Hepatocellular carcinoma tumour burden score to stratify prognosis after resection
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| Název: | Hepatocellular carcinoma tumour burden score to stratify prognosis after resection |
|---|---|
| Autoři: | Sorin Alexandrescu, Irinel Popescu, Alfredo Guglielmi, Guillaume Martel, Timothy M. Pawlik, A I Rodarte, Kazunari Sasaki, Demetrios Moris, Thomas J. Hugh, Luca Aldrighetti, Diamantis I. Tsilimigras, Silvia Silva, Itaru Endo, Francesca Ratti, Amika Moro, Hugo Marques, Fabio Bagante, Federico Aucejo, Anghela Z. Paredes, George A. Poultsides, Oliver Soubrane, Rittal Mehta, Kota Sahara, Aklile Workneh, J M Hyer, Vincent Lam |
| Zdroj: | British Journal of Surgery. 107:854-864 |
| Informace o vydavateli: | Oxford University Press (OUP), 2020. |
| Rok vydání: | 2020 |
| Témata: | Male, Carcinoma, Hepatocellular, Carcinoma, Hepatocellular / diagnosis, Carcinoma, Hepatocellular / surgery, Hepatocellular carcinoma, Liver Neoplasms / pathology, Kaplan-Meier Estimate, Liver Neoplasms / mortality, Disease-Free Survival, Neoplasm Staging / methods, 03 medical and health sciences, 0302 clinical medicine, Carcinoma, Hepatocellular / mortality, Humans, Aged, Neoplasm Staging, Carcinoma, Hepatocellular / pathology, Liver Neoplasms / surgery, Liver Neoplasms, Middle Aged, HCC CIR, Prognosis, Survival Analysis, Tumor Burden, 3. Good health, Liver Neoplasms / diagnosis, carcinoma, hepatocellular, neoplasms , Hepato-Pancreato-Biliary Surgery, Female |
| Popis: | Background Although the Barcelona Clinic Liver Cancer (BCLC) staging system has been largely adopted in clinical practice, recent studies have emphasized the need for further refinement and subclassification of this system. Methods Patients who underwent hepatectomy with curative intent for BCLC-0, -A or -B hepatocellular carcinoma (HCC) between 2000 and 2017 were identified using a multi-institutional database. The tumour burden score (TBS) was calculated, and overall survival (OS) was examined in relation to TBS and BCLC stage. Results Among 1053 patients, 63 (6·0 per cent) had BCLC-0, 826 (78·4 per cent) BCLC-A and 164 (15·6 per cent) had BCLC-B HCC. OS worsened incrementally with higher TBS (5-year OS 77·9, 61 and 39 per cent for low, medium and high TBS respectively; P < 0·001). No differences in OS were noted among patients with similar TBS, irrespective of BCLC stage (61·6 versus 58·9 per cent for BCLC-A/medium TBS versus BCLC-B/medium TBS, P = 0·930; 45 versus 13 per cent for BCLC-A/high TBS versus BCLC-B/high TBS, P = 0·175). Patients with BCLC-B HCC and a medium TBS had better OS than those with BCLC-A disease and a high TBS (58·9 versus 45 per cent; P = 0·005). On multivariable analysis, TBS remained associated with OS among patients with BCLC-A (medium TBS: hazard ratio (HR) 2·07, 95 per cent c.i. 1·42 to 3·02, P < 0·001; high TBS: HR 4·05, 2·40 to 6·82, P < 0·001) and BCLC-B (high TBS: HR 3·85, 2·03 to 7·30; P < 0·001) HCC. TBS could also stratify prognosis among patients in an external validation cohort (5-year OS 79, 51·2 and 28 per cent for low, medium and high TBS respectively; P = 0·010). Conclusion The prognosis of patients with HCC varied according to the BCLC stage but was largely dependent on the TBS. |
| Druh dokumentu: | Article |
| Popis souboru: | application/pdf |
| Jazyk: | English |
| ISSN: | 1365-2168 0007-1323 |
| DOI: | 10.1002/bjs.11464 |
| Přístupová URL adresa: | https://pubmed.ncbi.nlm.nih.gov/32057105 https://moh-it.pure.elsevier.com/en/publications/hepatocellular-carcinoma-tumour-burden-score-to-stratify-prognosi https://pubmed.ncbi.nlm.nih.gov/32057105/ https://www.ncbi.nlm.nih.gov/pubmed/32057105 https://academic.oup.com/bjs/article/107/7/854/6094069 https://researchers.mq.edu.au/en/publications/hepatocellular-carcinoma-tumour-burden-score-to-stratify-prognosi https://bjssjournals.onlinelibrary.wiley.com/doi/abs/10.1002/bjs.11464 https://academic.oup.com/bjs/article/107/7/854/6094069?login=true https://doi.org/10.1002/bjs.11464 https://hdl.handle.net/20.500.11768/106319 http://hdl.handle.net/10400.17/4447 |
| Rights: | OUP Standard Publication Reuse |
| Přístupové číslo: | edsair.doi.dedup.....fd12fefb6701570dffd84d7ddd06ff1f |
| Databáze: | OpenAIRE |
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