Outcome after partial hepatectomy for hepatocellular cancer within the Milan criteria

Fan, Sheung Tat; Poon, Ronnie Tung‐Ping; Yeung, Chun; Lam, Chi‐Ming; Lo, Chung Mau; Yuen, WK; Ng, Kelvin K. C.; Liu, C. L.; Chan, See Ching

doi:10.1002/bjs.7583

Cited by 103 publications

(89 citation statements)

References 38 publications

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“…It has been generally confirmed that certain clinicopathological data including tumor multiplicity, large tumor size and vascular invasion are poor prognostic indicators and risk factors for early recurrence of HCC (15)(16)(17)(18)(19). Previously, we reported that the mathematical product of tumor number and size of largest tumor (NxS factor) could be a comprehensive measure of tumor burden to predict the prognosis of HCC patients who underwent liver resection, especially for predicting disease-free survival (20,21).…”

Section: Introductionmentioning

confidence: 90%

A new prognostic model for hepatocellular carcinoma recurrence after curative hepatectomy

et al. 2018

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Abstract. We previously reported the effectiveness of the product of tumor number and size (NxS factor) for the prognosis of hepatocellular carcinoma (HCC) in patients following hepatectomy. The present study aimed to propose a new score based on the NxS factor to predict HCC recurrence following hepatectomy. A total of 406 patients who underwent hepatectomy for HCC at Osaka University Graduate School of Medicine were retrospectively analyzed to develop the new score. Among clinicopathological factors, including the NxS factor, the marker subset that achieved the best performance for prediction of early recurrence was assessed, and a prognostic model for HCC recurrence after curative hepatectomy (REACH) was developed. As the validation set, 425 patients who underwent hepatectomy for HCC at Yamaguchi University Graduate School of Medicine and Shimonoseki Medical Center were analyzed, and the prognostic ability of the REACH score was compared with that of well-known staging systems. Following analysis, the REACH score was constructed using six covariates (NxS factor, microscopic hepatic vein invasion, differentiation, serum albumin, platelet count and indocyanine green retention rate at 15 min). In the validation set, the REACH score predicted early recurrence in 73 of 81 samples, with a sensitivity of 89% and a specificity of 58%. The area under the curve (AUC) of the receiver operating characteristic curve of the REACH score was 0.78 and 0.74, respectively, for 1-and 2-year recurrence after hepatectomy; each AUC was higher than that of any of the other staging systems. Survival analysis indicated the REACH score had the best predictive value in disease-free and overall survival. The present findings demonstrated that the REACH score may be used to classify patients with HCC into high-and low-risk of recurrence, and to predict subsequent survival following hepatic resection.

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Section: Introductionmentioning

confidence: 90%

A new prognostic model for hepatocellular carcinoma recurrence after curative hepatectomy

et al. 2018

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“…23 These outcomes might be somewhat better if the tumors were limited to only those meeting the Milan criteria and not just resectable tumors. 24 These results appear to be lower than the rates for both liver transplantation and RFA in these age groups. However, surgical resection in elderly patients with HCC does not involve the justice or utility arguments for organ allocation.…”

Section: See Article On Page 423mentioning

confidence: 76%

Treatment of an elderly patient with hepatocellular carcinoma: Counseling from the patient's point of view

Perkins

2012

Liver Transpl

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“…Previous studies have suggested that portal venous metastasis, intrahepatic metastasis and cirrhosis may represent critical predictors of disease recurrence, metastasis and poor clinical outcome in patients with HCC (32)(33)(34). Therefore, the present study conducted further subgroup survival analysis stratified by portal venous metastasis, intrahepatic metastasis and cirrhosis status.…”

Section: Status Of Dclk1 Expression In Portal Venous Metastasis Intrmentioning

confidence: 90%

Expression and prognostic significance of doublecortin‑like kinase 1 in patients with hepatocellular carcinoma

2017

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Abstract. Doublecortin-like kinase 1 (DCLK1), a putative cancer stem cell marker in intestinal and pancreatic tumors, is associated with tumor pathogenesis and progression, and poor survival outcomes in numerous types of cancer. However, DCLK1 expression and its prognostic value remain unclear in hepatocellular carcinoma (HCC). In the present study, the expression of DCLK1 was assessed using immunohistochemistry in 96 resected HCC and 68 adjacent tissue specimens. The staining intensity and the percentage of stained cells were scored on a scale of 0-3 and 0-4, respectively. Tissue was defined as positive for DCLK1 if the composite multiple score was >3. Cytoplasmic expression of DCLK1 was observed in HCC and adjacent tissue specimens with an expression rate of 81% (78/96) and 74% (50/68), respectively; the median score was 4.6 and 3.9, respectively, and no statistically significant difference was observed between HCC and adjacent tissues (P=0.087). DCLK1 expression was positively associated with intrahepatic metastasis (P=0.035). Furthermore, univariate analysis revealed that DCLK1 expression was significantly associated with poor disease-free survival (DFS) and overall survival (P=0.024 and 0.034). Multivariate analysis also demonstrated that DCLK1 expression was an independent prognostic factor for DFS in HCC (P=0.019; hazard ratio, 1.546; 95% confidence interval, 1.330-1.725). Stratified Kaplan-Meier survival curves revealed that DCLK1 expression predicted poorer DFS with respect to positivity for three characteristics: Portal venous metastasis, intrahepatic metastasis, and cirrhosis (P=0.020, P=0.007 and P=0.017, respectively). Collectively, the results of the present study suggested that DCLK1, functioning as a tumor promoter, is frequently overexpressed in HCC, and that DCLK1 expression is associated with poor DFS in patients with HCC. DCLK1 may represent a promising therapeutic target in HCC and requires further study.

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Outcome after partial hepatectomy for hepatocellular cancer within the Milan criteria

Cited by 103 publications

References 38 publications

A new prognostic model for hepatocellular carcinoma recurrence after curative hepatectomy

A new prognostic model for hepatocellular carcinoma recurrence after curative hepatectomy

Treatment of an elderly patient with hepatocellular carcinoma: Counseling from the patient's point of view

Expression and prognostic significance of doublecortin‑like kinase 1 in patients with hepatocellular carcinoma

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