Histopathologic-Based Prognostic Factors of Colorectal Cancers Are Associated With the State of the Local Immune Reaction

2011 ◽  
Vol 29 (6) ◽  
pp. 610-618 ◽  
Author(s):  
Bernhard Mlecnik ◽  
Marie Tosolini ◽  
Amos Kirilovsky ◽  
Anne Berger ◽  
Gabriela Bindea ◽  
...  
Keyword(s):  
Predictive Accuracy ◽  
Early Stage ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Tnm Staging ◽  
Time Dependent ◽  
Colorectal Cancers ◽  
Tumor Extension ◽  
T Stage ◽  
Immune Score

Purpose The prognosis of patients with colorectal cancer has sometimes proved uncertain; thus, the prognostic significance of immune criteria was compared with that of the tumor extension criteria using the American Joint Committee on Cancer/International Union Against Cancer–TNM (AJCC/UICC-TNM) staging system. Patients and Methods We studied the intratumoral immune infiltrates in the center of the tumor and in the invasive margin of 599 specimens of stage I to IV colorectal cancers from two independent cohorts. We analyzed these findings in relation to the degree of tumor extension and to the frequency of recurrence. Results Growth of the primary tumor and metastatic spread were associated with decreased intratumoral immune T-cell densities. Sixty percent of patients with high densities of CD8+ cytotoxic T-lymphocyte infiltrate presented with stage Tis/T1 tumor, whereas no patients with low densities presented with such early-stage tumor. In patients who did not relapse, the density of CD8 infiltrates was inversely correlated with T stage. In contrast, in patients whose tumor recurred, the number of CD8 cells was low regardless of the T stage of the tumor. Univariate analysis showed that the immune score was significantly associated with differences in disease-free, disease-specific, and overall survival (hazard ratio [HR], 0.64, 0.60, and 0.70, respectively; P < .005). Time-dependent receiver operating characteristic curve analysis illustrated the predictive accuracy of the immune parameters (c-index = 65.3%, time-dependent c-index [Cτ] = 66.5%). A final stepwise model for Cox multivariate analysis supports the advantage of the immune score (HR, 0.64; P < .001; Cτ = 67.9%) compared with histopathologic features in predicting recurrence as well as survival. Conclusion Assessment of CD8+ cytotoxic T lymphocytes in combined tumor regions provides an indicator of tumor recurrence beyond that predicted by AJCC/UICC-TNM staging.

sFRP-1: A functional prognostic marker for gastric cancer?

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 37-37
Author(s):  
C. J. Moran ◽  
P. S. Ray ◽  
S. P. Bagaria ◽  
Y. Qu ◽  
A. J. Fleisig ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Cell Lines ◽  
Clinical Stage ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Nuclear Grade ◽  
Functional Markers ◽  
T Stage ◽  
E Cadherin

37 Background: Despite being a leading cause of cancer-related death world wide, gastric adenocarcinoma (GA) lacks distinctive biomarkers and targeted therapies. Underexpression of the E-cadherin gene in GA is associated with an aggressive phenotype and a poor prognosis but the mechanisms of this difference are poorly understood. Developing effective therapies for GA requires identification of critical functional markers and deeper understanding of its pathophysiology. Methods: Unsupervised hierarchical clustering analysis of a publicly available 230-sample GA microarray dataset identified a prominent cluster (21.7%) associated with underexpression of E-cadherin and overexpression of a Wnt-family protein: secreted frizzled-related protein 1 (sFRP-1). Archival GA specimens were then assessed for the expression of sFRP-1 by immunohistochemistry. Prognostic significance was assessed using univariate and multivariate analyses. GA cell lines transfected with sFRP-1 were used to determine the role of sFRP-1 in gastric cancer. Results: 85 patients with GA underwent surgery with curative intent; 39 stained positive for sFRP-1 (46%). In this positive group, sFRP-1 staining was focal; was commonly found on the leading edge of the infiltrating tumor mass; and was not restricted to one histopathologic group, grade, or clinical stage. On univariate analysis T stage, nodal involvement, pathologic stage, nuclear grade, E-cadherin status and sFRP-1 status were predictive of overall survival. In a multivariate model, T stage (p < 0.001), nuclear grade (p < 0.001), E-cadherin status (p = 0.031) and sFRP-1 status (p = 0.0097) were predictive of overall survival. Overexpression of sFRP-1 in GA cell lines induced mesenchymal phenotype, enhanced growth and stem cell-like properties. sFRP-1 also attenuated Wnt signaling and E-cadherin expression, but potentiated Notch and Hedgehog signaling known to be involved in GA progression. These findings suggest a Wnt-independent mechanism mediated by sFRP-1. Conclusions: The aggressive biological subtype of gastric cancer may be linked to overexpression of sFRP-1. Our findings identify sFRP-1 as a functional prognostic biomarker for gastric cancer, which may serve as a potential therapeutic target. No significant financial relationships to disclose.

