Identification of the resection severity index as a significant independent prognostic factor for early mortality and observed survival &gt;5 and &gt;10 years after liver resection for hepatocellular carcinoma

Gwiasda, Jill; Schulte, Aron; Kaltenborn, Alexander; Ramackers, Wolf; Kleine, Moritz; Beetz, Oliver; Klempnauer, Jürgen; Emmanouilidis, Nikos; Schrem, Harald

doi:10.1016/j.suronc.2017.03.004

Cited by 12 publications

(16 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this study, we investigated and compared the outcomes and prognostic factors diachronically (5, 10, and 15 years of survival among the same populations). Some studies have reported that an advanced tumor stage, patient age, and extent of liver resection predict 5-year survival (Table 7) [35,36]. Particularly, advanced tumor-related factors have been reported to affect recurrence during early postoperative periods (2-3 years) [37][38][39][40][41], leading to poor OS [32,33]; this finding corresponds with our results.…”

Section: Discussionsupporting

confidence: 90%

“…The achievement of SVR with IFN-based therapy is essential for long-term (≥15 years) survival after hepatic resection for HCV-related HCC. [23,24,26,27,35] tumor number (multiple) [8,23,27] tumor size >5 cm [27] tumor without capsule [36] AJCC/UICC, American Joint Committee on Cancer/International Union Against Cancer; HCC, hepatocellular carcinoma; ICGR15, indocyanine green retention rate at 15 min.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Long-Term Prognostic Factors after Hepatic Resection for Hepatitis C Virus-Related Hepatocellular Carcinoma, with a Special Reference to Viral Status

et al. 2018

View full text Add to dashboard Cite

Background: Although studies have reported on long-term (10-year) survival after hepatic resection for hepatocellular carcinoma (HCC), they did not focus on patients with hepatitis C virus (HCV)-related HCC, and the contribution of antiviral therapy to long-term survival (especially ≥15 years) has not been adequately examined. We investigated the long-term outcome after hepatic resection for HCV-related HCC, including the effects of interferon (IFN) therapy, and the changes in prognostic factors according to postoperative duration. Methods: The data of 207 patients who underwent hepatic resection for HCV-related HCC between January 1992 and December 2001 were retrospectively reviewed. We investigated the disease-free and overall survival rates after surgery and analyzed the prognostic factors at 5, 10, and 15 years postoperatively. Results: The proportion of patients who survived at 5, 10, and 15 years after hepatic resection was 52% (n = 107), 18% (n = 38), and 9% (n = 19). The overall survival rate was significantly higher in patients who achieved sustained virological response (SVR) with IFN therapy than in those without SVR. Tumor-related factors such as multiple tumor, microscopic vascular invasion, and a high indocyanine green retention rate at 15 min (ICGR15) were unfavorable prognostic factors for 5-year survival. Conversely, a low ICGR15 and SVR were favorable prognostic factors at 10 years, and SVR alone was a favorable prognostic factor at 15 years postoperatively; no tumor-related factors were prognostic factors at 10 and 15 years postoperatively. Conclusion: The prognostic factors varied according to the duration after hepatic resection for HCV-related HCC. Tumor-related factors were unfavorable prognostic factors in the early postoperative period, whereas SVR and good liver function were favorable prognostic factors at 10 and 15 years postoperatively. Achievement of SVR with IFN therapy is essential for long-term (≥15 years) survival after hepatic resection for HCVrelated HCC.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Long-Term Prognostic Factors after Hepatic Resection for Hepatitis C Virus-Related Hepatocellular Carcinoma, with a Special Reference to Viral Status

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Identification of independent risk factors influencing overall patient survival was achieved by developing a multivariable Cox regression model including potential multiplicative or additional factor interactions based on backwards likelihood elimination followed by forward likelihood inclusion of variables as has been proposed by Hosmer et al and has been applied and published recently by our workgroup [ 18 , 19 ].…”

