scholarly journals Preoperative Inflammatory Markers as Prognostic Predictors After Hepatocellular Carcinoma Resection: Data From a Western Referral Center

2021 ◽  
Author(s):  
João Paulo Maciel Silva ◽  
Fabricio Ferreira Coelho ◽  
Alex Jones Flores Cassenote ◽  
Vagner Birk Jeismann ◽  
Gilton Marques Fonseca ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Inflammatory Markers ◽  
Independent Predictor ◽  
Disease Free Survival ◽  
Rank Test ◽  
Prognostic Impact ◽  
Long Term Outcomes ◽  
Curative Intent ◽  
Lymphocyte Ratio

Abstract Background Recent studies from eastern centers have demonstrate an association between inflammatory response and long-term outcomes after hepatocellular carcinoma (HCC) resection. However, the prognostic impact of inflammatory markers in western patients, with distinct tumor and epidemiologic features, is still unknown. Aim To evaluate the prognostic impact of preoperative neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), as well as their impact according to tumor size (< 5 cm, 5-10 cm, > 10 cm) in patients undergoing HCC resection with curative intent. Methods Optimal cut-off values for NLR, PLR, and MLR were determined by plotting the receiver operator curves. Overall survival (OS) and disease-free survival (DFS) curves were calculated using the Kaplan-Meier method and compared using the log-rank test. The Cox method was used to identify independent predictors of OS and DFS. Results In total, 161 consecutive adult patients were included. A high NLR (>1.715) was associated with worse OS (P=0.018). High NLR (>2.475; P=0.047) and PLR (>100.25; P=0.028) were predictors of short DFS. In HCC < 5 cm, MLR (>1.715) was associated with worse OS (P=0.047). In the multivariate analysis, high PLR was an independent predictor of worse DFS (hazard ratio [HR]=3.029; 1.499-6.121; P=0.002). Conclusions Inflammatory markers are useful tools to predict long-term outcomes after liver resection in western patients, high NLR was able to stratify subgroups of patients with short OS and DFS, an increased PLR was an independent predictor of short DFS, while high MLR was associated with short OS in patients with early HCC.

scholarly journals More Favorable Short and Long-Term Outcomes for Screen-Detected Colorectal Cancer Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Gaya Spolverato ◽  
Giulia Capelli ◽  
Jessica Battagello ◽  
Andrea Barina ◽  
Susi Nordio ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Disease Free Survival ◽  
Target Population ◽  
Proximal Colon ◽  
Long Term Outcomes ◽  
Curative Intent ◽  
Diagnostic Modality ◽  
Screening Programs ◽  
Short And Long Term

BackgroundScreening significantly reduces mortality from colorectal cancer (CRC). Screen detected (SD) tumors associate with better prognosis, even at later stage, compared to non-screen detected (NSD) tumors. We aimed to evaluate the association between diagnostic modality (SD vs. NSD) and short- and long-term outcomes of patients undergoing surgery for CRC.Materials and MethodsThis retrospective cohort study involved patients aged 50–69 years, residing in Veneto, Italy, who underwent curative-intent surgery for CRC between 2006 and 2018. The clinical multi-institutional dataset was linked with the screening dataset in order to define diagnostic modality (SD vs. NSD). Short- and long-term outcomes were compared between the two groups.ResultsOf 1,360 patients included, 464 were SD (34.1%) and 896 NSD (65.9%). Patients with a SD CRC were more likely to have less comorbidities (p = 0.013), lower ASA score (p = 0.001), tumors located in the proximal colon (p = 0.0018) and earlier stage at diagnosis (p &lt; 0.0001). NSD patients were found to have more aggressive disease at diagnosis, higher complication rate and higher readmission rate due to surgical complications (all p &lt; 0.05). NSD patients had a significantly lower Disease Free Survival and Overall Survival (all p &lt; 0.0001), even after adjusting by demographic, clinic-pathological, tumor, and treatment characteristics.ConclusionsSD tumors were associated with better long-term outcomes, even after multiple adjustments. Our results confirm the advantages for the target population to participate in the screening programs and comply with their therapeutic pathways.

scholarly journals Impact of Angiogenesis- and Hypoxia-Associated Polymorphisms on Tumor Recurrence in Patients with Hepatocellular Carcinoma Undergoing Surgical Resection

