Prognostic impact of tumor size on isolated hepatocellular carcinoma without vascular invasion may have age variance
BackgroundPrevious studies suggested that tumor size was an independent risk factor of prognosis for hepatocellular carcinoma (HCC). However, the general prognostic analysis did not consider the interaction between variables. The purpose of this study was to investigate whether the effect of tumor s...
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.988484/full |
| _version_ | 1797960072811249664 |
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| author | Yi Zhang Yi Zhang Jun-Gang Zhang Jun-Gang Zhang Wei Yu Lei Liang Chun Wu Cheng-Wu Zhang Ya-Ming Xie Dong-Sheng Huang Ying Shi |
| author_facet | Yi Zhang Yi Zhang Jun-Gang Zhang Jun-Gang Zhang Wei Yu Lei Liang Chun Wu Cheng-Wu Zhang Ya-Ming Xie Dong-Sheng Huang Ying Shi |
| author_sort | Yi Zhang |
| collection | DOAJ |
| description | BackgroundPrevious studies suggested that tumor size was an independent risk factor of prognosis for hepatocellular carcinoma (HCC). However, the general prognostic analysis did not consider the interaction between variables. The purpose of this study was to investigate whether the effect of tumor size on the prognosis of isolated HCC without vascular invasion varies according to covariates.MethodsPatients were selected from the Surveillance, Epidemiology, and End Results (SEER) database to investigate whether there was an interaction between age and tumor size on the prognosis. Then the trend test and the value of per 1 SD of tumor size were calculated. In addition, the data of Zhejiang Provincial People's Hospital meeting the requirements were selected to verify the obtained conclusions.ResultsMultivariable Cox regression analysis of the database cohort showed that age, gender, tumor size, pathological grade and marital status were independent risk factors for prognosis. Interaction test showed that there was an interaction between age and tumor size (P for interaction < 0.05). Stratified analysis by age showed that tumor size was an independent risk factor for prognosis when age ≤65 years old (HR:1.010,95%CI1.007–1.013 P < 0.001), while tumor size was not an independent risk factor for prognosis when age >65 years old. This result was confirmed by trend analysis (P for trend < 0.001), and the prognostic risk increased by 42.1% for each standard deviation increase of tumor size among patients age ≤65 years. Consistent conclusion was obtained by multivariable cox regression analysis and interaction test on the verification cohort. In the validation cohort, for each standard deviation increase of tumor size in patients ≤65 years old, the risk of prognosis increased by 52.4%.ConclusionTumor size is not an independent risk factor for the prognosis of isolated HCC without vascular invasion when patient's age >65 years. Therefore, when analyzing the relationship between tumor size and prognosis, stratified analysis should be performed according to age. |
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| language | English |
| last_indexed | 2024-04-11T00:40:50Z |
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| series | Frontiers in Surgery |
| spelling | doaj.art-dab47c8966ae42bda89c2b924bbb58882023-01-06T08:04:56ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2023-01-01910.3389/fsurg.2022.988484988484Prognostic impact of tumor size on isolated hepatocellular carcinoma without vascular invasion may have age varianceYi Zhang0Yi Zhang1Jun-Gang Zhang2Jun-Gang Zhang3Wei Yu4Lei Liang5Chun Wu6Cheng-Wu Zhang7Ya-Ming Xie8Dong-Sheng Huang9Ying Shi10Zhejiang Provincial People's Hospital, Qingdao University, Hangzhou, ChinaGeneral Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, ChinaGeneral Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, ChinaKey Laboratory of Gastroenterology of Zhejiang Province, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, ChinaGeneral Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, ChinaGeneral Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, ChinaZhejiang Provincial People's Hospital, Qingdao University, Hangzhou, ChinaGeneral Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, ChinaGeneral Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, ChinaGeneral Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, ChinaObstetrics and Gynecology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, ChinaBackgroundPrevious studies suggested that tumor size was an independent risk factor of prognosis for hepatocellular carcinoma (HCC). However, the general prognostic analysis did not consider the interaction between variables. The purpose of this study was to investigate whether the effect of tumor size on the prognosis of isolated HCC without vascular invasion varies according to covariates.MethodsPatients were selected from the Surveillance, Epidemiology, and End Results (SEER) database to investigate whether there was an interaction between age and tumor size on the prognosis. Then the trend test and the value of per 1 SD of tumor size were calculated. In addition, the data of Zhejiang Provincial People's Hospital meeting the requirements were selected to verify the obtained conclusions.ResultsMultivariable Cox regression analysis of the database cohort showed that age, gender, tumor size, pathological grade and marital status were independent risk factors for prognosis. Interaction test showed that there was an interaction between age and tumor size (P for interaction < 0.05). Stratified analysis by age showed that tumor size was an independent risk factor for prognosis when age ≤65 years old (HR:1.010,95%CI1.007–1.013 P < 0.001), while tumor size was not an independent risk factor for prognosis when age >65 years old. This result was confirmed by trend analysis (P for trend < 0.001), and the prognostic risk increased by 42.1% for each standard deviation increase of tumor size among patients age ≤65 years. Consistent conclusion was obtained by multivariable cox regression analysis and interaction test on the verification cohort. In the validation cohort, for each standard deviation increase of tumor size in patients ≤65 years old, the risk of prognosis increased by 52.4%.ConclusionTumor size is not an independent risk factor for the prognosis of isolated HCC without vascular invasion when patient's age >65 years. Therefore, when analyzing the relationship between tumor size and prognosis, stratified analysis should be performed according to age.https://www.frontiersin.org/articles/10.3389/fsurg.2022.988484/fullhepatocellular carcinomatumor sizeP for interactionP for trendper 1 SD |
| spellingShingle | Yi Zhang Yi Zhang Jun-Gang Zhang Jun-Gang Zhang Wei Yu Lei Liang Chun Wu Cheng-Wu Zhang Ya-Ming Xie Dong-Sheng Huang Ying Shi Prognostic impact of tumor size on isolated hepatocellular carcinoma without vascular invasion may have age variance Frontiers in Surgery hepatocellular carcinoma tumor size P for interaction P for trend per 1 SD |
| title | Prognostic impact of tumor size on isolated hepatocellular carcinoma without vascular invasion may have age variance |
| title_full | Prognostic impact of tumor size on isolated hepatocellular carcinoma without vascular invasion may have age variance |
| title_fullStr | Prognostic impact of tumor size on isolated hepatocellular carcinoma without vascular invasion may have age variance |
| title_full_unstemmed | Prognostic impact of tumor size on isolated hepatocellular carcinoma without vascular invasion may have age variance |
| title_short | Prognostic impact of tumor size on isolated hepatocellular carcinoma without vascular invasion may have age variance |
| title_sort | prognostic impact of tumor size on isolated hepatocellular carcinoma without vascular invasion may have age variance |
| topic | hepatocellular carcinoma tumor size P for interaction P for trend per 1 SD |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.988484/full |
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