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

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.

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

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.

scholarly journals The Prognostic Value of the Albumin to Gamma-Glutamyltransferase Ratio in Patients with Hepatocellular Carcinoma Undergoing Radiofrequency Ablation

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Wenfeng Liu ◽  
Feng Zhang ◽  
Bing Quan ◽  
Miao Li ◽  
Shenxin Lu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Validation Cohort ◽  
Early Stage ◽  
Roc Curves ◽  
Free Survival ◽  
Training Cohort ◽  
Gamma Glutamyltransferase ◽  
Lemeshow Test ◽  
Early Hcc

Albumin to gamma-glutamyltransferase ratio (AGR) is a newly developed biomarker for the prediction of patients’ prognosis in solid tumors. The purpose of the study was to establish a novel AGR-based nomogram to predict tumor prognosis in patients with early-stage HCC undergoing radiofrequency ablation (RFA). 394 hepatocellular carcinoma (HCC) patients who had received RFA as initial treatment were classified into the training cohort and validation cohort. Independent prognostic factors were identified by univariate and multivariate analyses. The value of AGR was evaluated by the concordance index ( C -index), receiver operating characteristic (ROC) curves, and likelihood ratio tests (LAT). Logistic regression and nomogram were performed to establish the pretreatment scoring model based on the clinical variables. As a result, AGR = 0.63 was identified as the best cutoff value to predict overall survival (OS) in the training cohort. According to the results of multivariate analysis, AGR was an independent indicator for OS and recurrence-free survival (RFS). In both training cohort and validation cohort, the high-AGR group showed better RFS and OS than the low-AGR group. What is more, the C -index, area under the ROC curves, and LAT χ 2 values suggested that AGR outperformed the Child-Pugh (CP) grade and albumin-bilirubin (ALBI) grade in terms of predicting OS. The AGR, AKP, and tumor size were used to establish the OS nomogram. Besides, the results of Hosmer-Lemeshow test and calibration curve analysis displayed that both nomograms in the training and validation cohorts performed well in terms of calibration. Therefore, the AGR-based nomogram can predict the postoperative prognosis of early HCC patients undergoing RFA.

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

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.

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

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.

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

2019 ◽  
Author(s):  
Jianyong Lei ◽  
Yan Lunan ◽  
Li Dajiang ◽  
Wang Wentao
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.

scholarly journals Predictors of Survival in Atypical Meningiomas

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1970
Author(s):  
Michele Da Broi ◽  
Paola Borrelli ◽  
Torstein R. Meling
Keyword(s):  
Neurological Outcome ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
University Hospital ◽  
Neurological Deficits ◽  
Karnofsky Performance Scale ◽  
Free Survival ◽  
Neurological Outcomes ◽  
Progression Of Disease ◽  
Atypical Meningiomas

Introduction: Predictors of survival and progression of disease in atypical meningiomas are less well documented in the literature compared to benign meningiomas. Higher grade meningiomas tend to recur often and one of the most critical aspects is how to best deal with relapses. Methods: A total of 77 consecutive patients who underwent craniotomy for atypical meningioma between 1990–2010 at Oslo University Hospital (OUH) were reviewed. Results: Median age at surgery was 62.21 [interquartile range (IQR): 22.87] years. Fifty-one patients (66.2%) had neurological deficits at presentation. Fifty-four patients (70.1%) underwent gross total resection (GTR). Thirty-nine patients (50.7%) had improved/stable neurological outcomes at 6–12 months. Twenty-two patients (28.6%) underwent retreatment, of whom 20 (26.0%) were subjected to resection followed by adjuvant radiotherapy. Overall survival (OS) was significantly longer in patients <65 years (p < 0.001), with preoperative Karnofsky performance scale (KPS) score of ≥ 70 (p = 0.006), and who required no retreatment (p = 0.033). GTR significantly prolonged the retreatment-free survival rate (p < 0.001). STR carried almost a six-fold greater risk of neurological outcome deterioration (p = 0.044). Conclusions: GTR significantly prolonged retreatment-free survival but had no significant impact on OS. STR was a significant risk factor for deteriorated neurological outcome. Age, preoperative KPS, and retreatment were all strong predictors of OS. Median time-to-retreatment (TTR) did not shorten significantly throughout repeated surgeries.

A multicenter nonrandomized controlled trial to evaluate the efficacy of surgery versus radiofrequency ablation for small hepatocellular carcinoma (SURF cohort trial).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 4581-4581
Author(s):  
Ryosuke Tateishi ◽  
Kiyoshi Hasegawa ◽  
Yoshikuni Kawaguchi ◽  
Tadatoshi Takayama ◽  
Namiki Izumi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Early Stage ◽  
Controlled Trial ◽  
Patient Characteristics ◽  
Small Hepatocellular Carcinoma ◽  
Multicenter Randomized Controlled Trial ◽  
Early Hcc ◽  
The Difference