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3826
Author(s):  
Hannah Miller ◽  
Zoltan Czigany ◽  
Isabella Lurje ◽  
Sophie Reichelt ◽  
Jan Bednarsch ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Surgical Resection ◽  
Tumor Angiogenesis ◽  
Disease Free Survival ◽  
High Expression ◽  
Rank Test ◽  
Care Hospital ◽  
Curative Intent ◽  
Log Rank Test ◽  
Primary Care Hospital

Tumor angiogenesis plays a pivotal role in hepatocellular carcinoma (HCC) biology. Identifying molecular prognostic markers is critical to further improve treatment selection in these patients. The present study analyzed a subset of 10 germline polymorphisms involved in tumor angiogenesis pathways and their impact on prognosis in HCC patients undergoing partial hepatectomy in a curative intent. Formalin-fixed paraffin-embedded (FFPE) tissues were obtained from 127 HCC patients at a German primary care hospital. Genomic DNA was extracted, and genotyping was carried out using polymerase chain reaction (PCR)–restriction fragment length polymorphism-based protocols. Polymorphisms in interleukin-8 (IL-8) (rs4073; p = 0.047, log-rank test) and vascular endothelial growth factor (VEGF C + 936T) (rs3025039; p = 0.045, log-rank test) were significantly associated with disease-free survival (DFS). After adjusting for covariates in the multivariable model, IL-8 T-251A (rs4073) (adjusted p = 0.010) and a combination of “high-expression” variants of rs4073 and rs3025039 (adjusted p = 0.034) remained significantly associated with DFS. High-expression variants of IL-8 T-251A may serve as an independent molecular marker of prognosis in patients undergoing surgical resection for HCC. Assessment of the patients’ individual genetic risks may help to identify patient subgroups at high risk for recurrence following curative-intent surgery.

scholarly journals Prognostic value of the postoperative neutrophil-lymphocyte ratio in solid tumors: A meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250091
Author(s):  
Meilong Wu ◽  
Shizhong Yang ◽  
Xiaobin Feng ◽  
Chengquan Li ◽  
Fei Yu ◽  
...  
Keyword(s):  
Solid Tumors ◽  
Relevant Literature ◽  
Disease Free Survival ◽  
Cochrane Library ◽  
Tumor Type ◽  
Long Term Outcomes ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
The Impact

Purpose Numerous studies have demonstrated that a variety of systemic inflammatory markers were associated with the survival of different tumors. However, the association between elevated postoperative neutrophil-lymphocyte ratio (postNLR) and long-term outcomes, including overall survival (OS), disease-free survival (DFS), in patients with solid tumors remains controversial. A systematic review was conducted to explore the association between the postNLR and long-term outcomes in solid tumors. Materials and methods Relevant literature was identified using PubMed, Embase, Web of Science, and the Cochrane Library from the initiation of the databases to October 2020. Data were extracted from included studies reporting hazard ratio (HR) and 95% confidence intervals (CI), and were pooled using generic inverse-variance and random-effects modeling. 25 studies reporting on7539 patients were included in the analysis. Results Elevated postNLR was associated with poor OS (HR 1.87, 95% CI = 1.53–2.28; P < 0.00001), and worse DFS (HR 1.69, 95% CI = 1.28–2.22; P = 0.0002). Subgroup analyses showed that the trend of the pooled HR for most of the subgroups was not changed, and the heterogeneity of the same tumor type was not obvious. However, there was no correlation between high postNLR obtained within 7days and poor DFS (n = 3, HR 1.25, 95CI% = 0.54–2.88; P = 0.60). Conclusions Elevated postNLR might be a readily available and inexpensive biomarker for long-term outcomes in solid tumors. Multicenter and prospective studies are needed to explore the impact of the postNLR on the prognosis of solid tumors.

scholarly journals Laparoscopic versus open major liver resection for hepatocellular carcinoma: A case-matched analysis of short- and long-term outcomes

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 964-972
Author(s):  
Aoxiao He ◽  
Zhihao Huang ◽  
Jiakun Wang ◽  
Qian Feng ◽  
Rongguiyi Zhang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Major Hepatectomy ◽  
Disease Free Survival ◽  
Perioperative Outcomes ◽  
Long Term Outcomes ◽  
Significant Difference ◽  
Short And Long Term ◽  
Laparoscopic Major Hepatectomy