scholarly journals The Predictive Value of Vessels Encapsulating Tumor Clusters in Treatment Optimization for Recurrent Early-Stage Hepatocellular Carcinoma

2020 ◽  
Author(s):  
Zhi-Yuan Chen ◽  
Zhi-Xing Guo ◽  
Liang-He Lu ◽  
Jie Mei ◽  
Wen-Ping Lin ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Predictive Value ◽  
Early Stage ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Survival Outcomes ◽  
Treatment Optimization ◽  
Initial Hepatectomy ◽  
Significant Difference

Abstract Background. The vessels encapsulating tumor clusters (VETC) pattern is an effective predictor of survival in patients with hepatocellular carcinoma (HCC) after resection. The predictive value of VETC in recurrent early-stage HCC remains unclear. Therefore, the aim of the present study was to investigate the prognostic significance of VETC in patients with recurrent early-stage HCC after repeat hepatic resection (RHR) or radiofrequency ablation (RFA). Methods. From December 2005 to December 2016, 138 patients who underwent RHR and 188 patients who underwent RFA were enrolled. VETC was evaluated by immunohistochemical staining for CD34. The survival outcomes of treatment for patients with or without the VETC pattern was investigated. Results. Among VETC-positive HCC patients, 50 patients underwent RHR, and 69 patients underwent RFA; among VETC-negative HCC patients, 88 patients underwent RHR, and 119 patients underwent RFA. There was no significant difference between the RHR and RFA groups in disease-free survival (DFS) or overall survival (OS) as determined by univariate analysis of the whole cohort. In the subgroup analysis of the VETC-positive cohort, the patients in the RHR group had a longer median DFS time compared to those in the RFA group (15.0 vs 5.0 months, P=0.001). Similarly, the patients in the RHR group had a longer median OS time compared to those in the RFA group (39.5 vs 19 months, P=0.001). In the VETC-negative cohort, there was no significant difference in DFS and OS rates between the RHR and RFA groups (P>0.05).Conclusions. The results of our study suggested that RHR was relatively safe and superior to RFA in improving survival outcomes for recurrent early-stage HCC after initial hepatectomy. Furthermore, the VETC pattern may represent a reliable marker for selecting HCC patients who may benefit from RHR.

Ribonucleotide reductase subunit 2 (RRM2) to predict shorter survival in resected stage I-III non-small cell lung cancer (NSCLC) patients.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e21065-e21065
Author(s):  
Erika Rijavec ◽  
Maria Giovanna Dal Bello ◽  
Graziana Savarino ◽  
Claudio Sini ◽  
Giulia Barletta ◽  
...  
Keyword(s):  
Ribonucleotide Reductase ◽  
Excision Repair ◽  
Early Stage ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Stage I ◽  
Stage Ii ◽  
Class Iii ◽  
Qrt Pcr ◽  
Resected Stage

