu Weirong Ren Yejing Zhu Shouzheng Ma Fenghua Xu Yuxin Tang Xilin Du Junlong Zhao Jing Li Jing Li Xingshun Qi Ying Han Dongfeng Chen Lei Liu Lei Liu |
| author_facet | Tingting Bai Enxin Wang Shoujie Zhao Dandan Han Yan Zhao Hui Chen Jun Zhu Tenghui Han Yang Bai Yanju Lou Yongchao Zhang Man Yang Luo Zuo Jiahao Fan Xing Chen Jia Jia Wenbin Wu Weirong Ren Yejing Zhu Shouzheng Ma Fenghua Xu Yuxin Tang Xilin Du Junlong Zhao Jing Li Jing Li Xingshun Qi Ying Han Dongfeng Chen Lei Liu Lei Liu |
| author_sort | Tingting Bai |
| collection | DOAJ |
| description | BackgroundAdvanced hepatocellular carcinoma (HCC) is characterized as symptomatic tumors [performance status (PS) score of 1-2], vascular invasion and extrahepatic spread, but patients with PS1 alone may be eliminated from this stage. Although liver resection is used for liver-confined HCC, its role in patients with PS1 alone remains controversial. Therefore, we aimed to explore its application in such patients and identify potential candidates.MethodsEligible liver-confined HCC patients undergoing liver resection were retrospectively screened in 15 Chinese tertiary hospitals, with limited tumor burden, liver function and PS scores. Cox-regression survival analysis was used to investigate the prognostic factors and develop a risk-scoring system, according to which patients were substratified using fitting curves and the predictive values of PS were explored in each stratification.ResultsFrom January 2010 to October 2021, 1535 consecutive patients were selected. In the whole cohort, PS, AFP, tumor size and albumin were correlated with survival (adjusted P<0.05), based on which risk scores of every patient were calculated and ranged from 0 to 18. Fitting curve analysis demonstrated that the prognostic abilities of PS varied with risk scores and that the patients should be divided into three risk stratifications. Importantly, in the low-risk stratification, PS lost its prognostic value, and patients with PS1 alone achieved a satisfactory 5-year survival rate of 78.0%, which was comparable with that PS0 patients (84.6%).ConclusionSelected patients with PS1 alone and an ideal baseline condition may benefit from liver resection and may migrate forward to BCLC stage A. |
| first_indexed | 2024-03-13T03:13:20Z |
| format | Article |
| id | doaj.art-caf2c1bb35e448a8ac9f8f59934f7c1c |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-13T03:13:20Z |
| publishDate | 2023-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-caf2c1bb35e448a8ac9f8f59934f7c1c2023-06-26T10:04:07ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-06-011310.3389/fonc.2023.11709231170923Potential candidates for liver resection in liver-confined advanced HCC: a Chinese multicenter observational studyTingting Bai0Enxin Wang1Shoujie Zhao2Dandan Han3Yan Zhao4Hui Chen5Jun Zhu6Tenghui Han7Yang Bai8Yanju Lou9Yongchao Zhang10Man Yang11Luo Zuo12Jiahao Fan13Xing Chen14Jia Jia15Wenbin Wu16Weirong Ren17Yejing Zhu18Shouzheng Ma19Fenghua Xu20Yuxin Tang21Xilin Du22Junlong Zhao23Jing Li24Jing Li25Xingshun Qi26Ying Han27Dongfeng Chen28Lei Liu29Lei Liu30Department of Digestive Diseases, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, ChinaDepartment of Digestive Diseases, Air Force Hospital of Western Theater Command, Chengdu, ChinaDepartment of Digestive Diseases, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi’an, ChinaDepartment of General Surgery, The Air Force Hospital of Southern Theater Command, Guangzhou, ChinaDepartment of Digestive Diseases, The First Affiliated Hospital of Xi’an Jiao Tong University, Xi’an, ChinaXijing Hospital of Digestive Diseases, Air Force Medical University (Fourth Military Medical University), Xian, ChinaDepartment of General Surgery, The Southern Theater Air Force Hospital, Guangzhou, ChinaDepartment of Internal Medicine, Air Force Medical University (Fourth Military Medical University), Xian, ChinaDepartment of Neurosurgery, General Hospital of Northern Theater Command, Shenyang, China0Department of Orthopedic Surgery, Air Force Hospital of Western Theater Command, Chengdu, China1Department of Medical Affairs, Air Force Hospital of Western Theater Command, Chengdu, China2Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China3Department of Digestive Diseases, the Second Affiliated Hospital of Chengdu Medical College, Chengdu, China4Department of Digestive Diseases, the Affiliated Hospital of Southwest Medical University, Luzhou, China5Department of Oncology, Qingdao Women and Children’s Hospital, Qingdao, China6Department of Emergency, Shaanxi Provincial People’s Hospital, Xi’an, China7Department of Digestive Diseases, Xi’an First Hospital, Xi’an, China8Department of Digestive Diseases, Sanmenxia Central