Comparison of open liver resection and RFA for the treatment of solitary 3-5 cm hepatocellular carcinoma: a retrospective study

Abstract Aim: The goal of this study was to compare the postoperative results of liver resection and radiofrequency ablation (RFA) for the treatment of small hepatocellular carcinoma (HCC) (3-5 cm). Patients and methods: We retrospectively collected 122 patients with small solitary HCC treated at our center from Jan 2011 to Dec 2015, with diameters in the range of 3-5 cm. According to the treatment program received at our center, they were divided into the liver resection group (72 patients) and the RFA group (50 patients). Result: In comparison with the RFA group, the resection group had a longer operative time, and greater intra-operative blood loss (P<0.01), more hepatic inflow occlusion , and longer postoperative hospital stay (P<0.01). The 1-, 3-, and 5-year expected overall survival rates and tumor-free survival rates were comparable between the two groups. Cox regression analysis showed that resection or RFA was not a significant risk factor for overall or tumor-free survival for HCC. Conclusions: For solitary HCC of 3-5 cm in diameter, RFA can achieve better in-hospital clinical results and similar long-term outcomes, and RFA can be considered for wide application, especially for central cases.

Download Full-text

Comparison of open liver resection and RFA for the treatment of solitary 3-5 cm hepatocellular carcinoma: a retrospective study

10.21203/rs.2.11159/v4 ◽

2019 ◽

Author(s):

Jianyong Lei ◽

LN Yan ◽

DJ Li ◽

WT Wang

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Resection ◽

Cox Regression ◽

Survival Rates ◽

Significant Risk ◽

Significant Risk Factor ◽

Small Hepatocellular Carcinoma ◽

Free Survival ◽

Cox Regression Analysis ◽

Resection Group

Abstract Aim: The goal of this study was to compare the postoperative results of liver resection and radiofrequency ablation (RFA) for the treatment of small hepatocellular carcinoma (HCC) (3-5 cm). Patients and methods: We retrospectively collected 122 patients with small solitary HCC treated at our center from Jan 2011 to Dec 2015, with diameters in the range of 3-5 cm. According to the treatment program received at our center, they were divided into the liver resection group (72 patients) and the RFA group (50 patients). Result : In comparison with the RFA group, the resection group had a longer operative time, and greater intra-operative blood loss (P<0.01), more hepatic inflow occlusion , and longer postoperative hospital stay (P<0.01). The 1-, 3-, and 5-year expected overall survival rates and tumor-free survival rates were comparable between the two groups. Cox regression analysis showed that resection or RFA was not a significant risk factor for overall or tumor-free survival for HCC. Conclusions : For solitary HCC of 3-5 cm in diameter, RFA can achieve better in-hospital clinical results and similar long-term outcomes, and RFA can be considered for wide application, especially for central cases.

Download Full-text

Comparison of open liver resection and RFA for the treatment of solitary 3-5 cm hepatocellular carcinoma: a retrospective study

10.21203/rs.2.11159/v2 ◽

2019 ◽

Author(s):

Jianyong Lei ◽

LN Yan ◽

DJ Li ◽

WT Wang

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Resection ◽

Cox Regression ◽

Survival Rates ◽

Significant Risk ◽

Significant Risk Factor ◽

Small Hepatocellular Carcinoma ◽

Free Survival ◽

Cox Regression Analysis ◽

Resection Group

Abstract Aim: The goal of this study was to compare the postoperative results of liver resection and radiofrequency ablation (RFA) for the treatment of small hepatocellular carcinoma (HCC) (3-5 cm). Patients and methods: We retrospectively collected 122 patients with small solitary HCC treated at our center from Jan 2011 to Dec 2015, with diameters in the range of 3-5 cm. According to the treatment program received at our center, they were divided into the liver resection group (72 patients) and the RFA group (50 patients). Result: In comparison with the RFA group, the resection group had a longer operative time, and greater intra-operative blood loss (P<0.01), more hepatic inflow occlusion, and longer postoperative hospital stay (P<0.01). The 1-, 3-, and 5-year expected overall survival rates and tumor-free survival rates were comparable between the two groups. Cox regression analysis showed that resection or RFA was not a significant risk factor for overall or tumor-free survival for HCC. Conclusions: For solitary HCC of 3-5 cm in diameter, RFA can achieve better in-hospital clinical results and similar long-term outcomes, and RFA can be considered for wide application, especially for central cases.