4581 Background: In parallel with a multicenter randomized controlled trial that reported an equal recurrence-free survival (RFS) of early-stage hepatocellular carcinoma (HCC) patients who underwent either surgery (SUR) or radiofrequency ablation (RFA), we also enrolled HCC patients who fulfilled the enrollment criteria but did not give consent to participate in the RCT. Methods: All patients gave informed consent to participate in this study. Inclusion criteria were as follows: primary HCC with less than or equal to 3 tumors, each measuring 3 cm or smaller; without vascular invasion or extrahepatic metastasis; Child-Pugh score of 7 or less; and ages between 20 and 79 years. The feasibility for both treatments was confirmed by a joint chart review by surgeons and hepatologists. The primary endpoint was RFS and overall survival. A pre-specified interim analysis was performed to compare RFS. Results: Between April 2009 and August 2015, 740 patients (371 in SUR, 369 in RFA) were enrolled from 49 participating hospitals in Japan. The SUR group had significantly fewer patients with chronic hepatitis C (56.6% vs. 69.4%), higher median value of platelet count (145 vs. 120 × 109/L), and more patients with > 2 cm tumors (49.9% vs. 27.9%); most patients had a single tumor (91.1% vs. 88.3%). During the median follow-up period of 5 years, tumor recurrence was observed in 192 of SUR and 218 of RFA with 3-year RFS being 66.0% and 61.7%, respectively ( P = 0.091). In subgroup analysis, RFS was significantly better in SUR in patients with ≤ 2 cm tumors (62.9% vs. 51.7% in 3 years; hazard ratio [HR] 0.72, 95% confidence interval [CI] 0.56-0.93; P = 0.014), whereas the difference was not significant in those with > 2 cm tumors (52.7% vs. 46.4%; HR 0.85, 95% CI 0.63-1.18; P = 0.34). The adjusted HR for RFS using inversed probability of treatment weighting was 0.89 (95% CI, 0.72-1.10; P = 0.287). Conclusions: The imbalance in patient characteristics reflected a real-world practice. Factors related to background liver disease rather than tumor characteristics might have a larger impact on the recurrence in early HCC. Clinical trial information: C000001796 .

Percutaneous radiofrequency ablation for the treatment of early stage hepatocellular carcinoma: A health technology assessment

2010 ◽  
Vol 26 (4) ◽  
pp. 390-397 ◽  
Author(s):  
Xuanqian Xie ◽  
Nandini Dendukuri ◽  
Maurice McGregor
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Survival Rate ◽  
Cohort Studies ◽  
Early Stage ◽  
Disease Free Survival ◽  
Sufficient Evidence ◽  
Percutaneous Radiofrequency Ablation ◽  
Free Survival ◽  
Disease Free

Objectives: The aim of this study was to compare the clinical effectiveness and cost of percutaneous radiofrequency ablation (PRFA) and surgical resection (SRS) for the management of early stage Hepatocellular Carcinoma.Methods: A systematic literature search of articles in English, French, and Chinese was performed using online databases. Only articles with patients classified as Child-Pugh Class A or B, with tumor size <5 cm were included. A meta-analysis was carried out to estimate the survival rate and disease-free survival rate following PRFA or SRS treatments. The cost of each treatment was estimated from the third party perspective. Univariate sensitivity analyses were used to study the relative importance of each component cost.Results: We identified six studies (one randomized controlled trial (RCT) and five comparative cohort studies) meeting our inclusion criteria. There is good evidence that among Child-Pugh A patients for whom both SRS and PRFA are available options, survival rates following either procedure are comparable, while complications are more frequent and hospitalization longer following SRS. The evidence concerning recurrence rates and disease-free survival is less clear. Whereas the RCT indicates comparable outcomes with either procedure up to 3 years, the results of five cohort studies (with possible selection bias), particularly those with a mix of Child-Pugh A and B patients, favor the surgical option. SRS, costs approximately Canadian $8,275 more per case than PRFA.Conclusions: Continuing doubts on this issue can only be resolved by a substantial RCT. Meanwhile, for early stage HCC patients classified as Child-Pugh A, who despite a possibly higher recurrence rate, prefer the less invasive PRFA to open surgery with its attendant risks, there is sufficient evidence to justify such a choice. For those classified as Child-Pugh (B) it is possible that overall survival is equally good with PRFA, but the evidence is less certain.

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

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.

scholarly journals Autoantibody to GNAS in Early Detection of Hepatocellular Carcinoma: A Large-Scale Sample Study Combined with Verification in Serial Sera from HCC Patients

Biomedicines ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 97
Author(s):  
Xiao Wang ◽  
Keyan Wang ◽  
Cuipeng Qiu ◽  
Bofei Wang ◽  
Xiaojun Zhang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Early Detection ◽  
Large Scale ◽  
Early Stage ◽  
Decompensated Cirrhosis ◽  
Compensated Cirrhosis ◽  
Autoantibody Response ◽  
Potential Biomarker ◽  
Early Hcc ◽  
Normal Controls

The aim of this study was to explore the value of autoantibody to GNAS in the early detection of hepatocellular carcinoma (HCC). In a large-scale sample set of 912 participants (228 cases in each of HCC, liver cirrhosis (LC), chronic hepatitis B (CHB), and normal controls (NCs) groups), autoantibody to GNAS was detected with a positive result in 47.8% of HCC patients, which was significantly higher than that in patients with LC (35.1%), CHB (19.7%), and NCs (19.7%). Further analysis showed that the frequency of autoantibody to GNAS started increasing in compensated cirrhosis patients (37.0%) with a jump in decompensated cirrhosis patients (53.2%) and reached a peak in early HCC patients (62.4%). The increasing autoantibody response to GNAS in patients at different stages was closely associated with the progression of chronic liver lesions. The result from 44 human serial sera demonstrated that 5 of 11 (45.5%) HCC patients had elevated autoantibody to GNAS before and/or at diagnosis of HCC. Moreover, 46.1% and 62.4% of high positive rates in alpha-fetoprotein (AFP) negative and early-stage HCC patients can supplement AFP in early detection of HCC. These findings suggest that autoantibody to GNAS could be used as a potential biomarker for the early detection of HCC.

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