e21065 Background: Biomarkers can help in identifying patients (pts) with early-stage NSCLC with high risk of relapse and poor prognosis. The aim of this study was to investigate the relationship between the levels of expression of 7 biomarkers, various clinicopathological characteristics and their prognostic significance. Methods: Tumor tissue from 82 radically resected stage I-III NSCLC pts were consecutively collected to investigate the mRNA expression and protein levels of the following biomarkers using quantitative reverse transcriptase real-time PCR (qRT-PCR) and immunohistochemistry (IHC) with a tissue microarray technique: excision repair cross-complementation group 1 (ERCC1), breast cancer 1 (BRCA1), ribonucleotide reductase subunit 1 (RRM1), RRM2, p53R2, thymidylate synthase (TS) and class III beta-tubulin (β-Tub-III). Results: On a univariate analysis, p53R2 expression was significantly higher in adenocarcinoma (ADK) compared to squamous cell carcinoma (SSC) samples (p=0.002) and in stage I compared to stage II-III (p≤0.001). ERCC1 expression was significantly higher in females compared to males (p=0.03), and β-Tub-III expression was significantly higher in ADK than in SSC (p=0.03). Pts with lower RRM2 expression survived longer than pts with higher RRM2 expression (p=0.069). The multivariate analysis confirmed RRM2 as an independent prognostic marker of shorter survival (p= 0.031). The comparison between survival curves with qRT-PCR and IHC showed similar results with a trend towards longer survival among ERCC1 negative pts, BRCA1 negative pts, p53R2 positive pts and among pts with low levels of RRM1 and RRM2, although the difference was not statistically significant with both methods. qRT-PCR and IHC have shown that β-Tub-III and TS had no significant impact on survival. Conclusions: This is the first study that identifies RRM2 expression as a negative prognostic factor in resected stage I-III NSCLC. Moreover, we have demonstrated the differential expression of p53R2 and β-Tub-III in ADK compared to SSC and higher expression of p53R2 in pts with stage I compared to stage II-III NSCLC.

Prognostic significance of HER2 expression and associated clinical characteristics in esophageal adenocarcinoma.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 114-114
Author(s):  
Ellie Chan ◽  
Ahmad Alkhasawneh ◽  
Lizette Vila Duckworth ◽  
Tania Zuluaga Toro ◽  
Wei Hou ◽  
...  
Keyword(s):  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Early Stage ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Stage I ◽  
Stage Iii ◽  
Her2 Overexpression ◽  
Her2 Expression ◽  
Early Stage Disease

114 Background: The incidence of adenocarcinoma of the esophagus (EA) and gastroesophageal junction (GEJ) is on the rise. Her2Neu (HER2) is overexpressed in 20-25% of gastric cancers and is associated with poor prognosis. However, the prognostic significance of HER2 in EA/GEJ is less clear. Methods: This retrospective analysis included all sequential patients (pts) with EA or GEJ who underwent primary resection at the University of Florida from 2001 to 2011without neoadjuvant therapy or HER2 inhibition. Demographics, risk factors, tumor features, and outcome data were analyzed. Central blinded immunohistochemistry (IHC) was performed on paraffin embedded tumor specimens with HER2 expression scored as negative (-) (0 or 1+), indeterminate (2+) or positive (+) (3+). Results: 56 pts were eligible for analysis (45 M/11 F) with median age 67 years (37-83). Mean BMI was 29.6±6.6 and 43 pts (92%) had underlying Barrett’s esophagus. Most tumors (60%) were stage I (T1N0). Overall testing revealed tumors to be HER2 + (38%), indeterminate (21%) or - (41%). 50% of Stage I, 18% of stage IIA, 33% of stage IIB, and 14% of stage III tumors were HER2 + (p=0.035 for stage I compared to other stages). Underlying Barrett’s esophagus was associated with HER2 + (60 vs. 0%; p=0.045). The median follow up of the entire cohort was 2.9 years. Overall survival (OS) at 3 years was 80% for stage I, 50% for stage IA, 40% for stage IIB and 50% for stage III (p= 0.153). 3 year OS for HER2+ pts was 64% vs. 70% for HER2- (p=0.63). Univariate analysis did not show significant correlation among tobacco use, BMI, disease progression, survival and HER2 expression. Conclusions: This data suggests that HER2 overexpression is more frequent in early stage disease with underlying Barrett’s esophagus. Our data do not support HER2 as a prognostic factor in EA/GEJ. The relationship of HER2 overexpression in the development of early stage GEJ, particularly in the setting of Barrett’s, is of clinical interest. Further investigation is warranted.

scholarly journals Comprehensive analysis of coagulation indices for predicting survival in patients with biliary tract cancer