Download Full-text

Comparison of open liver resection and RFA for the treatment of solitary 3-5 cm hepatocellular carcinoma: a retrospective study

10.21203/rs.2.11159/v5 ◽

2019 ◽

Author(s):

Jianyong Lei ◽

LN Yan ◽

DJ Li ◽

WT Wang

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Resection ◽

Cox Regression ◽

Survival Rates ◽

Significant Risk ◽

Significant Risk Factor ◽

Clinical Results ◽

Small Hepatocellular Carcinoma ◽

Free Survival ◽

Cox Regression Analysis

Abstract Background: The goal of this study was to compare the postoperative results of liver resection and radiofrequency ablation (RFA) for the treatment of small hepatocellular carcinoma (HCC) (3-5 cm). Patients and methods: We retrospectively collected 122 cases of small solitary HCC treated at our center from Jan 2011 to Dec 2015, with diameters in the range of 3-5 cm. According to the treatment program received at our center, the patients were divided into liver resection (72 patients) and RFA (50 patients) groups. Result: In comparison with the RFA group, the resection group had a longer operative time, greater intraoperative blood loss (P<0.01), more hepatic inflow occlusion, and a longer postoperative hospital stay (P<0.01). The 1-, 3-, and 5-year expected overall survival rates and tumor-free survival rates were comparable between the two groups. Cox regression analysis showed that neither resection nor RFA was a significant risk factor for overall or tumor-free survival in HCC. Conclusions: For solitary HCC of 3-5 cm in diameter, RFA can achieve better in-hospital clinical results and similar long-term outcomes than resection and can be considered for wide application, especially for central-location cases.

Download Full-text

Comparison open liver resection and RFA on the treatment of solitary 3-5cm hepatocellular carcinoma

10.21203/rs.2.11159/v1 ◽

2019 ◽

Author(s):

Jianyong Lei ◽

LN Yan ◽

DJ Li ◽

WT Wang

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Resection ◽

Cox Regression ◽

Survival Rates ◽

Significant Risk ◽

Small Hepatocellular Carcinoma ◽

Long Term Outcome ◽

Free Survival ◽

Cox Regression Analysis ◽

Resection Group

Abstract Aim The goal of this study is to compare the postoperative results of liver resection and radiofrequency ablation (RFA) for the treatment of small hepatocellular carcinoma (HCC) (3-5cm). Patients and methods We retrospectively collected 122 patients with small solitary HCC treated at our center, with diameters in the range of 3-5cm. According to the treatment program received at our center, they are divided into the liver resection group (72 cases) and the RFA group (50 cases). Result In comparison with the RFA group, the resection group requires a longer operative time, and the intra-operative blood loss is more (P<0.01); there is also more hepatic inflow occlusion, and the postoperative days of hospital stay are significantly longer (P<0.01). The 1-, 3-, and 5- year expected overall survival rates and tumor-free survival rates are comparable between two groups. Cox regression analysis showed that resection or RFA was not a significant risk factor for overall or tumor-free survival for HCC. Conclusions For solitary HCC of 3-5cm, RFA can achieve better hospital clinical results and similar long-term outcome, and RFA can be considered for wide application especially for central cases.

Download Full-text

Comparison of open liver resection and RFA for the treatment of solitary 3–5-cmhepatocellular carcinoma: a retrospective study

BMC Surgery ◽

10.1186/s12893-019-0663-9 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Lei Jianyong ◽

◽

Yan Lunan ◽

Li Dajiang ◽

Wang Wentao

Keyword(s):

