A Conceptual Classification of Resectability for Hepatocellular Carcinoma
© 2022. The Author(s)..
BACKGROUNDS: In the era of multidisciplinary treatment strategy, resectability for hepatocellular carcinoma (HCC) should be defined. This study aimed to propose and validate a resectability classification of HCC.
METHODS: We proposed following the three groups; resectable-(R), borderline resectable-(BR), and unresectable (UR)-HCCs. Resectable two groups were sub-divided according to the value of indocyanine green clearance of remnant liver (ICG-Krem) and presence of macrovascular invasion (MVI); BR-HCC was defined as resectable HCCs with MVI and/or ICG-Krem≥0.03-<0.05, and R-HCC was the remaining. Consecutive patients with HCC who underwent liver resection (LR) and non-surgical treatment(s) (i.e., UR-HCC) between 2011 and 2017 were retrospectively analyzed to validate the proposed classification.
RESULTS: A total of 361 patients were enrolled in the study. Of these, R-, BR- and UR-HCC were found in 251, 46, and 64 patients, respectively. In patients with resected HCC, ICG-Krem≥0.05 was associated with decreased risk of clinically relevant posthepatectomy liver failure (p=0.013) and the presence of MVI was associated with worse overall survival (OS) (p<0.001). The 3-5-years OS rates according to the proposed classification were 80.3, and 68.3% versus 51.4, and 35.6%, in the R and BR groups, respectively (both p<0.001). Multivariate analysis showed BR-HCC was independently associated with poorer OS (p<0.001) after adjusting for known tumor prognostic factors. Meanwhile, BR-HCC was associated with benefit in terms of OS compared with UR-HCC (p<0.001).
CONCLUSION: Our proposal of resectability for HCC allows for stratifying survival outcomes of HCC and may help to determine treatment strategy.
| Errataetall: | |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:47 |
|---|---|
| Enthalten in: |
World journal of surgery - 47(2023), 3 vom: 26. März, Seite 740-748 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Yoh, Tomoaki [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 06.02.2023 Date Revised 28.04.2023 published: Print-Electronic ErratumIn: World J Surg. 2022 Nov 23;:. - PMID 36418554 Citation Status MEDLINE |
|---|
| doi: |
10.1007/s00268-022-06803-7 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM348017685 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM348017685 | ||
| 003 | DE-627 | ||
| 005 | 20231226035214.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s00268-022-06803-7 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1160.xml |
| 035 | |a (DE-627)NLM348017685 | ||
| 035 | |a (NLM)36287266 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Yoh, Tomoaki |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A Conceptual Classification of Resectability for Hepatocellular Carcinoma |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 06.02.2023 | ||
| 500 | |a Date Revised 28.04.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ErratumIn: World J Surg. 2022 Nov 23;:. - PMID 36418554 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022. The Author(s). | ||
| 520 | |a BACKGROUNDS: In the era of multidisciplinary treatment strategy, resectability for hepatocellular carcinoma (HCC) should be defined. This study aimed to propose and validate a resectability classification of HCC | ||
| 520 | |a METHODS: We proposed following the three groups; resectable-(R), borderline resectable-(BR), and unresectable (UR)-HCCs. Resectable two groups were sub-divided according to the value of indocyanine green clearance of remnant liver (ICG-Krem) and presence of macrovascular invasion (MVI); BR-HCC was defined as resectable HCCs with MVI and/or ICG-Krem≥0.03-<0.05, and R-HCC was the remaining. Consecutive patients with HCC who underwent liver resection (LR) and non-surgical treatment(s) (i.e., UR-HCC) between 2011 and 2017 were retrospectively analyzed to validate the proposed classification | ||
| 520 | |a RESULTS: A total of 361 patients were enrolled in the study. Of these, R-, BR- and UR-HCC were found in 251, 46, and 64 patients, respectively. In patients with resected HCC, ICG-Krem≥0.05 was associated with decreased risk of clinically relevant posthepatectomy liver failure (p=0.013) and the presence of MVI was associated with worse overall survival (OS) (p<0.001). The 3-5-years OS rates according to the proposed classification were 80.3, and 68.3% versus 51.4, and 35.6%, in the R and BR groups, respectively (both p<0.001). Multivariate analysis showed BR-HCC was independently associated with poorer OS (p<0.001) after adjusting for known tumor prognostic factors. Meanwhile, BR-HCC was associated with benefit in terms of OS compared with UR-HCC (p<0.001) | ||
| 520 | |a CONCLUSION: Our proposal of resectability for HCC allows for stratifying survival outcomes of HCC and may help to determine treatment strategy | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Ishii, Takamichi |e verfasserin |4 aut | |
| 700 | 1 | |a Nishio, Takahiro |e verfasserin |4 aut | |
| 700 | 1 | |a Koyama, Yukinori |e verfasserin |4 aut | |
| 700 | 1 | |a Ogiso, Satoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Fukumitsu, Ken |e verfasserin |4 aut | |
| 700 | 1 | |a Uchida, Yoichiro |e verfasserin |4 aut | |
| 700 | 1 | |a Ito, Takashi |e verfasserin |4 aut | |
| 700 | 1 | |a Seo, Satoru |e verfasserin |4 aut | |
| 700 | 1 | |a Hata, Koichiro |e verfasserin |4 aut | |
| 700 | 1 | |a Hatano, Etsuro |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t World journal of surgery |d 1993 |g 47(2023), 3 vom: 26. März, Seite 740-748 |w (DE-627)NLM000180734 |x 1432-2323 |7 nnns |
| 773 | 1 | 8 | |g volume:47 |g year:2023 |g number:3 |g day:26 |g month:03 |g pages:740-748 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s00268-022-06803-7 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 47 |j 2023 |e 3 |b 26 |c 03 |h 740-748 | ||