scholarly journals From LI-RADS Classification to HCC Pathology: A Retrospective Single-Institution Analysis of Clinico-Pathological Features Affecting Oncological Outcomes after Curative Surgery

Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 160
Author(s):  
Leonardo Centonze ◽  
Riccardo De Carlis ◽  
Ivan Vella ◽  
Luca Carbonaro ◽  
Niccolò Incarbone ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Disease ◽  
Meld Score ◽  
Cancer Specific Survival ◽  
Oncological Outcomes ◽  
Pathological Characteristics ◽  
R1 Resection ◽  
Risk Factors For Recurrence ◽  
Independent Risk Factors ◽  
Ecog Ps

Background: The latest Liver Imaging Reporting and Data System (LI-RADS) classification by the American College of Radiology has been recently endorsed in the American Association for the Study of Liver Disease (AASLD) guidelines for Hepatocellular carcinoma (HCC) management. Although the LI-RADS protocol has been developed as a diagnostic algorithm, there is some evidence concerning a possible correlation between different LI-RADS classes and specific pathological features of HCC. We aimed to investigate such radiological/pathological correlation and the possible prognostic implication of LI-RADS on a retrospective cohort of HCC patients undergoing surgical resection. Methods: We performed a retrospective analysis of the pathological characteristics of resected HCC, exploring their distribution among different LI-RADS classes and analyzing the risk factors for recurrence-free, overall and cancer-specific survival Results: LI-RADS-5 (LR-5) nodules showed a higher prevalence of microvascular invasion (MVI), satellitosis and capsule infiltration, as well as higher median values of alpha-fetoprotein (αFP) compared to LI-RADS-3/4 (LR-3/4) nodules. MVI, αFP, satellitosis and margin-positive (R1) resection resulted as independent risk factors for recurrence-free survival, while LI-RADS class did not exert any significant impact. Focusing on overall survival, we identified patient age, Eastern Cooperative Oncology Group performance status (ECOG-PS), Model for End Stage Liver Disease (MELD) score, αFP, MVI, satellitosis and R1 resection as independent risk factors for survival, without any impact of LI-RADS classification. Last, MELD score, log10αFP, satellitosis and R1 resection resulted as independent risk factors for cancer-specific survival, while LI-RADS class did not exert any significant impact. Conclusions: Our results suggest an association of LR-5 class with unfavorable pathological characteristics of resected HCC; tumor histology and underlying patient characteristics such as age, ECOG-PS and liver disease severity exert a significant impact on postoperative oncological outcomes.

scholarly journals Health-related quality of life in Chinese population with non-alcoholic fatty liver disease: a national multicenter survey

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Rui Huang ◽  
Jian-Gao Fan ◽  
Jun-Ping Shi ◽  
Yi-Min Mao ◽  
Bing-Yuan Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Disease ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Alcoholic Fatty Liver ◽  
Related Quality ◽  
Health Related ◽  
Independent Risk Factors ◽  
Alcoholic Fatty Liver Disease

Abstract Background Health Related Quality of Life (HRQL) is a multi-dimensional construct that can comprehensively evaluate the patient’s health status, including physical, emotional, mental and social well-being. In this study, we aimed to evaluate the impact of non-alcoholic fatty liver disease (NAFLD) on HRQL in a Chinese population. Methods In this national multicenter cross-sectional survey, patients with NAFLD were enrolled. Chronic Liver Disease Questionnaire (CLDQ)-NAFLD was used to qualify HRQL. Univariate and multivariate analysis were used to identify independent risk factors of HRQL. Results A total of 5181 patients with NAFLD from 90 centers were enrolled in this study (mean age, 43.8 ± 13.3 years; male, 65.8%). The overall CLDQ score was 5.66 ± 0.89. Multivariate logistic regression analysis showed that body mass index (BMI: HR, 1.642; 95% CI, 1.330–2.026), alanine transaminase (ALT: HR, 1.006; 95% CI, 1.001–1.011), triglyceride (HR, 1.184; 95% CI, 1.074–1.305), disease severity (HR, 3.203; 95% CI, 1.418–7.232) and cardiovascular disease (HR, 4.305; 95% CI, 2.074–8.939) were independent risk factors for overall CLDQ score. In the logistic analyses of individual domain, BMI and triglyceride were independent risk factors of all domains. ALT, disease severity, diabetes, depression and cardiovascular disease were influencing factors for the CLDQ score of several domains. Conclusions This national multicenter cross-sectional survey in China indicated that the HRQL in patients with NAFLD was impaired. HRQL was found to be significantly associated with sociodemographic and clinical factors. Attention should be paid to the optimally managing care of patients with NAFLD to improve their HRQL.

