Risk Factors for Early Recurrence of Single Lesion Hepatocellular Carcinoma After Curative Resection

Shimoda, Mitsugi; Tago, Kazuma; Sakai, Takayuki; Mori, Shiro; Kato, Masato; Aoki, Taku; Kubota, Keiichi

doi:10.1007/s00268-016-3529-7

Cited by 49 publications

(37 citation statements)

References 35 publications

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“…In the present study, we defined mVI according to these criteria. The rate of mVI in this study was 22.4%, comparable to that seen in previous studies (Kim et al, 2008;Eguchi et al, 2010;Rodriguez-Peralvarez et al, 2013;Shimoda et al, 2016). Since mVI cannot be identified preoperatively, knowledge of significant risk factors could be of great help to the surgeon for preoperative preparation.…”

Section: Discussionsupporting

confidence: 85%

“…The presence of mVI is strongly associated with HCC recurrence and early disease-related death (Poon et al, 2000a;Poon et al, 2007;Lim et al, 2011). Several studies have shown that mVI+ patients have poorer prognosis than mVI− patients (Pawlik et al, 2005;Yamamoto et al, 2015;Hirokawa et al, 2016;Shimoda et al, 2016). Although there is currently no consensus definition of mVI, Rodriguez-Peralvarez (2013) recently proposed the following criteria: (i) the presence of tumor cells forming plug or polyp and (ii) tumor thrombus partially or totally covered by endothelial cells in either the portal vein or hepatic vein branches.…”

Section: Discussionmentioning

confidence: 99%

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Platelet-to-Lymphocyte Ratio and Large Tumor Size Predict Microvascular Invasion after Resection for Hepatocellular Carcinoma

Rungsakulkij

Mingphruedhi

Suragul

et al. 2018

Asian Pac J Cancer Prev

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Background: Recurrence after curative resection of hepatocellular carcinoma (HCC) is associated with early death and poor prognosis. Microvascular invasion (mVI) is strongly associated with disease recurrence. Although many studies have examined the relationship between various serum inflammatory indices and post-treatment prognosis, little is known about preoperative predictors of microvascular invasion in HCC. Methods: Patients who underwent curative hepatic resection for HCC at our institute from January 2006 to December 2016 were retrospectively reviewed. The associations between mVI and various potential risk factors, including tumor size, hepatitis B and C virus infection, Child-Pugh scores, platelet-to-lymphocyte ratio, and neutrophil-to-lymphocyte ratio, were analyzed. Optimal cutoff values were determined using receiver operating characteristic curves. Results: A total of 330 HCC patients were enrolled in this study, of whom 74 (22.4%) had tumors with mVI. After univariate analysis, two parameters were significantly associated with mVI after hepatic resection: platelet-to-lymphocyte ratio ≥102 (odds ratio [OR] 2.385, p = 0.001) and tumor size ≥5 cm (OR 4.29, p < 0.001). Both variables remained significant risk factors for mVI after multivariate analysis: platelet-to-lymphocyte ratio ≥102 (OR 1.831, p = 0.034) and tumor size ≥5 cm (OR 3.791, p < 0.001). Conclusions: Large tumor size (≥5 cm) and high platelet-to-lymphocyte ratio (≥102) are independent predictive factors for mVI in HCC.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Platelet-to-Lymphocyte Ratio and Large Tumor Size Predict Microvascular Invasion after Resection for Hepatocellular Carcinoma

Rungsakulkij

Mingphruedhi

Suragul

et al. 2018

Asian Pac J Cancer Prev

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“…NLR was also not associated with early (<1 year) mortality from cancer recurrence after liver resection for huge (at least 10 cm in diameter) HCC in 166 patients [35]. NLR was an independent factor that predicted (p = 0.029) early recurrence after curative resection of HCC presenting as a single focus in 193 Japanese patients [36]. However, contrary results have been reported as well, e.g., NLR had no prognostic significance in early HCC (BCLC stage 0/A) treated by surgical resection in 324 patients [37].…”

Section: Neutrophil-to-lymphocyte Ratio In Surgically Treated Hccmentioning

confidence: 92%

Innovative Blood Tests for Hepatocellular Carcinoma: Liquid Biopsy and Evaluation of Systemic Inflammatory Reaction