Liver Resection ◽

Cox Regression ◽

Survival Rates ◽

Significant Risk ◽

Significant Risk Factor ◽

Clinical Results ◽

Small Hepatocellular Carcinoma ◽

Free Survival ◽

Cox Regression Analysis

Abstract Background The goal of this study was to compare the postoperative results of liver resection and radiofrequency ablation (RFA) for the treatment of small hepatocellular carcinoma (HCC) (3–5 cm). Patients and methods We retrospectively collected 122 cases of small solitary HCC treated at our center from Jan 2011 to Dec 2015, with diameters in the range of 3–5 cm. According to the treatment program received at our center, the patients were divided into liver resection (72 patients) and RFA (50 patients) groups. Result In comparison with the RFA group, the resection group had a longer operative time, greater intraoperative blood loss (P < 0.01), more hepatic inflow occlusion, and a longer postoperative hospital stay (P < 0.01). The 1-, 3-, and 5-year expected overall survival rates and tumor-free survival rates were comparable between the two groups. Cox regression analysis showed that neither resection nor RFA was a significant risk factor for overall or tumor-free survival in HCC. Conclusions For solitary HCC of 3–5 cm in diameter, RFA can achieve better in-hospital clinical results and similar long-term outcomes than resection and can be considered for wide application, especially for central-location cases.

Download Full-text

Identification and validation of AKR1C1/2/3 as hepatocellular carcinoma risk modules via an integrated strategy

10.21203/rs.2.24543/v1 ◽

2020 ◽

Author(s):

Mingxing Xu ◽

Yuesi Zhong ◽

Fangji Yang ◽

Kai Liu ◽

Baoding Zhuang ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Cox Regression ◽

Significant Risk ◽

Reduction Process ◽

Progression Free Survival ◽

Tumor Stage ◽

Genetic Alterations ◽

Metabolic Process ◽

Free Survival ◽

Cox Regression Analysis

Abstract Background The human aldo-keto reductase 1 (AKR1) C family comprises four enzymes, AKR1C1–AKR1C4. Lots of studies have investigated the function of AKR1Cs in tumors, however little is known in hepatocellular carcinoma (HCC). Methods Public databases were used to explore expression and role of AKR1Cs in HCC. Meanwhile, data of 134 HCC patients from Firebrowse website was used for validation. Results The results revealed that AKR1Cs expression was negatively correlated with the infiltration level of CD4+ T cells. Overexpression of AKR1C1/2/3 was significantly associated with tumor stage and pathological grade. Moreover, higher mRNA expression of AKR1C1/2/3 was related with shorter overall survival (OS), progression-free survival (PFS) and relapse-free survival (RFS). Multivariate Cox regression analysis showed that AKR1C1/2/3 could be significant risk factors for HCC patients. Additionally, genetic alterations of AKR1Cs can significantly affect patient OS and PFS, and expression of AKR1Cs was linked to functional networks involving oxidation-reduction process, cellular hormone metabolic process and organic hydroxy compound metabolic process, as well as retinol metabolism, steroid hormone biosynthesis, metabolic pathway and fatty acid degradation pathways. Conclusions In conclusion, we successfully elaborated the relationship between AKR1Cs expression and immune infiltrations, and identified AKR1C1/2/3 could be novel prognostic biomarkers for HCC patients.

Download Full-text

The impact of thrombocytopenia on prognosis of HBV-related small hepatocellular carcinoma: a propensity score matching analysis

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02160-2 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Wei Peng ◽