Section: Methodsmentioning

confidence: 99%

Relevant prognostic factors influencing outcome of patients after surgical resection of distal cholangiocarcinoma

et al. 2018

Self Cite

View full text Add to dashboard Cite

BackgroundDistal cholangiocarcinoma (DCC) is a rare but over the last decade increasing malignancy and is associated with poor prognosis. According to the present knowledge curative surgery is the only chance for long term survival. This study was performed to evaluate prognostic factors for the outcome of patients undergoing curative surgery for distal cholangiocarcinoma.Methods75 patients who underwent surgery between January 2000 and December 2014 for DCC in curative intention were analysed retrospectively. Potential prognostic factors for survival were investigated including the extent of surgery using purposeful selection of covariates in multivariable Cox regression modeling.ResultsPreoperative biliary stenting (Hazard ratio (HR): 2.530; 95%-CI: 1.146–6.464, p = 0.020), the extent of surgery in case of positive histological venous invasion (HR: 1.209; 95%-CI: 1.017–1.410, p = 0.032), lymph node staging (HR: 2.183; 95%-CI: 1.250–3.841, p = 0.006), perineural invasion (HR: 2.118; 95%-CI: 1.147–4.054, p = 0.016) and postoperative complications graded in points according to Clavien-Dindo (HR: 1.395; 95%-CI: 1.148–1.699, p = 0.001) were indentified as independent significant risk factors for survival. Patients receiving preoperative biliary stenting showed prolonged duration between onset of symptoms and date of operation (p = 0.048).ConclusionsPreoperative biliary stenting reduces survival possibly due to delayed surgery. The extent of surgery is not an independent risk factor for survival except for patients with concomitant histological venous invasion. Oncological factors and postoperative surgical complications are independent prognostic factors for survival.

show abstract

“…The pseudometric grading of the extent of liver resection in points was used as published before. Further, the resection severity index (RSI) was calculated by the preoperative AST (GOT) in U/l divided by the preoperative Quickʼs value in percent multiplied by the extent of resected liver tissue graded in points as has been described before [3,7]. The extent of hepatic disease was evaluated referring to the diameter of the largest lesion since the absolute number of hepatic metastases did not show an impact on overall survival in previous studies from our center.…”

Section: Definition Of Relevant Variablesmentioning

confidence: 99%

Proposal of a Multivariable Prediction Model for Graded Morbidity after Liver Resection for Colorectal Metastases

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background Prognostic models to predict individual early postoperative morbidity after liver resection for colorectal liver metastases (CLM) are not available but could enable optimized preoperative patient selection and postoperative surveillance for patients at greater risk of complications. The aim of this study was to establish a prognostic model for the prediction of morbidity after liver resection graded according to Dindo. Methods N = 679 cases of primary liver resection for CLM were retrospectively analyzed using univariable and multivariable ordinal regression analyses. Receiver operating characteristics curve (ROC) analysis was utilised to assess the sensitivity and specificity of predictions and their potential usefulness as prognostic models. Internal validation of the score was performed using data derived from 129 patients. Results The final multivariable regression model revealed lower preoperative levels, a greater number of units of intraoperatively transfused packed red blood cells (pRBCs), longer duration of surgery, and larger metastases to independently influence postoperatively graded morbidity. ROC curve analysis demonstrated that the multivariable regression model is able to predict each individual grade of postoperative morbidity with high sensitivity and specificity. The areas under the receiver operating curves (AUROC) for all of these predictions of individual grades of morbidity were > 0.700, indicating potential usefulness as a predictive model. Moreover, a consistent concordance in Grades I, II, IV, and V according to the classification proposed by Dindo et al. was observed in the internal validation. Conclusion This study proposes a prognostic model for the prediction of each grade of postoperative morbidity after liver resection for CLM with high sensitivity and specificity using pre- and intraoperatively available variables.

show abstract

Identification of the resection severity index as a significant independent prognostic factor for early mortality and observed survival >5 and >10 years after liver resection for hepatocellular carcinoma

Cited by 12 publications

References 26 publications

Long-Term Prognostic Factors after Hepatic Resection for Hepatitis C Virus-Related Hepatocellular Carcinoma, with a Special Reference to Viral Status

Long-Term Prognostic Factors after Hepatic Resection for Hepatitis C Virus-Related Hepatocellular Carcinoma, with a Special Reference to Viral Status

Relevant prognostic factors influencing outcome of patients after surgical resection of distal cholangiocarcinoma

Proposal of a Multivariable Prediction Model for Graded Morbidity after Liver Resection for Colorectal Metastases

Contact Info

Product

Resources

About