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xindi Ke ◽  
Bao Jin ◽  
Wen You ◽  
Yang Chen ◽  
Haifeng Xu ◽  
...  
Keyword(s):  
Biliary Tract ◽  
Biliary Tract Cancer ◽  
Cox Regression ◽  
Predictive Accuracy ◽  
Prognostic Significance ◽  
Tnm Staging ◽  
Coagulation System ◽  
The Novel ◽  
Cox Regression Analysis ◽  
Tract Cancer

Abstract Background Abnormal activation of the coagulation system has been reported in patients with malignancies, but its prognostic significance in biliary tract cancer (BTC) remains unclear. This study aims to analyze and compare the prognostic value of coagulation indices in patients with BTC. Methods The medical records of 450 patients with BTC who underwent surgical resection at our hospital between 2003 and 2017 were retrospectively analyzed. Time-dependent receiver operating characteristic curves were plotted to compare the predictive accuracy of coagulation indices. A predictive nomogram for overall survival (OS) was established based on the Cox regression analysis and validated in both the training and validation cohorts. A novel stratification model was created according to the total points of the nomogram. Results Fibrinogen and international normalized ratio (INR) had the best predictive accuracy among the coagulation indices considered and were also the independent prognostic factors for OS. The nomogram and the novel stratification model had satisfactory performance and outperformed TNM staging. Conclusions The study demonstrated that coagulation indices are valuable in predicting OS in BTC, with fibrinogen and INR having the best predictive ability. The nomogram and the novel stratification model could be applied to predict survival for patients with BTC.

Prognostic significance of lymph node retrieval in localized rectal cancer (RC): A registry analysis of 8,964 patients (pts).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 3566-3566
Author(s):  
Amandeep Gill ◽  
Ann Brunson ◽  
Primo Lara ◽  
Kristin Olson ◽  
Arta Monjazeb ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Early Stage ◽  
Prognostic Significance ◽  
Cox Proportional Hazards ◽  
Node Number ◽  
Node Negative ◽  
T Stage ◽  
Lymph Node Retrieval ◽  
Positive Lymph Nodes

3566 Background: In contrast to colon cancer, the prognostic implications of reduced lymph node retrieval in RC are unclear. We investigated the association between the total number of lymph nodes examined in early stage RC and disease specific survival (DSS) in two cohorts: 1) pts who underwent surgery and adjuvant (ADJ) chemoradiation (chemoXRT), and 2) those who received neoadjuvant (NEO) chemoXRT. Methods: Using the California Cancer Registry, we identified 8,946 pts with stage I – III RC diagnosed from 2000 to 2007. Of these, 4,790 underwent tri-modality therapy: 2,946 patients (61.5%) had NEO chemoXRT and 1,844 patients (38.5%) had ADJ chemoXRT. Multivariate Cox proportional hazards models were constructed for DSS, adjusting for age, sex, race, socioeconomic status, T-stage and lymph node number. DSS was compared between NEO and ADJ cohorts within separate subgroups of pathologic node positive and node negative RC. Results: Although there was no difference in overall DSS between the NEO and ADJ cohorts, the median number of lymph nodes examined was reduced in patients who had undergone NEO chemoXRT (8 vs. 11, p<0.0001). For all pts treated with tri-modality therapy, advancing age and higher T-stage were associated with significantly reduced DSS. Positive lymph nodes were associated with worse DSS regardless of the timing of therapy, although the effect was stronger for residual lymph nodes in the NEO cohort (HR 2.8 vs. 1.8 in ADJ cohort, p<0.001). For node negative pts in the ADJ cohort, increased lymph node retrieval was associated with improved DSS (HR per node 0.952, p=0.017); however, no association between lymph nodes examined and DSS was seen in the NEO cohort (p=0.282). Conclusions: Residual positive lymph nodes in pts treated with NEO chemoXRT are more strongly associated with poorer DSS than in pts treated with surgery and ADJ chemoXRT. NEO chemoXRT dissociates the connection between lymph node retrieval and survival in RC. This finding highlights a key difference between colon and RC and underscores the need for a different interpretation of the pathologic findings after NEO therapy.

scholarly journals High Pretreatment Plasma D-dimer Levels Are Associated With Poor Prognosis in Patients With Ovarian Cancer Independently of Venous Thromboembolism and Tumor Extension