Abstract Background The feasibility and safety of laparoscopic major hepatectomy (LMH) are still uncertain. The purpose of the present study is to compare the short- and long-term outcomes of LMH with those of open major hepatectomy (OMH) for hepatocellular carcinoma (HCC). Method Between January 2012 and December 2018, a total of 26 patients received laparoscopic major hepatectomy in our center. To minimize any confounding factors, a 1:3 case-matched analysis was conducted based on the demographics and extent of liver resection. Data of demographics, perioperative outcomes, and long-term oncologic outcomes were reviewed. Results Intraoperative blood loss (P = 0.007) was significantly lower in the LMH group. In addition, the LMH group exhibited a lower overall complication rate (P = 0.039) and shorter postoperative hospital stay (P = 0.024). However, no statistically significant difference was found between LMH and OMH regarding operation time (P = 0.215) and operative cost (P = 0.860). Two laparoscopic cases were converted to open liver resection. In regard to long-term outcomes, there was no significant difference between LMH and OMH regarding disease-free survival (DFS) (P = 0.079) and overall survival (OS) (P = 0.172). Conclusion LMH can be an effective and safe alternative to OMH for selected patients with liver cancer in short- and long-term outcomes.

scholarly journals Long-Term Surgical Outcomes of Liver Resection for Hepatocellular Carcinoma in Patients With HBV and HCV Co-Infection: A Multicenter Observational Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Hang-Dong Jia ◽  
Lei Liang ◽  
Chao Li ◽  
Han Wu ◽  
Hong Wang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Surgical Outcomes ◽  
Long Term Outcomes ◽  
Curative Intent ◽  
Multicenter Observational Study ◽  
Chronic Hepatitis B Virus ◽  
B Virus ◽  
Before And After

BackgroundHepatocellular carcinoma (HCC) is one of the most serious consequences of chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. This study sought to investigate long-term outcomes after liver resection for HCC among patients with HBV/HCV co-infection (HBV/HCV-HCC) compared with patients with HBV infection (HBV-HCC).MethodsPatients who underwent curative-intent liver resection for HCC were identified from a multicenter Chinese database. Using propensity score matching (PSM), patients with HBV/HCV-HCC were matched one-to-one to patients with HBV-HCC. Overall survival (OS) and recurrence-free survival (RFS) were compared between the two groups before and after PSM.ResultsAmong 2,467 patients identified, 93 (3.8%) and 2,374 (96.2%) patients had HBV/HCV-HCC and HBV-HCC, respectively. Compared with patients with HBV-HCC, patients with HBV/HCV-HCC were older, have poorer liver-related characteristics but better tumor-related characteristics. PSM created 88 pairs of patients with comparable liver- and tumor-related characteristics (all P &gt; 0.2). In the PSM cohort, the 3- and 5-year RFS rates in patients with HBV/HCV-HCC were 48.3% and 38.9%, which were significantly poorer than patients with HBV-HCC (61.8% and 49.2%, P = 0.037). Meanwhile, the 3- and 5-year OS rates in patients with HBV/HCV-HCC were also poorer than patients with HBV-HCC (65.4% and 51.1% vs. 73.7% and 63.0%), with a difference close to be significant between them (P = 0.081).ConclusionComparing to patients with HBV-HCC, liver resection resulted in relatively poorer long-term surgical outcomes in patients with HBV/HCV-HCC.

scholarly journals Preoperative prognostic nutritional index predicts both short and long-term outcomes after liver resection for hepatocellular carcinoma.

2019 ◽  
Author(s):  
Yu Saito ◽  
Satoru Imura ◽  
Yuji Morine ◽  
Tetsuya Ikemoto ◽  
Shinichiro Yamada ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Disease Free Survival ◽  
Prognostic Nutritional Index ◽  
Long Term Outcomes ◽  
Free Survival ◽  
Nutritional Index ◽  
Short And Long Term ◽  
Disease Free

Abstract Background The aim of this study was to investigate the prognostic significance of the prognostic nutritional index (PNI) for both short and long term outcomes after liver resection for hepatocellular carcinoma (HCC). Methods 162 (without any previous treatment) of 229 surgically treated HCC patients were retrospectively analyzed. The cut off value of the preoperative PNI was 45.0. Patients were divided into two groups, PNI low (n=76) and high (n=86) group. Results Among some immune parameters such as PNI, neutrophil to lymphocyte ratio (NLR) and aspartate aminotransferase (AST) to lymphocyte ratio (ALRI), PNI had most reliable parameters in terms with prediction of both short and long term outcomes. Preoperative PNI tended to correlate with low skeletal muscle mass (SMM). In short term outcomes, PNI low group were more likely to have postoperative complications. The disease-free survival rate in PNI low group was significantly worse than that in the PNI high group (20.5 vs. 48.7 %, 5 year SR, p=0.03). On multivariate analysis, Low PNI was an independent prognostic factor for disease free survival (HR 1.65, p= 0.04). Conclusions The preoperative PNI was the most significant prognostic factor for evaluating both short and long-term outcomes after liver resection for HCC.