Chuan Li ◽

Xiaoyun Zhang ◽

Tianfu Wen ◽

Zheyu Chen

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Resection ◽

Propensity Score ◽

Propensity Score Matching ◽

Surgical Outcome ◽

Cox Regression ◽

Small Hepatocellular Carcinoma ◽

Cox Regression Analysis ◽

Small Hcc ◽

The Impact

Abstract Background Thrombocytopenia was reported both detrimental and advantageous to hepatocellular carcinoma (HCC). However, there is little evidence showing clearly the clinical value of preoperative thrombocytopenia on the surgical outcome of patients with small HCC. This retrospective study aimed at elucidating the correlation between preoperative thrombocytopenia and surgical outcome of small HCC patients within Milan criteria treated with liver resection. Methods Data of hepatitis B virus (HBV)-related small HCC patients were retrospectively analyzed, and we performed the propensity score matching (PSM) analysis to overcome the imbalance of clinicopathological features. Patients enrolled were subsequently categorized into two groups according to preoperative platelet counts: thrombocytopenia group and non-thrombocytopenia group. Survival outcomes of the patients in both groups were described with the Kaplan-Meier method, and the difference was compared with a log-rank test. Cox regression analysis was applied to identify the risk factors of surgical outcome. Results After PSM, the estimated 1-, 3-, and 5-year overall survival (OS) rates for small HCC patients in the thrombocytopenia group were 94.5%, 77.0%, and 57.6%, and 95.0%, 79.6%, and 68.0%, respectively, for small HCC patients in the non-thrombocytopenia group (P = 0.042). And the 1-, 3-, and 5-year estimated recurrence-free survival (RFS) rates for small HCC patients in the thrombocytopenia group were 70.4%, 51.0%, and 42.1%, and 83.8%, 63.7%, and 46.7%, respectively, for small HCC patients in the non-thrombocytopenia group (P = 0.035). Multivariate analysis indicated preoperative thrombocytopenia was a significant prognosticator of poor RFS (hazard ratio (HR) = 1.388, 95% confidence interval (CI) 1.028~1.874, P = 0.033). Conclusion Preoperative thrombocytopenia had an undesirable impact on the recurrence of small HCC patients treated with liver resection.

Download Full-text

Development and Validation of Prognostic Nomograms Predicting Recurrence and Survival in Patients with Solitary Hepatocellular Carcinoma Following Curative Liver Resection

10.21203/rs.3.rs-1070685/v1 ◽

2021 ◽

Author(s):

Xinxin Chen ◽

Wenxia Qiu ◽

Xuekun Xie ◽

Zefeng Chen ◽

Zhiwei Han ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Resection ◽

Cox Regression ◽

Disease Free Survival ◽

Clinicopathological Characteristics ◽

Tumor Diameter ◽

Cox Regression Analysis ◽

Tumor Capsule ◽

Calibration Curves ◽

Solitary Hepatocellular Carcinoma

Abstract Background: This work was designed to establish and verify our nomograms integrating clinicopathological characteristics with hematological biomarkers to predict both disease-free survival (DFS) and overall survival (OS) in solitary hepatocellular carcinoma (HCC) patients following hepatectomy.Methods: We scrutinized the data retrospectively from 414 patients with a clinicopathological diagnosis of solitary HCC from Guangxi Medical University Cancer Hospital (Nanning, China) between January 2004 and December 2012. Following the random separation of the samples in a 7:3 ratio into the training set and validation set, the former set was assessed by Cox regression analysis to develop two nomograms to predict the 1-year and 3-year DFS and OS (3-years and 5-years). This was followed by discrimination and calibration estimation employing Harrell’s C-index (C-index) and calibration curves, while the internal validation was also assessed.Results: In the training cohort, the tumor diameter, tumor capsule, macrovascular invasion, and alpha-fetoprotein (AFP) were included in the DFS nomogram. Age, tumor diameter, tumor capsule, macrovascular invasion, microvascular invasion, and aspartate aminotransferase (AST) were included in the OS nomogram. The C-index was 0.691 (95% CI: 0.644-0.738) for the DFS-nomogram and 0.713 (95% CI: 0.670-0.756) for the OS-nomogram. The survival probability calibration curves displayed a fine agreement between the predicted and observed ranges in both data sets. Conclusion: Our nomograms combined clinicopathological features with hematological biomarkers to emerge effective in predicting the DFS and OS in solitary HCC patients following curative liver resection. Therefore, the potential utility of our nomograms for guiding individualized treatment clinically and monitor the recurrence monitoring in these patients.

Download Full-text

Surgical Resection Significantly Promotes the Overall Survival of Patients with Hepatocellular Carcinoma: A Propensity Score Matching Analysis

10.21203/rs.3.rs-148506/v1 ◽

2021 ◽

Author(s):

Pei-Min Hsieh ◽

Hung-Yu Lin ◽

Chao-Ming Hung ◽

Gin-Ho Lo ◽

I-Cheng Lu ◽

...

