Comparison of the efficacy of radiofrequency ablation vs. liver resection in the treatment of hepatocellular carcinoma within Milan criteria with severe fibrosis

Abstract BackgroundThe efficacy of RFA in the treatment of HCC with severe fibrosis is still unclear. The objective of this study is to compare the efficacy of RFA with liver resection in the treatment of HCC within Milan criteria.MethodsThe data used in the study were from the SEER database. Patients with HCC within Milan criteria were included in the study. A total of 1432 patients were included in the study; among them, 1038 patients received RFA, and 394 patients received liver resection. Propensity score matching (PSM) was used to reduce selection bias.ResultsBefore PSM, the median overall survival (mOS) and median cancer-specific survival (mCSS) in the resection group were longer than the mOS and mCSS in the RFA group. However, the8re were no statistically significant differences in mOS or mCSS between the two groups (both P>0.05). After PSM, similar results were presented, and the mOS and mCSS in the resection group were similar to those in the RFA group (both P>0.05). The multivariable Cox regression analysis showed that RFA did not increase the all-cause mortality risk and cancer-specific mortality risk compared with resection before PSM. In the competing risk analysis, after excluding the potential factors that might influence the outcomes, RFA still did not increase the mortality risk compared with resection before PSM and after PSM. In the subgroup analysis. The efficacy of RFA is comparable to that of resection in patients with tumor sizes no more than 3 cm before PSM and after PSM.ConclusionThe efficacy of RFA is similar to that of resection in the treatment of early HCC patients with severe fibrosis, especially in patients with tumor sizes no more than 3 cm.

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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.

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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.

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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/v3 ◽

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.

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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.

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Effects of marital status on overall and cancer-specific survival in laryngeal cancer patients: a population-based study

Scientific Reports ◽

10.1038/s41598-020-80698-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Zhao Ding ◽

Deshun Yu ◽

Hefeng Li ◽

Yueming Ding

Keyword(s):

Marital Status ◽

Cancer Patients ◽

Laryngeal Cancer ◽

Cox Regression ◽

Group Analysis ◽

Population Based ◽

Cancer Specific Survival ◽

Cox Regression Analysis ◽

Prognostic Effect ◽

The Difference

AbstractMarital status has long been recognized as an important prognostic factor for many cancers, however its’ prognostic effect for patients with laryngeal cancer has not been fully examined. We retrospectively analyzed 8834 laryngeal cancer patients in the Surveillance Epidemiology and End Results database from 2004 to 2010. Patients were divided into four groups: married, widowed, single, and divorced/separated. The difference in overall survival (OS) and cancer-specific survival (CSS) of the various marital subgroups were calculated using the Kaplan–Meier curve. Multivariate Cox regression analysis screened for independent prognostic factors. Propensity score matching (PSM) was also conducted to minimize selection bias. We included 8834 eligible patients (4817 married, 894 widowed, 1732 single and 1391 divorced/separated) with laryngeal cancer. The 5-year OS and CSS of married, widowed, single, and separated/divorced patients were examined. Univariate and multivariate analyses found marital status to be an independent predictor of survival. Subgroup survival analysis showed that the OS and CSS rates in widowed patients were always the lowest in the various American Joint Committee on Cancer stages, irrespective of sex. Widowed patients demonstrated worse OS and CSS in the 1:1 matched group analysis. Among patients with laryngeal cancer, widowed patients represented the highest-risk group, with the lowest OS and CSS.

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Trends of incidence and prognosis of primary adenocarcinoma of the bladder

Therapeutic Advances in Urology ◽

10.1177/17562872211018006 ◽

2021 ◽

Vol 13 ◽

pp. 175628722110180

Author(s):

Haowen Lu ◽

Weidong Zhu ◽

Weipu Mao ◽

Feng Zu ◽

Yali Wang ◽

...

