Is left-sided involvement of hepatocellular carcinoma an important preoperative predictive factor of poor outcome?

Abstract

Background The tumor location is the most simple clinical factor and important in liver surgery to make surgical procedure. However, no previous study has investigated the prognostic differences and clinical features of hepatocellular carcinoma showing specific laterality. This study is the first report to focus on the laterality and aimed to lead to more simple and useful predictive factor rather than recent complicated predictive models. Methods Patients who underwent liver resection for the first time for single tumors located within each lobe between 2000 and 2018 were enrolled. We divided them into two groups based on tumor location: a right-sided group and a left-sided group. Univariable and multivariable analyses were performed to assess survival differences in relation to several other factors. Results There were 595 eligible patients; the 5-year survival rates and disease-free survival rates were 49.5% and 19.1% in the left-sided group and 55.6% and 24.5% in the right-sided group, respectively (p = 0.026). Statistical analyses revealed that the following preoperative prognostic factors were independently significant (p < 0.05) in the left-sided group: indocyanine green retention rate at 15 min, alpha fetoprotein, protein induced by vitamin K absence or antagonists-II level, and larger tumor size. Conclusion The left-sided group had a poorer prognosis than the right-sided group. A left-sided tumor location is a significant preoperative factor predictive of poor outcome in patients with hepatocellular carcinoma.

The impact of body mass index on short-term and long-term surgical outcomes of laparoscopic hepatectomy in liver carcinoma patients: a retrospective study

“…Although patients could get an early diagnosis combined with comprehensive treatment nowadays, due to the tumor’s malignant character, the prognosis of liver cancer remains unsatisfactory [ 3 , 4 ]. Factors such as age, tumor size and tumor number, pathologic TNM stage, and vascular invasion have been identified as factors influencing the prognosis of liver cancer patients [ 5 – 7 ]. Several researchers have found that overweight status increases the risk of hepatocellular carcinoma (HCC) by 17%, and obese status increases the risk of HCC by 90% compared with normal-weight individuals [ 8 , 9 ].…”

Secondarily estimated cure fraction and five-year recurrence-free conditional survival probabilities among patients undergoing surgical resection for hepatocellular carcinoma presenting with minor gross vascular invasion

“…It has been reported that GVI is one of significant prognostic factors for patients with HCC [ 27 ]. A recent study with a relatively large cohort sample analyzed the preoperative factors associated with a survival rate of more than 2 years after SR for HCC with GVI [ 28 ].…”

“…Based on these results, we could reliantly deduce that the negative prognostic effect of mGVI would diminish after 1 year in the postoperative period. It has been reported that GVI is one of significant prognostic factors for patients with HCC [27]. A recent study with a relatively large cohort sample analyzed the preoperative factors associated with a survival rate of more than 2 years after SR for HCC with GVI [28].…”

Predictors of Successful Yttrium-90 Radioembolization Bridging or Downstaging in Patients with Hepatocellular Carcinoma

“…Nevertheless, no study to date has evaluated the clinical outcomes of HCC patients in relation to the disease site to be treated with Y90-RE. In the surgical literature, however, left hepatic lobe HCC disease has been associated with worse clinical outcomes after surgical intervention [46], suspected to be driven in part by the greater difficulty in attaining negative surgical margins.…”