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Background: Hepatic vein tumour thrombus (HVTT) is a major determinant of survival outcomes for patients with hepatocellular carcinoma (HCC). An Eastern Hepatobiliary Surgery Hospital (EHBH)-HVTT model was established to predict the prognosis of patients with HCC and HVTT after liver resection, in order to identify optimal candidates for liver resection. Methods: Patients with HCC and HVTT from 15 hospitals in China were included. The EHBH-HVTT model with contour plot was developed using a non-linear model in the training cohort, and subsequently validated in internal and external cohorts.Results: Of 850 patients who met the inclusion criteria, there were 292 patients who had liver resection and 198 who did not in the training cohort, and 124 and 236 in the internal and external validation cohorts respectively. Contour plots for the EHBH-HVTT model were established to predict overall survival (OS) rates of patients visually, based on tumour diameter, number of tumours and portal vein tumour thrombus. This differentiated patients into low-and high-risk groups with distinct long-term prognoses in the liver resection cohort (median OS 34⋅7 versus 12⋅0 months; P < 0⋅001), internal validation cohort (32⋅8 versus 10⋅4 months; P = 0⋅002) and external validation cohort (15⋅2 versus 6⋅5 months; P = 0⋅006). On subgroup analysis, the model showed the same efficacy in differentiating patients with HVTT in peripheral and major hepatic veins, the inferior vena cava, or in patients with coexisting portal vein tumour thrombus. Conclusion:The EHBH-HVTT model was accurate in predicting prognosis in patients with HCC and HVTT after liver resection. It identified optimal candidates for liver resection among patients with HCC and HVTT, including tumour thrombus in the inferior vena cava, or coexisting portal vein tumour thrombus.

PurposeThe aim of this study is to investigate the survival benefit of adjuvant chemotherapy in patients with colon cancer with the solitary tumor deposit (TD).MethodsThe primary study outcomes used in this study were colon cancer–specific survival (CSS) and overall survival (OS). The differences of the distribution of categorical variables in patients with colon cancer with the solitary TD according to adjuvant chemotherapy administration were tested using the Pearson’s chi-square test. The Kaplan–Meier method was utilized to evaluate CSS and OS. Hazard ratio (HR) and 95% confidence interval (CI) were calculated on the basis of Cox regression models to assess the prognostic value of different demographic and clinicopathological characteristics.ResultsA total of 877 patients with TanyN1cM0 colon cancer with solitary TD were identified in our analysis. It was found that OS (75.4% vs. 42.8% for 5-year OS rate, p &lt; 0.001) and CSS (82.9% vs. 69.3% for 5-year CSS rate, p &lt; 0.001) of patients with colon cancer with adjuvant chemotherapy administration were significantly better than those without adjuvant chemotherapy administration. Multivariate Cox survival analyses revealed that the overall and colon cancer–specific mortality risks of patients with adjuvant chemotherapy administration were decreased by 64.4% (HR = 0.356, 95% CI = 0.265–0.479, p &lt; 0.001) and 57.4% (HR = 0.426, 95% CI = 0.286–0.634, p &lt; 0.001) compared with those without adjuvant chemotherapy administration, respectively.ConclusionsAdjuvant chemotherapy administration could significantly improve OS and CSS in patients with colon cancer with the solitary TD. This is the first study to investigate and demonstrate the survival benefit of adjuvant chemotherapy in patients with colon cancer with the solitary TD.

Background Transarterial therapies, including transarterial chemoembolization (TACE), hepatic arterial infusion chemotherapy (HAIC), and selective internal radiation therapy, combined with first-line tyrosine kinase inhibitors (TKIs) are considered the standard therapy for unresectable hepatocellular carcinoma. However, inconsistent results have been reported in various studies assessing different combinations of targeted agents. Methods A network meta-analysis (NMA) was performed by including 23 randomized controlled trials (RCTs) with 6175 patients to investigate the efficiency of transarterial therapies in combination with different TKIs. Outcomes of interest included overall survival (OS), progression-free survival (PFS), time to progression (TTP), and tumor objective response rate (ORR). A random-effects consistency model was used in this Bayesian NMA. Hazard ratio and odd risks with a 95% credible interval were calculated and agents were ranked based on ranking probability. Results HAIC showed maximal OS and TTP and TACE plus lenvatinib showed maximal PFS, ORR, and disease control rate (DCR). HAIC and TACE plus lenvatinib were ranked highest based on their respective parameters, which were OS for HAIC and PFS, ORR, and DCR for TACE plus lenvatinib. Conclusion HAIC and TACE plus lenvatinib were relatively better choice for unresectable hepatocellular carcinoma. However, owing to the lack of statistically significant OS benefits among most agents, other agents should be considered as potential alternatives for unresectable hepatocellular carcinoma.

This study aimed to comprehensively examine the efficacy of chemotherapy in T1 colon cancer patients with lymph node metastasis.MethodsThe differences in categorical variables in colon cancer patients according to lymph node status were evaluated by Pearson’s chi-square test. The Kaplan-Meier method was used to assess Cancer-specific survival (CSS) and overall survival (OS) with the log-rank test. Cox proportional hazards models were built, multivariate Cox regression analyses were performed with the hazard ratio (HR) and 95% confidence interval (CI) to identify the potential independent prognostic factors. Propensity score matching was also undertaken to adjust for treatment bias due to measured confounders.ResultsYounger age (52.2% VS. 43.0% for ≤ 65 years old, p &lt; 0.001), female gender (50.3% VS. 46.8% for female, p &lt; 0.001), more lymph nodes harvested (68.1% VS. 46.6% for ≥12 lymph nodes harvested, p &lt; 0.001), Black race (13.6% VS. 12.0% for the Black race, p &lt; 0.001), and higher tumor grade (14.2% VS. 5.6% for grade III/IV, p &lt; 0.001) were more prone to be diagnosed with lymph node involvement. The receipt of adjuvant chemotherapy following radical surgery significantly reduced the risk of colon cancer-specific mortality by 33.9% after propensity-score matching (HR = 0.661, 95%CI = 0.476-0.917, p = 0.013).ConclusionsYounger age, female gender, more lymph nodes harvested, Black race, and higher tumor grade were more prone to be diagnosed with lymph node involvement. The receipt of adjuvant chemotherapy following radical surgery also significantly decreased the risk of colon cancer-specific mortality by 33.9% in T1 colon cancer with lymph node involvement.