Keyword(s):

Prediction Model ◽

Marital Status ◽

Cox Regression ◽

Tnm Staging ◽

Primary Site ◽

Primary Adenocarcinoma ◽

Cancer Specific Survival ◽

Training Cohort ◽

Cox Regression Analysis ◽

Ajcc Stage

Background: Primary adenocarcinoma of the bladder (ACB) is a rare malignant tumor of the bladder with limited understanding of its incidence and prognosis. Methods: Patients diagnosed with ACB between 2004 and 2015 were obtained from the SEER database. The incidence changes of ACB patients between 1975 and 2016 were detected by Joinpoint software. Nomograms were constructed based on the results of multivariate Cox regression analysis to predict overall survival (OS) and cancer-specific survival (CSS) in patients with ACB, and the constructed nomograms were validated. Results: The incidence of ACB was trending down from 1991 to 2016. A total of 1039 patients were included in the study and randomly assigned to the training cohort (727) and validation cohort (312). In the training cohort, multivariate Cox regression showed that age, marital status, primary site, histology type, grade, AJCC stage, T stage, SEER stage, surgery, radiotherapy, and chemotherapy were independent prognostic factors for OS, whereas these were age, marital status, primary site, histology type, grade, AJCC stage, T/N stage, SEER stage, surgery, and radiotherapy for CSS. Based on the above Cox regression results, we constructed prognostic nomograms for OS and CSS in ACB patients. The C-index of the nomogram OS was 0.773 and the C-index of CSS was 0.785, which was significantly better than the C-index of the TNM staging prediction model. The area under the curve (AUC) and net benefit of the prediction model were higher than those of the TNM staging system. In addition, the calibration curves were very close to the ideal curve, suggesting appreciable reliability of the nomograms. Conclusion: The incidence of ACB patients showed a decreasing trend in the past 25 years. We constructed a clinically useful prognostic nomogram for calculating OS and CSS of ACB patients, which can provide a personalized risk assessment for ACB patient survival.

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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.

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Anatomic Subsites and Prognosis of Gastric Signet Ring Cell Carcinoma: A SEER Population-based 1:1 Propensity-matched Study

10.21203/rs.3.rs-403278/v1 ◽

2021 ◽

Author(s):

Yangyang Xie ◽

Xue Song ◽

Haimin Jin ◽

Zhongkai Ni ◽

Xiaowen Li ◽

...

Keyword(s):

Cell Carcinoma ◽

Mortality Risk ◽

Cox Regression ◽

Signet Ring Cell Carcinoma ◽

Signet Ring Cell ◽

Survival Prediction ◽

Cancer Specific Survival ◽

Dismal Prognosis ◽

Signet Ring ◽

Ring Cell

Abstract Background: The dismal prognosis of gastric signet ring cell carcinoma (GSRC) is a global problem. The current study is conducted to comprehensively evaluate clinicopathological features and survival outcomes in GSRC patients stratified by anatomic subsites. Then predictive nomograms are constructed and validated to improve the effectiveness of personalized management.Method: The patients diagnosed with GSRC were recruited from the online SEER database. The influence of anatomic subsites on overall survival (OS) and cancer-specific survival (CSS) was evaluated using multivariate Cox regression and Kaplan-Meier analysis. Then we employed propensity score matching (PSM) technique to decrease selection bias and balance patients’ epidemiological factors. Predictive nomograms were constructed and validated.Results: Multivariate Cox regression demonstrated that the patients with overlapping gastric cancer (OGC) suffered the highest mortality risk for OS (HR, 1.29; 95%CI, 1.23-1.36; P<0.001) and CSS (HR, 1.33; 95%CI, 1.28-1.37; P<0.001). Age, TNM stage, tumor localization, tumor size, surgery and chemotherapy presented a highly significant relationship with OS and CSS. Following subgroup and PSM analysis, OGC patients were confirmed to have the worst OS and CSS. Then nomograms predicting 6 months, 12 months and 36 months OS and CSS were constructed. The calibration curves and reveiver operating characteristic curves demonstrated the great performance of the nomograms.Conclusion: We identified anatomic subsites as a predictor of survival in those with GSRC. Patients with OGC suffered the highest mortality risk. The proposed nomograms allowed a relatively accurate survival prediction for GSRC patients.

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A risk stratification model based on four novel biomarkers predicts prognosis for patients with renal cell carcinoma

World Journal of Surgical Oncology ◽

10.1186/s12957-020-02046-9 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Shigehisa Kubota ◽

Tetsuya Yoshida ◽

Susumu Kageyama ◽

Takahiro Isono ◽

Takeshi Yuasa ◽

...