scholarly journals A Nomogram Based on Preoperative Inflammatory Indices and ICG-R15 for Prediction of Liver Failure After Hepatectomy in HCC Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Tongdi Fang ◽  
Guo Long ◽  
Dong Wang ◽  
Xudong Liu ◽  
Liang Xiao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Failure ◽  
Validation Cohort ◽  
Meld Score ◽  
Decision Curve Analysis ◽  
Independent Risk Factors ◽  
Icg R15 ◽  
Score Model ◽  
End Stage ◽  
Central South

ObjectiveTo establish a nomogram based on inflammatory indices and ICG-R15 for predicting post-hepatectomy liver failure (PHLF) among patients with resectable hepatocellular carcinoma (HCC).MethodsA retrospective cohort of 407 patients with HCC hospitalized at Xiangya Hospital of Central South University between January 2015 and December 2020, and 81 patients with HCC hospitalized at the Second Xiangya Hospital of Central South University between January 2019 and January 2020 were included in the study. Totally 488 HCC patients were divided into the training cohort (n=378) and the validation cohort (n=110) by random sampling. Univariate and multivariate analysis was performed to identify the independent risk factors. Through combining these independent risk factors, a nomogram was established for the prediction of PHLF. The accuracy of the nomogram was evaluated and compared with traditional models, like CP score (Child-Pugh), MELD score (Model of End-Stage Liver Disease), and ALBI score (albumin-bilirubin) by using receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA).ResultsCirrhosis (OR=2.203, 95%CI:1.070-3.824, P=0.030), prothrombin time (PT) (OR=1.886, 95%CI: 1.107-3.211, P=0.020), tumor size (OR=1.107, 95%CI: 1.022-1.200, P=0.013), ICG-R15% (OR=1.141, 95%CI: 1.070-1.216, P<0.001), blood loss (OR=2.415, 95%CI: 1.306-4.468, P=0.005) and AST-to-platelet ratio index (APRI) (OR=4.652, 95%CI: 1.432-15.112, P=0.011) were independent risk factors of PHLF. Nomogram was built with well-fitted calibration curves on the of these 6 factors. Comparing with CP score (C-index=0.582, 95%CI, 0.523-0.640), ALBI score (C-index=0.670, 95%CI, 0.615-0.725) and MELD score (C-ibasedndex=0.661, 95%CI, 0.606-0.716), the nomogram showed a better predictive value, with a C-index of 0.845 (95%CI, 0.806-0.884). The results were consistent in the validation cohort. DCA confirmed the conclusion as well.ConclusionA novel nomogram was established to predict PHLF in HCC patients. The nomogram showed a strong predictive efficiency and would be a convenient tool for us to facilitate clinical decisions.

O30 NON-RADICAL ESOPHAGECTOMY FOR ESOPHAGEAL CANCER; A NATIONWIDE STUDY ON INCIDENCE, RISK FACTORS AND OUTCOMES IN SWEDEN

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
David Edholm ◽  
Petter Hollertz ◽  
Per Sandström ◽  
Bergthor Björnsson ◽  
Dennis Björk ◽  
...  
Keyword(s):  
Risk Factors ◽  
Esophageal Cancer ◽  
Cox Regression ◽  
Regional Lymph Node ◽  
Neoadjuvant Treatment ◽  
Resected Specimen ◽  
Radical Esophagectomy ◽  
Term Survival ◽  
R1 Resection ◽  
Independent Risk Factors