Štrumfa¹,

Mezale²,

Strumfs³

et al. 2018

Hepatocellular Carcinoma - Advances in Diagnosis and Treatment

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Hepatocellular carcinoma (HCC) is an aggressive tumour associated with dismal prognosis. To improve the outcome, early diagnostics is important. At present, classical HCC diagnostics is based on evaluation of risk factors, surveillance in cirrhotic patients, preference for non-invasive diagnosis by computed tomography or magnetic resonance imaging and biopsy confirmation in controversial cases. However, ambiguous radiological presentation, biopsy-related complications or insufficient representation of the pathology in the tissue core are well-known problems. Panel assessment of microRNAs has diagnostic and prognostic value; thus, in future, microRNA-based liquid biopsy could partially reduce the need for core biopsies. Systemic inflammatory reaction (SIR), characterised mainly by neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and Glasgow prognostic score, may have prognostic value and can be incorporated in criteria for certain treatment approaches, e.g., becoming an adjunct to Milan criteria. Thus, innovations in HCC diagnostics are expected in the field of miRNA-based liquid biopsy for diagnosis/prognosis and SIR for prognosis/selection of treatment.

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“…ER has been attributed to intrahepatic occult metastases or the multicenter metastasis of primary tumors. [6][7][8][9][10] In contrast, LR is caused by the formation of "de novo" tumors in the context of hepatitis and cirrhosis. 2,6,7,11 Various risk factors for HCC recurrence after hepatectomy have been reported, but the results are often conflicting.…”

Section: Introductionmentioning

confidence: 99%

<p>Novel Prognostic Nomograms for Predicting Early and Late Recurrence of Hepatocellular Carcinoma After Curative Hepatectomy</p>

Xu¹,

Li²,

Liu³

2020

CMAR

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Aim: Hepatectomy is the main curative method for patients with hepatocellular carcinoma (HCC) in China. Unfortunately, high recurrence rate after hepatectomy poses negative impact on the prognosis of patients. This study aimed to develop prognostic nomograms to predict early recurrence (ER) and late recurrence (LR) of HCC after curative hepatectomy. Patients and Methods: Total of 318 HCC patients undergoing curative hepatectomy from January 2012 to January 2018 were retrospectively recruited. Potential risk factors that were significant for predicting ER and LR in univariate analysis were selected for multivariate survival model analysis using the backward stepwise method. Risk factors identified in multivariate analysis were used to develop nomograms to predict ER and LR. The nomogram was internally validated using 2,000 bootstrap samples from 75% of the original data. Results: Among 318 patients, 164 showed postoperative recurrence, of which 140 and 24 had ER (≤2 years) and LR (>2 years), respectively. Multivariate analysis showed that age, Hong Kong Liver Cancer Stage, albumin-bilirubin, METAVIR fibrosis grade, and microvascular invasion were risk factors of ER for HCC after curative hepatectomy. The AUC of the ROC curve for ER in the development set (D-set) was 0.888 while that in the validation set (V-set) was 0.812. Neutrophil/lymphocyte ratio and glypican-3 (+) were risk factors for LR in HCC patients after curative hepatectomy. The AUC of the ROC curve for LR predictive nomogram that integrated all independent predictors was 0.831. The AUC of the ROC curve for LR in the D-set was 0.833, while that for LR in the V-set was 0.733. The C-index and AUC of ROC for the proposed nomograms were more satisfactory than three conventional HCC staging systems used in this study. Conclusion: We developed novel nomograms to predict ER and LR of HCC patients after curative hepatectomy for clinical use to individualize follow-up and therapeutic strategies.

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Risk Factors for Early Recurrence of Single Lesion Hepatocellular Carcinoma After Curative Resection

Abstract: Preoperative high AFP (more than 250 ng/ml) and high NLR (more than 1.829) were independent risk factors for ER HCC.

Cited by 49 publications

References 35 publications

Platelet-to-Lymphocyte Ratio and Large Tumor Size Predict Microvascular Invasion after Resection for Hepatocellular Carcinoma

Platelet-to-Lymphocyte Ratio and Large Tumor Size Predict Microvascular Invasion after Resection for Hepatocellular Carcinoma

Innovative Blood Tests for Hepatocellular Carcinoma: Liquid Biopsy and Evaluation of Systemic Inflammatory Reaction

<p>Novel Prognostic Nomograms for Predicting Early and Late Recurrence of Hepatocellular Carcinoma After Curative Hepatectomy</p>

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