Abstract
Background
This study aimed to clarify the risk factors for survival and recurrence of hepatocellular
carcinoma (HCC) in a cohort of Chinese HCC patients after hepatectomy and to compare
6 developed staging systems.
Methods
A retrospective analysis was performed on 165 consecutive patients. The Kaplan–Meier
method was used to calculate survival. Postoperative prognostic factors were evaluated
using univariate and multivariate analyses. The overall predictive power of each staging
system was evaluated by the area under the receiver operating characteristic curve.
Results
The overall survival rates of 1, 3, and 5 years were 81.2%, 58.6%, and 56.7%, respectively,
and the corresponding disease-free survival rates were 52.9%, 23.3%, and 15.5%, respectively.
α-fetoprotein level and blood transfusion were correlated significantly with patients'
overall survival, and portal vein thrombosis and tumor size (>5 cm) were correlated
significantly with poor disease-free survival.
Conclusions
The French staging system is better for predicting the prognosis of HCC patients receiving
surgical treatment.
Keywords
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References
- Novel advancements in the management of hepatocellular carcinoma in 2008.J Hepatol. 2008; 48: S20-S37
- A new prognostic system for hepatocellular carcinoma: a retrospective study of 435 patients.Hepatology. 1998; 28: 751-755
- Prognosis of hepatocellular carcinoma: the BCLC staging classification.Semin Liver Dis. 1999; 19: 329-338
- A new prognostic classification for predicting survival in patients with hepatocellular carcinoma.J Hepatol. 1999; 31: 133-141
- Construction of the Chinese University Prognostic Index for hepatocellular carcinoma and comparison with the TNM staging system, the Okuda staging system, and the Cancer of the Liver Italian Program staging system: a study based on 926 patients.Cancer. 2002; 94: 1760-1769
- Prognostic staging system for hepatocellular carcinoma (CLIP score): its value and limitations, and a proposal for a new staging system, the Japan Integrated Staging Score (JIS score).J Gastroenterol. 2003; 38: 207-215
- Edge S.B. Byrd D.R. Compton C.C. AJCC Cancer Staging Manual. 7th ed. Springer, New York2010: 237-246
- Transection of the oesophagus for bleeding oesophageal varices.Br J Surg. 1973; 60: 646-649
- Liver fibrosis increases the risk of intrahepatic recurrence after hepatectomy for hepatocellular carcinoma.Br J Surg. 2002; 89: 57-62
- Risk factors and outcome of early recurrence after resection of small hepatocellular carcinomas.Am J Surg. 2009; 198: 39-45
- Surgical treatment of 109 patients with symptomatic and asymptomatic hepatocellular carcinoma.Surgery. 1986; 99: 481-490
- Extent of liver resection influences the outcome in patients with cirrhosis and small hepatocellular carcinoma.Surgery. 2002; 131: 311-317
- Reevaluation of prognostic factors for survival after liver resection in patients with hepatocellular carcinoma in a Japanese nationwide survey.Cancer. 2004; 101: 796-802
- Partial hepatectomy with wide versus narrow resection margin for solitary hepatocellular carcinoma: a prospective randomized trial.Ann Surg. 2007; 245: 36-43
- Postoperative outcomes in patients with hepatocellular carcinomas resected with exposure of the tumor surface: clinical role of the no-margin resection.Arch Surg. 2007; 142: 596-603
- Anatomic versus limited nonanatomic resection for solitary hepatocellular carcinoma.Surgery. 2008; 143: 607-615
- Minor versus major hepatic resection for small hepatocellular carcinoma (HCC) in cirrhotic patients: a 20-year experience.Surgery. 2010; 147: 676-685
- Significance of resection margin in hepatectomy for hepatocellular carcinoma: a critical reappraisal.Ann Surg. 2000; 231: 544-551
- Diagnosis and treatment of hepatocellular carcinoma.Gastroenterology. 2008; 134: 1752-1763
- Significant influence of accompanying chronic hepatitis status on recurrence of hepatocellular carcinoma after hepatectomy.Ann Surg. 1996; 224: 591-595
- How much liver resection is too much?.Am J Surg. 2005; 190: 87-97
- Perioperative blood transfusion in hepatocellular carcinomas: influence of immunologic profile and recurrence free survival.Cancer. 2001; 91: 771-778
- Prognosis and postoperative lymphocyte count in patients with hepatocellular carcinoma who received intraoperative allogenic blood transfusion: a retrospective study.Eur J Surg Oncol. 2008; 34: 339-345
- Negative impact of blood transfusion on recurrence and prognosis of hepatocellular carcinoma after hepatic resection.J Gastrointest Surg. 2009; 13: 1636-1642
- Detrimental effects of perioperative blood transfusion.Br J Surg. 1995; 82: 582-587
- Blood loss in surgical oncology: neglected quality indicator?.J Surg Oncol. 2009; 99: 508-512
- Current role of bloodless liver resection.World J Gastroenterol. 2007; 13: 826-829
- Prognostic factors of hepatic resection for hepatocellular carcinoma with cirrhosis: univariate and multivariate analysis.J Surg Oncol. 2002; 81: 195-202
- Factors associated with disease survival after surgical resection in Chinese patients with hepatocellular carcinoma.World J Surg. 2006; 30: 439-445
- Natural history of untreated nonsurgical hepatocellular carcinoma: rationale for the design and evaluation of therapeutic trials.Hepatology. 1999; 29: 62-67
- Liver resection with portal vein thrombectomy for hepatocellular carcinoma with vascular invasion.Ann Surg Oncol. 2009; 16: 1254
- Surgical treatment of hepatocellular carcinoma with portal vein tumor thrombus.Ann Surg Oncol. 2010; 17: 2073-2080
- Effects of location and extension of portal vein tumor thrombus on long-term outcomes of surgical treatment for hepatocellular carcinoma.Ann Surg Oncol. 2006; 13: 940-946
- New utility of an old marker: serial alpha-fetoprotein measurement in predicting radiologic response and survival of patients with hepatocellular carcinoma undergoing systemic chemotherapy.J Clin Oncol. 2009; 27: 446-452
- Consensus and controversy in the management of hepatocellular carcinoma.J Am Coll Surg. 2007; 205: 108-123
- Hepatocellular carcinoma.Lancet. 2003; 362: 1907-1917
- Prospective validation of the Barcelona Clinic Liver Cancer staging system.J Hepatol. 2006; 44: 723-731
- Prognosis of hepatocellular carcinoma: comparison of 7 staging systems in an American cohort.Hepatology. 2005; 41: 707-716
Article info
Publication history
Published online: December 19, 2011
Received in revised form:
May 4,
2011
Received:
November 7,
2010
Footnotes
L.L. and R.M. contributed equally to this article.
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