scholarly journals Prognostic value of preoperative inflammatory markers in patients with hepatocellular carcinoma who underwent curative resection

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wenlong Wu ◽  
Quancheng Wang ◽  
Dandan Han ◽  
Jianhui Li ◽  
Ye Nie ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Factors ◽  
Inflammatory Markers ◽  
Curative Resection ◽  
Disease Free Survival ◽  
Information Criterion ◽  
Gamma Glutamyl Transpeptidase ◽  
Roc Curve Analysis ◽  
Lymphocyte Ratio ◽  
Kaplan Meier

Abstract Background The prognosis of hepatocellular carcinoma (HCC) is not optimistic. Our study focused on present inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), gamma-glutamyl transpeptidase-to-platelet ratio (GPR), aspartate aminotransferase-to-lymphocyte ratio (ALR) and fibrinogen-to-albumin ratio (FAR), and explored their optimal combination for the prognosis of HCC after resection. Methods A total of 347 HCC patients who underwent curative resection were enrolled. The optimal cutoff values of the inflammatory markers were calculated using receiver operating characteristic (ROC) curve analysis, and used to divide patients into two groups whose differences were compared by Kaplan–Meier analysis. Cox univariate and multivariate analyses were used to analyze the independent prognostic inflammatory markers. The χ2 test was chosen to determine the relationship between independent prognostic inflammatory markers and clinicopathological features. We created combined scoring models and evaluated them by Cox univariate and multivariate methods. The concordance index (C-index), Akaike information criterion (AIC) and likelihood ratio were calculated to compare the models. The selected optimal inflammatory markers and their combinations were tested in different stages of HCC by Kaplan–Meier analysis. Results The ALR and GPR were independent prognostic factors for disease-free survival (DFS); the ALR, PLR, and GPR were independent prognostic factors for overall survival (OS). The proposed GPR and ALR-GPR-PLR score models were independent predictors for DFS and OS, respectively. Conclusion The preoperative GPR and ALR-GPR-PLR score models were independent predictors for DFS and OS, respectively, and performed well in stratifying patients with HCC. The higher the score in the model was, the worse the prognosis.

scholarly journals Laparoscopic versus open major liver resection for hepatocellular carcinoma: a case-matched analysis of short- and long-term outcomes

2020 ◽  
Author(s):  
Aoxiao He ◽  
Yong Li ◽  
Jiakun Wang ◽  
Qian Feng ◽  
Wenjun Liao ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Major Hepatectomy ◽  
Disease Free Survival ◽  
Perioperative Outcomes ◽  
Long Term Outcomes ◽  
Significant Difference ◽  
Short And Long Term ◽  
Laparoscopic Major Hepatectomy

Abstract Background: The feasibility and safety of laparoscopic major hepatectomy (LMH) is still uncertain. The purpose of the present study is to compare the short- and long-term outcomes of LMH with those of open major hepatectomy (OMH) for hepatocellular carcinoma (HCC).Method: Between January 2012 and December 2018, a total of 26 patients received laparoscopic major hepatectomy in our center. To minimize any confounding factors, a 1:3 case-matched analysis was conducted based on the demographics and extent of liver resection. Data of demographics, perioperative outcomes and long-term oncologic outcomes were reviewed.Results: Intraoperative blood loss (P=0.007) were significantly lower in LMH group. In addition, LMH group exhibited a lower overall complication rate (P=0.039) and shorter postoperative hospital stay (P=0.024). However, no statistically significant difference was found between LMH and OMH regarding operation time (P=0.215) and overall cost (P=0.024). Two laparoscopic cases were converted to open liver resection. In regard with long-term outcomes, there was no significant difference between LMH and OMH regarding disease-free survival (DFS) (P=0.079) and overall survival (OS) (P=0.172).Conclusion: LMH can be an effective and safe alternative to OMH for selected patients with liver cancer in short- and long-term outcomes.

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