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Overall Survival ◽

Propensity Score ◽

Propensity Score Matching ◽

Surgical Resection ◽

Cox Regression ◽

Survival Rates ◽

Hbv Infection ◽

Cox Regression Analysis

Abstract Background: The benefits of surgical resection (SR) for various Barcelona Clinic Liver Cancer (BCLC) stages of hepatocellular carcinoma (HCC) remain unclear. We investigated the risk factors of overall survival (OS) and survival benefits of SR over nonsurgical treatments in patients with HCC of various BCLC stages.Methods: Overall, 2316 HCC patients were included, and their clinicopathological data and OS were recorded. OS was analyzed by the Kaplan-Meier method and Cox regression analysis. Propensity score matching (PSM) analysis was performed.Results: In total, 66 (2.8%), 865 (37.4%), 575 (24.8%) and 870 (35.0%) patients had BCLC stage 0, A, B, and C disease, respectively. Furthermore, 1302 (56.2%) of all patients, and 37 (56.9%), 472 (54.6%), 313 (54.4%) and 480 (59.3%) of patients with BCLC stage 0, A, B, and C disease, respectively, died. The median follow-up duration time was 20 (range 0-96) months for the total cohort and was subdivided into 52 (8-96), 32 (1-96), 19 (0-84), and 12 (0-79) months for BCLC stages 0, A, B, and C cohorts, respectively. The risk factors for OS were 1) SR and cirrhosis; 2) SR, cirrhosis, and Child-Pugh (C-P) class; 3) SR, hepatitis B virus (HBV) infection, and C-P class; and 4) SR, HBV infection, and C-P class for the BCLC stage 0, A, B, and C cohorts, respectively. Compared to non-SR treatment, SR resulted in significantly higher survival rates in all cohorts. The 5-year OS rates for SR vs non-SR were 44.0% vs 28.7%, 72.2% vs 42.6%, 42.6% vs 36.2, 44.6% vs 23.5%, and 41.4% vs 15.3% (all p-values<0.05) in the total and BCLC stage 0, A, B, and C cohorts, respectively. After PSM, SR resulted in significantly higher survival rates compared to non-SR treatment in various BCLC stages.Conclusion: SR conferred significant survival benefits to patients with HCC of various BCLC stages and should be considered a recommended treatment for select HCC patients, especially patients with BCLC stage B and C disease.

Download Full-text

Manuscript Impact on Prognosis of Different Anatomical Hepatectomy Approaches for Single Hepatocellular Carcinoma in Segment VI

10.21203/rs.2.14755/v1 ◽

2019 ◽

Author(s):

Jie Mei ◽

Shao-Hua Li ◽

Qiao-Xuan Wang ◽

Liang-He Lu ◽

Anna Kan ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Early Stage ◽

Significant Risk ◽

Significant Risk Factor ◽

Postoperative Recovery ◽

Free Survival ◽

Propensity Score Matching Analysis ◽

Early Hcc ◽

The Common ◽

Preoperative Factors

Abstract Background. Liver resection is effective for hepatocellular carcinoma (HCC). For a single HCC in subsegment 6 (S6), segmentectomy of S6, S5 (S6+5) and segmentectomy of S6, S7 (S6+7) are the common anatomical surgical procedures. However, the benefit of the two resection methods has not been clarified in this patient subgroup. This study aimed to compare the outcomes of S6+5 resection and S6+7 resection for single, early HCC located on S6 of the liver. Methods. In total, 115 patients with single HCC in S6 without vascular invasion and distant metastasis were included in this study. The patients were divided into the S6+5 group (n=73) and S6+7 group (n=42). A one-to-one propensity score-matching analysis (PSM) was performed to minimize the effect of potential confounders. Results. Forty patients from each group were matched. The preoperative factors were balanced between the two groups. The 1-, 2-, and 3-year overall survival (OS) rates in the S6+5 group were 92.3%, 82.1%, and 76.8%, respectively, and in the S6+7 group were 94.5%, 91.6% and 88.6%, respectively (p=0.197). The 1-, 2-, and 3-year recurrence-free survival (RFS) rates in the S6+5 group were 71.9%, 61.6%, and 58.9%, respectively, and in the S6+7 group were 83.5%, 77.7% and 68.8%, respectively (p=0.432). There were no significant differences in the recurrence pattern and postoperative recovery of liver function. The surgical procedure was not a significant risk factor for the OS and RFS in both the uni- and multivariate analyses. Conclusion. S6+5 and S6+7 resection achieved similar outcomes for early-stage solitary HCC in S6.

Download Full-text