Hospital, Henan University of Science and Technology, Sanmenxia, ChinaDepartment of Digestive Diseases, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi’an, China9Department of Surgery, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi’an, ChinaDepartment of Digestive Diseases, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, ChinaDepartment of Digestive Diseases, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, ChinaDepartment of Digestive Diseases, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi’an, China0State Key Laboratory of Cancer Biology, Medical Genetics and Development Biology, Fourth Military Medical University, Xi’an, China1Department of Digestive Diseases, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China2Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China3Department of Digestive Diseases, General Hospital of Northern Theater Command, Shenyang, ChinaXijing Hospital of Digestive Diseases, Air Force Medical University (Fourth Military Medical University), Xian, ChinaDepartment of Digestive Diseases, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, ChinaDepartment of Digestive Diseases, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, ChinaDepartment of Digestive Diseases, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi’an, ChinaBackgroundAdvanced hepatocellular carcinoma (HCC) is characterized as symptomatic tumors [performance status (PS) score of 1-2], vascular invasion and extrahepatic spread, but patients with PS1 alone may be eliminated from this stage. Although liver resection is used for liver-confined HCC, its role in patients with PS1 alone remains controversial. Therefore, we aimed to explore its application in such patients and identify potential candidates.MethodsEligible liver-confined HCC patients undergoing liver resection were retrospectively screened in 15 Chinese tertiary hospitals, with limited tumor burden, liver function and PS scores. Cox-regression survival analysis was used to investigate the prognostic factors and develop a risk-scoring system, according to which patients were substratified using fitting curves and the predictive values of PS were explored in each stratification.ResultsFrom January 2010 to October 2021, 1535 consecutive patients were selected. In the whole cohort, PS, AFP, tumor size and albumin were correlated with survival (adjusted P<0.05), based on which risk scores of every patient were calculated and ranged from 0 to 18. Fitting curve analysis demonstrated that the prognostic abilities of PS varied with risk scores and that the patients should be divided into three risk stratifications. Importantly, in the low-risk stratification, PS lost its prognostic value, and patients with PS1 alone achieved a satisfactory 5-year survival rate of 78.0%, which was comparable with that PS0 patients (84.6%).ConclusionSelected patients with PS1 alone and an ideal baseline condition may benefit from liver resection and may migrate forward to BCLC stage A.https://www.frontiersin.org/articles/10.3389/fonc.2023.1170923/fullhepatocellular carcinomaliver resectionperformance statusoverall survivalprognosis |
| spellingShingle | Tingting Bai Enxin Wang Shoujie Zhao Dandan Han Yan Zhao Hui Chen Jun Zhu Tenghui Han Yang Bai Yanju Lou Yongchao Zhang Man Yang Luo Zuo Jiahao Fan Xing Chen Jia Jia Wenbin Wu Weirong Ren Yejing Zhu Shouzheng Ma Fenghua Xu Yuxin Tang Xilin Du Junlong Zhao Jing Li Jing Li Xingshun Qi Ying Han Dongfeng Chen Lei Liu Lei Liu Potential candidates for liver resection in liver-confined advanced HCC: a Chinese multicenter observational study Frontiers in Oncology hepatocellular carcinoma liver resection performance status overall survival prognosis |
| title | Potential candidates for liver resection in liver-confined advanced HCC: a Chinese multicenter observational study |
| title_full | Potential candidates for liver resection in liver-confined advanced HCC: a Chinese multicenter observational study |
| title_fullStr | Potential candidates for liver resection in liver-confined advanced HCC: a Chinese multicenter observational study |
| title_full_unstemmed | Potential candidates for liver resection in liver-confined advanced HCC: a Chinese multicenter observational study |
| title_short | Potential candidates for liver resection in liver-confined advanced HCC: a Chinese multicenter observational study |
| title_sort | potential candidates for liver resection in liver confined advanced hcc a chinese multicenter observational study |
| topic | hepatocellular carcinoma liver resection performance status overall survival prognosis |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1170923/full |
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