Keyword(s):

Prognostic Model ◽

Cox Regression ◽

Treatment Strategies ◽

Immunohistochemical Analysis ◽

Cancer Specific Survival ◽

Clinical Prognosis ◽

Cox Regression Analysis ◽

Model Based ◽

Novel Biomarkers ◽

Metastatic Rcc

Abstract Background Accurate prediction of the prognosis of RCC using a single biomarker is challenging due to the genetic heterogeneity of the disease. However, it is essential to develop an accurate system to allow better patient selection for optimal treatment strategies. ARL4C, ECT2, SOD2, and STEAP3 are novel molecular biomarkers identified in earlier studies as survival-related genes by comprehensive analyses of 43 primary RCC tissues and RCC cell lines. Methods To develop a prognostic model based on these multiple biomarkers, the expression of four biomarkers ARL4C, ECT2, SOD2, and STEAP3 in primary RCC tissue were semi-quantitatively investigated by immunohistochemical analysis in an independent cohort of 97 patients who underwent nephrectomy, and the clinical significance of these biomarkers were analyzed by survival analysis using Kaplan-Meier curves. The prognostic model was constructed by calculation of the contribution score to prognosis of each biomarker on Cox regression analysis, and its prognostic performance was validated. Results Patients whose tumors had high expression of the individual biomarkers had shorter cancer-specific survival (CSS) from the time of primary nephrectomy. The prognostic model based on four biomarkers segregated the patients into a high- and low-risk scored group according to defined cut-off value. This approach was more robust in predicting CSS compared to each single biomarker alone in the total of 97 patients with RCC. Especially in the 36 metastatic RCC patients, our prognostic model could more accurately predict early events within 2 years of diagnosis of metastasis. In addition, high risk-scored patients with particular strong SOD2 expression had a much worse prognosis in 25 patients with metastatic RCC who were treated with molecular targeting agents. Conclusions Our findings indicate that a prognostic model based on four novel biomarkers provides valuable data for prediction of clinical prognosis and useful information for considering the follow-up conditions and therapeutic strategies for patients with primary and metastatic RCC.

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Survival predictors of metastatic angiosarcomas: a surveillance, epidemiology, and end results program population-based retrospective study

BMC Cancer ◽

10.1186/s12885-020-07300-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Shihong Ren ◽

Yucheng Wang ◽

Zhan Wang ◽

Jinxiang Shao ◽

Zhaoming Ye

Keyword(s):

Tumor Size ◽

Cox Regression ◽

Radiation Treatment ◽

Tumor Grade ◽

Population Based ◽

Cancer Specific Survival ◽

Cox Regression Analysis ◽

Metastatic Sites ◽

Survival Predictors ◽

End Results

Abstract Background Angiosarcomas (AS) have poor prognosis and often metastasize to distant sites. The potential predictors of metastatic angiosarcomas (MAS) have not been extensively investigated. The main objective of this study was to identify survival predictors of MAS. Methods Surveillance, Epidemiology, and End Results (SEER) datasets were used to identify patients with MAS from 2010 to 2016. Risk predictors were determined with the aid of Kaplan-Meier and Cox regression model analyses. Results A total of 284 MAS patients met the study entry criteria. Among these, 121 patients (42.6%) were diagnosed with metastasis in bone, 26 in brain (9.2%), 86 in liver (30.3%) and 171 in lung (60.2%). Overall, 96 patients (33.8%) had two or more metastatic sites. The 1- and 3-year overall survival (OS) rates were 20.8 and 3.8% while 1- and 3-year cancer-specific survival (CSS) rates were 22.0 and 5.2%, respectively. Cox regression analysis revealed chemotherapy, radiation treatment (RT) and tumor size ≤10 cm as independent favorable predictors of OS. In terms of CSS, tumor grade IV, tumor size > 10 cm and absence of chemotherapy were independent adverse predictors. Surgery did not prolong survival outcomes (both OS and CSS) in the current cohort. Conclusion MAS is associated with extremely poor survival. Chemotherapy, RT, and tumor size are independent predictors of OS. Chemotherapy and tumor size are independent prognostic factors of CSS. Chemotherapy is therefore recommended as the preferred treatment option for MAS patients.

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