Abstract Aim To identify potential risk factors for a microscopically non-radical esophageal cancer resection (R1) and investigate how such a resection affects long-term survival. Background & Methods Esophageal cancer resections that are considered R1 have been associated with worse survival. The Swedish National Register for Esophageal and Gastric Cancer includes information on all esophageal cancer resections in Sweden. All patients having undergone esophageal resection with curative intent 2006-2017 were included. Risk factors for R1 resection were assessed through logistic regression. Factors predicting five-year survival were assessed through Cox-regression, adjusted for T-stage, N-stage, age and R-status. Results The study included 1,504 patients. The margins were microscopically involved in 146 patients (10%). Of these the circumferential margin was involved in 115 (8%). The proximal margin was involved in 55 patients (4%) and the distal in 30 (2%). In 54 (4%) specimens two margins were involved. Independent risk factors for R1-resection were absence of neoadjuvant treatment and clinical T3 stage or higher. The 5-year survival for the entire cohort was 41%, but only 19% for those with an R1 resection. Independent risk factors for death within 5-year from resection were regional lymph node metastasis (Hazard Ratio (HR) 2.6 (95% CI 2.2-3.1), histopathological stage T3 or higher (HR 1.2 95% CI 1.1-1.5), age above 60 years and R1-resection (HR 1.6 95% CI 1.4-2.0) Conclusion Involved margin in the resected specimen is an independent risk factor predicting worse 5-year survival. Besides striving for adequate surgical margins, the rate of R1-resections could be decreased through neoadjuvant treatment in fit patients.

Independent risk factors for recurrence of apparent life-threatening events in infants

2017 ◽  
Vol 176 (4) ◽  
pp. 443-448 ◽  
Author(s):  
Riyo Ueda ◽  
Osamu Nomura ◽  
Takanobu Maekawa ◽  
Hirokazu Sakai ◽  
Satoshi Nakagawa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Life Threatening ◽  
Risk Factors For Recurrence ◽  
Independent Risk Factors

scholarly journals Diabetes Mellitus, Obesity and Underlying Non Alcoholic Fatty Liver Disease - Independent Risk Factors for Hepatocellular Carcinoma

2013 ◽  
Vol 20 (2) ◽  
pp. 117-122
Author(s):  
Andra-Iulia Suceveanu ◽  
Laura Mazilu ◽  
Doina Catrinoiu ◽  
Adrian-Paul Suceveanu ◽  
Felix Voinea ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Liver Disease ◽  
Cumulative Incidence ◽  
Fatty Liver Disease ◽  
Diabetic Patients ◽  
Obese Patients ◽  
Cirrhotic Patients ◽  
Independent Risk Factors

AbstractBackground and Aims. Hepatocellular carcinoma (HCC) is one of the most common malignancies. Obesity, together with the underlying liver steatosis, has received increased attention as a risk factor for HCC. Diabetes Mellitus (DM) is also reported to be associated with HCC. We aimed to estimate the risk of HCC in obese and diabetic patients. Material and method. We prospectively analyzed 414 obese and diabetic patients, over a period of 5 years. We evaluated all patients using screening methods such as abdominal ultrasound and serum alpha-fetoprotein every 6 month, in order to detect HCC occurrence. Kaplan-Meier analysis estimated the cumulative incidence of HCC. Univariate and multivariate Cox regression analysis assessed the association between HCC and obesity. Results. Median follow-up was 4.3 years. 11 from 77 cirrhotic obese patients, and 18 from 150 non-cirrhotic obese patients developed HCC (p=ns). 7 from 51 patients with DM and cirrhosis, and 14 from 136 non-cirrhotic patients with DM developed HCC (p=ns). The cumulative incidence of HCC was 2.8%, respectively 2.6%, in cirrhotic patients with obesity or DM, compared with 2.2%, respectively 2.0%, in non-cirrhotic patients with obesity or DM (p=ns). Conclusion. Obesity and DM, along with nonalcoholic fatty liver disease (NAFLD), seems to be independent risk factors for HCC occurrence.

Serum Levels of Endocannabinoids are Independent Risk Factors for Non-Alcoholic Fatty Liver Disease

2016 ◽  
Vol 64 (2) ◽  
pp. S498
Author(s):  
S. Zelber-Sagi ◽  
S. Azar ◽  
A. Nemirovski ◽  
M. Webb ◽  
Z. Halpern ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Serum Levels ◽  
Alcoholic Fatty Liver ◽  
Independent Risk Factors ◽  
Alcoholic Fatty Liver Disease
Sign in / Sign up

Export Citation Format

Share Document