Differences in Surgical Outcomes Between Hepatitis B- and Hepatitis C–Related Hepatocellular Carcinoma

Franssen, Bernardo; Alshebeeb, Kutaiba; Tabrizian, Parissa; Marti, Josep; Pierobon, Elisa Sefora; Lubezky, Nir; Roayaie, Sasan; Florman, Sander; Schwartz, Myron

doi:10.1097/sla.0000000000000917

Cited by 79 publications

(56 citation statements)

References 37 publications

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“…Moreover, when this signature was present, the prognosis was impaired, as it is in case of macrovascular invasion on imaging [37]. A size larger than 5 cm is also an independent factor of poor prognosis [38].…”

Section: Discussionmentioning

confidence: 99%

Imaging-based surrogate markers of transcriptome subclasses and signatures in hepatocellular carcinoma: preliminary results

et al. 2017

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Objectives In this preliminary study, we examined whether imaging-based phenotypes are associated with reported predictive gene signatures in hepatocellular carcinoma (HCC). Methods 38 patients (M/F 30/8, mean age 61 y) who underwent pre-operative CT or MR imaging before surgery as well as transcriptome profiling were included in this IRB approved single centre retrospective study. Eleven qualitative and 4 quantitative imaging traits (size, enhancement ratios, wash-out ratio, tumour-to-liver contrast ratios) were assessed by 3 observers and were correlated with 13 previously reported HCC gene signatures by using logistic regression analysis. Results 39 HCC tumours (mean size 5.7 ± 3.2 cm) were assessed. Significant positive associations were observed between certain imaging traits and gene signatures of aggressive HCC phenotype (G3-Boyault, Proliferation-Chiang profiles, CK19-Villanueva, S1/S2-Hoshida) with odds ratios ranging from 4.44–12.73 (P <0.045). Infiltrative pattern at imaging was significantly associated with signatures of microvascular invasion and aggressive phenotype. Significant but weak associations were also observed between each of enhancement ratios and tumour-to-liver contrast ratios and certain gene expression profiles. Conclusions This preliminary study demonstrates a correlation between phenotypic imaging traits with gene signatures of aggressive HCC, which warrants further prospective validation to establish imaging-based surrogate markers of molecular phenotypes in HCC.

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Section: Discussionmentioning

confidence: 99%

Imaging-based surrogate markers of transcriptome subclasses and signatures in hepatocellular carcinoma: preliminary results

et al. 2017

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“…Many of these studies were large series of liver resections in centers outside the United States. Large United States studies of liver resection for HCC have been primarily based on cancer databases with limited information on underlying liver function[30,33,37], or were conducted in single centers that focused on the comparison between liver transplant and resection[29-38]. …”

Section: Discussionmentioning

confidence: 99%

“…Wu et al[40] reported that among 110 Taiwanese patients who underwent hepatic resection for HCC, neither underlying cirrhosis nor viral status affected operative morbidity or mortality, but the poorer liver reserve in HCV cirrhotic patients resulted in worse survival compared to the HBV patients. Franssen et al[37] reported that among 567 United States patients who underwent liver resection, HBV rather than HCV-related HCC had better survival and less recurrence. Our study allowed comparison of a primarily HBV-related HCC group of patients (China), a primarily HCV-related HCC group (Japan) and a mixed group (Hawaii), and when considered together viral hepatitis status had little bearing on overall 1- and 5-year survival as the cirrhosis, tumor size, AFP and underlying liver function had the greatest effect on outcome.…”

Section: Discussionmentioning

confidence: 99%

Liver resection for early hepatocellular cancer: Comparison of centers in 3 different countries

Hernandez

Shvetsov

Kawano

et al. 2016

WJH

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AIMTo compare patients who underwent resection of early stage hepatocellular cancer (HCC) in three different countries.METHODSThis retrospective study characterizes 573 stage I/II HCC patients treated with liver resection in 3 tertiary-referral centers: Tokyo (n = 250), Honolulu (n = 146) and Shanghai (n = 177).RESULTSShanghai patients were younger, predominantly male, hepatitis-B seropositive (94%) and cirrhotic (93%). Tokyo patients were older and more likely to have hepatitis-C (67%), smaller tumors, low albumin, and normal alpha-fetoprotein. The Honolulu cohort had the largest tumors and 30% had no viral hepatitis. Age-adjusted mortality at 1 and 5-years were lower in the Tokyo cohort compared to Honolulu and there was no difference in mortality between Shanghai and Honolulu cohorts. Elevated alpha-fetoprotein, low albumin and tumor > 5 cm were associated with increased 1-year mortality. These factors and cirrhosis were independently associated with increased 5-year mortality. Independent risk factors of survival varied when examined separately by center.CONCLUSIONThe profile of early-stage HCC patients is strikingly different across countries and likely contributes to survival differences. Underlying differences in patient populations including risk factors/comorbidities influencing disease progression may also account for variation in outcomes.

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“…However, literature seems to suggest low adherence in patients with chronic hepatitis, which may be a factor in long delays of follow-up imaging studies (10). As such, calculated mean time to the appearance of tumoral recurrence may be considerably decreased by shorter times to follow-up in patients treated for HCC (11).…”

Section: Discussion Discussionmentioning

confidence: 99%

Lipiodol Uptake and Wash-out Rate Detection on Computed Tomography as Predictors for Tumor Recurrence in Hepatocellular Carcinoma Treated by Transcatheter Arterial Chemoembolization

Scheau¹,

Scheau²,

Lupescu³

2017

SGO

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Background: Transcatheter arterial chemoembolization (TACE) is a dedicated method for treating intermediate stage hepatocellular carcinoma (HCC). The Lipiodol used in conventional TACE presents the advantage of being easily visualized and quantified on Computed Tomography (CT). Methods: Immediate postprocedural (baseline) and follow-up CT examinations of twenty patients treated by TACE for HCC were evaluated in this study. Lipiodol uptake on baseline images and progressive washout on follow-up examinations were assessed. Results: Statistically significant lower baseline Lipiodol densities are found in patients that develop tumoral recurrence at some point on follow-up examinations (p=0.0280). Using the treated nodule density as a predictive factor for tumoral recurrence, we obtained a diagnostic sensitivity of 92.31% in patients with cut-off values ≤ 545.36 HU, albeit with a low specificity. All patients develop a quantifiable Lipiodol density decrease over time, regardless of tumoral recurrence implication (p=0.0298). There is evidence to suggest that specific Lipiodol accumulation patterns may be associated with a higher risk of tumor recurrence. Conclusions: Baseline post-procedural Lipiodol accumulation levels may serve as a predictor for tumoral recurrence in patients treated for HCC using TACE, with good sensitivity provided a high cut-off value is set for the measured densities.

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Differences in Surgical Outcomes Between Hepatitis B- and Hepatitis C–Related Hepatocellular Carcinoma

Abstract: Survival after both resection and transplantation for HCC was better in HBV- than in HCV-related HCC whereas recurrence was also lower for HBV-HCC in the resection group, these differences are influenced by both liver and tumor factors.

Cited by 79 publications

References 37 publications

Imaging-based surrogate markers of transcriptome subclasses and signatures in hepatocellular carcinoma: preliminary results

Imaging-based surrogate markers of transcriptome subclasses and signatures in hepatocellular carcinoma: preliminary results

Liver resection for early hepatocellular cancer: Comparison of centers in 3 different countries

Lipiodol Uptake and Wash-out Rate Detection on Computed Tomography as Predictors for Tumor Recurrence in Hepatocellular Carcinoma Treated by Transcatheter Arterial Chemoembolization

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