The power of tumor sizes in predicting the survival of solitary hepatocellular carcinoma patients

Yang, Anli; Xiao, Weikai; Chen, Dong; Wei, Xiaoli; Huang, Shanzhou; Lin, Ye; Zhang, Chuanzhao; Lin, Jia Wei; Deng, Feiwen; Wu, Chenglin; He, Xiaoshun

doi:10.1002/cam4.1873

Cited by 14 publications

(10 citation statements)

References 35 publications

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“…This study found that AFP[ 11 ], NLR[ 12 ], PLR[ 13 ], tumour size[ 14 ] and tumour differentiation[ 15 ] were independent risk factors for OS, which is consistent with the findings of previous studies. Tumour size and tumour differentiation were used as key variables in the AJCC TNM staging system.…”

Section: Discussionsupporting

confidence: 91%

Nomogram based on inflammation-related markers for predicting survival of patients undergoing hepatectomy for hepatocellular carcinoma

Tian¹,

Li²,

Jiang³

et al. 2021

WJCC

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BACKGROUND Previous nomograms for hepatocellular carcinoma (HCC) did not include the neutrophil-to-lymphocyte ratio (NLR) or platelet-to-lymphocyte ratio (PLR). This study aimed to establish an effective nomogram capable of estimating the association between preoperative inflammatory factors and overall survival (OS) of HCC patients after hepatectomy. AIM To analyse the factors affecting the prognosis of HCC and establish a nomogram. METHODS A total of 626 HCC patients (410 training set patients from the First Affiliated Hospital of Anhui Medical University and 216 validation set patients from the First Affiliated Hospital of University of Science and Technology of China) underwent hepatectomy from January 2014 to December 2017 and were followed up every 3–6 mo. The nomogram was based on OS-related independent risk factors identified by Cox regression analysis. The C-index, calibration curve, and area under the curve (AUC) were used to evaluate the nomogram’s accuracy. RESULTS The 1-, 2- and 3-year OS rates were 79.0%, 68.0% and 45.4% in the training cohort (median OS = 34 mo) and 92.1%, 73.9% and 51.2% in the validation cohort (median OS = 38 mo). Higher α-fetoprotein [hazard ratio (HR) = 1.812, 95% confidence interval (CI): 1.343–2.444], NLR (HR = 2.480, 95%CI: 1.856–3.312) and PLR (HR = 1.974, 95%CI: 1.490–2.616), tumour size ≥ 5 cm (HR = 1.323, 95%CI: 1.002–1.747), and poor differentiation (HR = 3.207, 95%CI: 1.944–5.290) were significantly associated with shortened OS. The developed nomogram integrating these variables showed good reliability in both the training (C-index = 0.71) and validation cohorts (C-index = 0.75). For predicting 1-, 2- and 3-year OS, the nomogram had AUCs of 0.781, 0.743 and 0.706 in the training cohort and 0.789, 0.815 and 0.813 in the validation cohort. The nomogram was more accurate in predicting prognosis than the AJCC TNM staging system. CONCLUSION The prognostic nomogram combining pathological characteristics and inflammation indicators could provide a more accurate individualized risk estimate for the OS of HCC patients with hepatectomy.

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Section: Discussionsupporting

confidence: 91%

Nomogram based on inflammation-related markers for predicting survival of patients undergoing hepatectomy for hepatocellular carcinoma

Tian¹,

Li²,

Jiang³

et al. 2021

WJCC

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“…Little evidence supports its formerly assumed inferiority to HR [19,24]. Indeed, our DSS after TA is not inferior to rates reported after HR [25,26]. More uncertain is the optimal relationship between TA and OLTx.…”

Section: Discussioncontrasting

confidence: 70%

Outcomes after primary and repeat thermal ablation of hepatocellular carcinoma with or without liver transplantation

et al. 2022

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Objectives Thermal ablation (TA) is an established treatment for early HCC. There is a lack of data on the efficacy of repeated TA for recurrent HCC, resulting in uncertainty whether good oncologic outcomes can be obtained without performing orthotopic liver transplantation (OLTx). This study analyses outcomes after TA, with a special focus on repeat TA for recurrent HCC, either as a stand-alone therapy, or in relationship with OLTx. Methods Data from a prospectively registered database on interventions for HCC in a tertiary hepatobiliary centre was completed with follow-up until December 2020. Outcomes studied were rate of recurrence after primary TA and after its repeat interventions, the occurrence of untreatable recurrence, OS and DSS after primary and repeat TA, and complications after TA. In cohorts matched for confounders, OSS and DSS were compared after TA with and without the intention to perform OLTx. Results After TA, 100 patients (56·8%) developed recurrent HCC, of whom 76 (76·0%) underwent up to four repeat interventions. During follow-up, 76·7% of patients never developed a recurrence unamenable to repeat TA or OLTx. OS was comparable after primary TA and repeat TA. In matched cohorts, OS and DSS were comparable after TA with and without the intention to perform OLTx. Conclusions We found TA to be an effective and repeatable therapy for primary and recurrent HCC. Most recurrences can be treated with curative intent. There are patients who do well with TA alone without ever undergoing OLTx. Key Points • Recurrent HCC after primary TA can often be treated effectively with repeat TA. Survival after repeat TA is comparable to primary TA. • In matched cohorts, outcomes after TA with and without subsequent waitlisting for OLTx are comparable. • There are patients who do well for many years with primary and repeat TA alone; some despite multiple recurrences.

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“…However, these staging systems and prognostic factors were only applied to patients with HCC without pulmonary metastasis. 15 As shown in the present study, several prognostic variables, including sex, T stage, bone metastasis, AFP levels, treatment allocation, radiation and chemotherapy, were associated with OS and were then integrated into the nomogram for predicting the OS of patients with HCC presenting pulmonary metastasis. Among these factors, T stage, AFP levels, treatment, radiation and chemotherapy were most strongly associated with the OS of patients with HCC and pulmonary metastasis.…”

Section: Discussionmentioning

confidence: 70%

Nomogram for Predicting the Prognosis of Patients with Hepatocellular Carcinoma Presenting with Pulmonary Metastasis

Zhou¹,

Zhou²,

Ma³

et al. 2021

CMAR

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The power of tumor sizes in predicting the survival of solitary hepatocellular carcinoma patients

Cited by 14 publications

References 35 publications

Nomogram based on inflammation-related markers for predicting survival of patients undergoing hepatectomy for hepatocellular carcinoma

Nomogram based on inflammation-related markers for predicting survival of patients undergoing hepatectomy for hepatocellular carcinoma

Outcomes after primary and repeat thermal ablation of hepatocellular carcinoma with or without liver transplantation

Nomogram for Predicting the Prognosis of Patients with Hepatocellular Carcinoma Presenting with Pulmonary Metastasis

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