2015 ◽  
Vol 25 (4) ◽  
pp. 593-598 ◽  
Author(s):  
Manabu Sakurai ◽  
Toyomi Satoh ◽  
Koji Matsumoto ◽  
Hiroo Michikami ◽  
Yuko Nakamura ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Venous Thromboembolism ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Distant Metastases ◽  
Tumor Extension ◽  
Poor Overall Survival ◽  
Gynecology And Obstetrics ◽  
D Dimer

ObjectiveElevated plasma D-dimer (DD) is associated with decreased survival among patients with breast, lung, and colon cancers. The present study clarifies the prognostic significance of pretreatment plasma DD levels in patients with epithelial ovarian cancer (EOC).MethodsWe investigated pretreatment DD levels and other variables for overall survival using univariate and multivariate analyses in 134 consecutive patients with EOC stages II to IV who were initially treated between November 2004 and December 2010.ResultsThe median follow-up period was 53 (7–106) months. Univariate analysis significantly associated elevated pretreatment DD (≥2.0 μg/mL) levels to poor 5-year overall survival rates irrespective of previously treated venous thromboembolism (72.2% vs 52.6%,P= 0.039). Cancer antigen 125 levels of 200 U/mL or higher (P= 0.011), distant metastases (P= 0.0004), residual tumors (P< 0.0001), and International Federation of Gynecology and Obstetrics stage III/IV (P= 0.0033) were also poor prognostic factors. Multivariate analysis independently associated DD levels of 2.0 μg/mL or higher (P= 0.041), distant metastases (P= 0.013), and residual tumors (P< 0.0001) with poor overall survival.ConclusionsHigh pretreatment DD levels are associated with poor overall survival in patients with EOC independently of venous thromboembolism and tumor extension and might comprise a promising prognostic biomarker for patients with EOC.

scholarly journals Tumor-infiltrating CD8+ T cells combined with tumor-associated CD68+ macrophages predict postoperative prognosis and adjuvant chemotherapy benefit in resected gastric cancer

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jun Lu ◽  
Yu Xu ◽  
Yuan Wu ◽  
Xiao-yan Huang ◽  
Jian-wei Xie ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Predictive Accuracy ◽  
Malignant Tumors ◽  
Controlled Trial ◽  
Prognostic Significance ◽  
Staging System ◽  
Tnm Staging ◽  
Tnm System ◽  
Cluster Of Differentiation

Abstract Background Tumor-infiltrating immune cells are present in various malignant tumors, but their clinical significance in gastric cancer (GC) remains unclear. This study aimed to investigate the prognostic significance of tumor-infiltrating lymphocytes (TILs) and tumor-associated macrophages (TAMs). Methods Using a prospective database containing 401 cases of GC, we evaluated TIL (cluster of differentiation 8 (CD8) expression) and TAM (cluster of differentiation 68 (CD68) expression) statuses via immunohistochemical staining. Results Compared with CD8+ TIL-negative cases (n = 196, 48.6%), CD8+ TIL-positive cases (n = 205, 51.1%) showed significantly better recurrence-free survival (RFS) [log-rank p<0.001; multivariate HR: 0.372; 95% confidence interval (CI): 0.239–0.579, p<0.001]. In contrast, compared with CD68+ TAM-negative cases (n = 217, 54.1%), CD68+ TAM-positive cases (n = 184, 45.9%) had significantly poor RFS [log-rank p<0.001; multivariate HR: 2.182; 95% CI: 1.435–3.318, p<0.001]. Thus, patients with a positive CD8+ TIL and negative CD68+ TAM status exhibited significantly increased RFS. Multivariate analysis demonstrated that CD8+ TILs and CD68+ TAMs may serve as independent prognostic markers for RFS. Incorporating CD8+ TIL and CD68+ TAM statuses into the AJCC TNM system generated a predictive model with better predictive accuracy for RFS. More importantly, patients with a positive TIL and negative TAM status showed a tendency of improved RFS after postoperative adjuvant chemotherapy (PAC). Similar results were obtained by overall survival (OS) analysis. Conclusions CD8+ TIL and CD68+ TAM statuses were identified as independent prognostic factors that may be integrated into the current TNM staging system to refine risk stratification and to better predict the survival benefit from PAC in patients with GC. Trial registration The current controlled trial was registered at ClinicalTrials.gov (ID: NCT02327481) on December 30, 2014.

