A novel classification in predicting prognosis and guiding postoperative management after R0 liver resection for patients with hepatocellular carcinoma and microvascular invasion |
| |
| Affiliation: | 1. Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China;2. Department of Hepatobiliary Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China;3. Department of Health Statistics, Second Military Medical University, Shanghai, China;4. Faculty of Hepato-Biliary-Pancreatic Surgery, The First Medical Center of Chinese People''s Liberation Army (PLA) General Hospital, Beijing, China;5. Department of Pathology, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, China;6. Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China;1. Department of Medical and Surgical Sciences (DIMEC), IRCCS Sant’Orsola-Malpighi, Obstetric and Gynecologic Unit, University of Bologna, Bologna, Italy;2. Gynecologic and Breast Oncologic Surgery Department, Georges Pompidou European Hospital, APHP. Centre, Université de Paris, Paris, France;3. INSERM UMR-S 1124, Université de Paris, Centre Universitaire des Saint-Père, Paris, France;4. INSERM UMR-S 1147, Université de Paris, Centre de Recherche des Cordeliers, Paris, France;1. Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan;2. Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan;1. Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands;2. Department of Surgery, ETZ (Elisabeth-TweeSteden) Hospital, Tilburg, the Netherlands;3. Department of GROW, School for Developmental Biology & Oncology, Maastricht University, Maastricht, the Netherlands;1. Department of Medicine and Surgery, University of Parma, Parma, Italy;2. Dipartimento per le Scienze della Salute della Donna e del Bambino, Fondazione Policlinico Universitario A. Gemelli IRCCS, Department of Gynecology and Obstetrics, Roma, Italy;3. Department of Gynecologic Oncology, Gemelli Molise SpA, Campobasso, Italy;4. Department of Gynecologic Oncology, University of Palermo, Palermo, Italy;5. Department of Medicine and Health Science “V.Tiberio” Università degli Studi del Molise, Campobasso, Italy |
| |
| Abstract: | BackgroundMicrovascular invasion (MVI) is a significant risk factor affecting survival outcomes of patients after R0 liver resection (LR) for hepatocellular carcinoma (HCC). The current classification of MVI is not refined enough to prognosticate long-term survival of these patients, and a new MVI classification is needed.MethodsPatients with HCC who underwent R0 LR at the Eastern Hepatobiliary Surgery Hospital from January 2013 to December 2013 and with resected specimens showing MVI were included in this study with an aim to establish a novel MVI classification. The classification which was developed using multivariate cox regression analysis was externally validated.ResultsThere were 180 patients in the derivation cohort and 131 patients in the external validation cohort. The following factors were used for scoring: α-fetoprotein level (AFP), liver cirrhosis, tumor number, tumor diameter, MVI number, and distance between MVI and HCC. Three classes of patients could be distinguished by using the total score: class A, ≤3 points; class B, 3.5–5 points and class C, >5 points with distinct long-term survival outcomes (median recurrence free survival (mRFS), 22.6, 10.2, and 1.9 months, P < 0.001). The predictive accuracy of this classification was more accurate than the other commonly used classifications for HCC patients with MVI. In addition, the mRFS of class C patients was significantly prolonged (1.9 months vs. 6.2 months, P < 0.001) after adjuvant transcatheter arterial chemoembolization (TACE).ConclusionsA novel MVI classification was established in predicting prognosis of HCC patients with MVI after R0 LR. Adjuvant TACE was useful for class C patients. |
| |
| Keywords: | Hepatocellular carcinoma (HCC) Microvascular invasion (MVI) Staging system |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