Sentinel lymph node biopsy (SLNB) in melanoma and a simple prognostic score in a prospective cohort with long term follow-up

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 8058-8058
Author(s):  
F. Nasroulah ◽  
A. Gonzalez ◽  
J. Kaplan ◽  
C. Tajer ◽  
J. M. O'connor ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Early Stage ◽  
Prognostic Score ◽  
Univariate Analysis ◽  
Roc Curves ◽  
Tnm Staging ◽  
Lymph Node Biopsy ◽  
Male Sex

8058 Background: Outcome of early stage melanoma is related to pathological and clinical findings like SLNB status, but a systematic approach to risk stratification is lacking. Objectives: To assess outcome, and clinico-pathological criteria associated to recurrence and death of patients (pts) who underwent SLNB Methods: From 11/1994 to 5/2005, 286 clinical stages I/II melanoma pts underwent SLNB in our Institution. Median follow up was 38 months. Prognostic factors were analysed with Logranktest and proportional hazard regression. Survival curves with Kaplan-Meier method. A score was derived from coefficients of multivariate analysis and evaluated with ROC curves on 259 pts with complete data. Results: Median age: 48yr; male sex: 54%; median Breslow (Br): 1.8mm. SLNB +: 46 pts (16.1%). Ulcerated: 31%. 5-yr overall survival was 56% in SLNB+ vs 84% in SLNB-, p=0.0002. Five-yr relapse free survival was 52% in SLNB+ vs 73% in SLNB-, p=0.0017. SLNB status, Br, Clark level, Age>50yr, male sex, and ulceration were related to death by univariate analysis, but in multivariate analysis, only SLNB status (HR 2.36), Br (HR 1.66 for each T level of TNM staging) and ulceration (HR 2.35) remained. The score derived from the model was: 5 points (p) for SLNB +; 4p for ulceration; and 0p for Br<1mm, 2p for Br 1–2mm, 4p for Br 2–4mm, and 6p for Br>4mm. Conclusions: SLNB status, Br, and ulceration were, in concordance with literature, statistically significant prognostic factors. This allowed us to build a simple score with good correlation with prognosis (c index: 0.79). This score could be a useful tool for clinical practice and for future clinical trials, but validation in different populations is required. [Table: see text] No significant financial relationships to disclose.

scholarly journals The Predictive Value of Vessels Encapsulating Tumor Clusters in Treatment Optimization for Recurrent Early-stage Hepatocellular Carcinoma

2021 ◽  
Author(s):  
Zhi-Yuan Chen ◽  
Zhi-Xing Guo ◽  
Liang-He Lu ◽  
Jie Mei ◽  
Wen-Ping Lin ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Predictive Value ◽  
Early Stage ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Survival Outcomes ◽  
Treatment Optimization ◽  
Initial Hepatectomy ◽  
Significant Difference

Abstract Background: The predictive value of vessels encapsulating tumor clusters (VETC) in recurrent early-stage Hepatocellular Carcinoma (HCC) remains unclear. Therefore, the aim of the present study was to investigate the prognostic significance of VETC in patients with recurrent early-stage HCC after repeat hepatic resection (RHR) or radiofrequency ablation (RFA). Methods: From December 2005 to December 2016, 138 patients receiving RHR and 188 patients receiving RFA were recruited. VETC was evaluated by immunohistochemical staining for CD34. The survival outcomes of patients with VETC pattern or not were investigated. Results: There was no significant difference between the RHR and RFA groups in disease-free survival (DFS) or overall survival (OS) as determined by univariate analysis of the whole cohort. In the subgroup analysis of the VETC-positive cohort, the patients in the RHR group showed a longer median DFS time in contrast to those in the RFA group (15.0 vs 5.0 months, P=0.001). Similarly, the patients in the RHR group showed a longer median OS time in contrast to those in the RFA group (39.5 vs 19 months, P=0.001). In the VETC-negative cohort, no significant differences in DFS and OS rates between the RHR and RFA groups were observed (P>0.05).Conclusions: The results of our study suggested that RHR was relatively safe and superior to RFA in improving survival outcomes for recurrent early-stage HCC after initial hepatectomy. Furthermore, the VETC pattern may represent a reliable marker for selecting HCC patients who may benefit from RHR.

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