Less Fibrotic Burden Differently Affects the Long-Term Outcomes of Hepatocellular Carcinoma after Curative Resection

Lee, Hye Won; Choi, Gi Hong; Kim, Do Young; Park, Young Nyun; Kim, Kyung Sik; Choi, Jin Sub; Ahn, Sang Hoon; Han, Kwang Hyub

doi:10.1159/000477173

Cited by 7 publications

(6 citation statements)

References 26 publications

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“…Abstracts of the remaining 485 studies were reviewed again and 113 studies were selected for full-text review. Of these studies, 18 were qualified for this study [ 19 - 36 ]. Fig.…”

Section: Resultsmentioning

confidence: 99%

“…It was calculated with the fraction of the risk of tumor recurrence in the cirrhosis group compared to that in the non-cirrhosis group. Original HRs of the RFS could be extracted from ten studies [ 20 , 21 , 26 , 27 , 29 - 31 , 33 , 35 , 36 ]. However, eight studies did not show their own HRs [ 19 , 22 - 25 , 28 , 32 , 34 ].…”

Section: Resultsmentioning

confidence: 99%

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Is partial hepatectomy a curable treatment option for hepatocellular carcinoma accompanied by cirrhosis? A meta-analysis and cure model analysis

Bae

Kang

Song

et al. 2022

Ann Hepatobiliary Pancreat Surg

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Backgrounds/Aims It is challenging to assess the efficacy of partial hepatectomy (PH) as a treatment option for patients with hepatocellular carcinoma (HCC) accompanied by cirrhosis. This study aimed to determine the cure fraction of PH for HCC accompanied by cirrhosis compared to that for HCC without cirrhosis. Methods A systematic review was performed on outcomes of previous studies that compared recurrence-free survival (RFS) after PH in patients with HCC with or without cirrhosis. A meta-analysis was conducted to obtain the cumulative hazard ratio for two patient groups: cirrhosis and non-cirrhosis. Cure fractions after PH in both groups were determined using a cure model analysis. Results A total of 18 studies were eligible for meta-analysis and 13 studies were selected for the cure model analysis. The cumulative hazard ratio for RFS of the cirrhosis group compared to that of the non-cirrhosis group was 1.66 (95% confidence interval [CI], 1.43–1.93). Survival data of 3,512 patients in both groups were reconstructed from survival curves of original articles for cure model analysis. The probability of being statistically cured after PH for HCC was 14.1% (95% CI, 10.6%–18.1%) in the cirrhosis group lower than that (32.5%) in the non-cirrhosis group (95% CI, 28.6%–36.4%). Conclusions The prognosis after PH for HCC accompanied by cirrhosis is inferior to that for HCC without cirrhosis. However, a cure can be expected for one-seventh of patients with HCC accompanied by cirrhosis after PH.

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“…Abstracts of the remaining 485 studies were reviewed again and 113 studies were selected for full-text review. Of these studies, 18 were qualified for this study [ 19 - 36 ]. Fig.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Is partial hepatectomy a curable treatment option for hepatocellular carcinoma accompanied by cirrhosis? A meta-analysis and cure model analysis

Bae

Kang

Song

et al. 2022

Ann Hepatobiliary Pancreat Surg

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“…A meta-analysis and review indicated that portal hypertension had an adverse impact on short- and long-term outcomes for HCC patients undergoing partial hepatectomy ( 22 ). Meanwhile, liver cirrhosis was considered as one of the most important risk factors for surgical outcomes in HCC patients ( 3 , 16 , 23 , 24 ). In the present study, the 5-year OS and DFS in HCC patients with liver cirrhosis are 63.2 and 38.1%, whereas 82.7 and 59.8% for those without liver cirrhosis.…”

Section: Discussionmentioning

confidence: 99%

Sub-Classification of Cirrhosis Affects Surgical Outcomes for Early Hepatocellular Carcinoma Independent of Portal Hypertension

Zhang

Jiang

et al. 2021

Front. Oncol.

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Severity of liver cirrhosis is distinct from clinical portal hypertension because there exist different degrees of liver cirrhosis in hepatocellular carcinoma (HCC) patients without significant clinical portal hypertension. Whether severity of cirrhosis affects surgical outcomes for HCC patients in absence of portal hypertension or not remains unclear. This study aims to analyze the effect of cirrhotic severity on surgical outcomes for HCC patients with hepatitis B virus (HBV) infection in absence of portal hypertension. This retrospective study enrolled 166 patients who underwent curative resection for a single HCC ≤5 cm in absence of portal hypertension between February 2011 and December 2013. Liver cirrhosis was sub-classified into no/mild (no/F4A) and moderate/severe (F4B/F4C) according to the Laennec scoring system. The surgical outcomes and complications were analyzed. The surgical mortality was zero in this study. Major complications were apparently higher in the F4B/F4C group than in the no/F4A group (17.0% vs 7.4%, p <0.001). The 1-year, 3-year and 5-year overall survival (OS) rates were 98.5, 88.1 and 80%, respectively, in the no/F4A group, which were significantly higher than those in the F4B/F4C group (98.0, 69.2 and 54.7%, p = 0.001). Microscopic vascular invasion, absence of tumor capsule and severity of liver cirrhosis were independent risk factors of surgical outcomes for HCC patients without portal hypertension. In conclusion, severity of liver cirrhosis affected surgical outcomes for early-stage HCC patients independent of portal hypertension.

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“…Conversely, the complication rate is often high, ranging from 22% to 43% (57,58,60,62,63,(65)(66)(67)(68)70,71,73). This may be explained by the high rate of major liver resections in non-cirrhotic patients, which exceeds 50% in some series (67,68,70,72). The main complications reported were PHLF, sepsis (pneumonia, abdominal collections), bile leakage, and pleural effusion (57,63,(65)(66)(67)70,71).…”

Section: Resection Of Large Hccs In the Non-cirrhotic Livermentioning

confidence: 99%

Treatment strategies for locally advanced hepatocellular carcinoma

Fernandes

Rodrigues

Álvares‐da‐Silva

et al. 2019

Transl. Gastroenterol. Hepatol

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Liver cancer ranks fifth in incidence and fourth in overall cancer-related mortality, with approximately 854,000 new cases and 810,000 deaths per year worldwide. Hepatocellular carcinoma (HCC) accounts for 90% of these cases, and, over time, both the incidence and mortality of this cancer have been rising in many regions. Several staging systems are used to assess the extent of primary tumor, presence of metastasis, and underlying liver disease, and thereby aid in the definition of treatment strategies and prognosis for these patients. The consequence of this heterogeneity in HCC staging is that no consensual definition of advanced disease exists, and there is still ongoing debate on the optimal treatment for these patients. Patients with advanced tumors can be candidates for multiple therapies, ranging from potentially curative options such as transplantation and resection-to locoregional and systemic treatments; these should be evaluated on an individual basis by a multidisciplinary team. This paper provides an overview of treatment options for advanced stage HCC, based on a review of the latest relevant literature and the personal experience of the authors.

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Less Fibrotic Burden Differently Affects the Long-Term Outcomes of Hepatocellular Carcinoma after Curative Resection

Cited by 7 publications

References 26 publications

Is partial hepatectomy a curable treatment option for hepatocellular carcinoma accompanied by cirrhosis? A meta-analysis and cure model analysis

Is partial hepatectomy a curable treatment option for hepatocellular carcinoma accompanied by cirrhosis? A meta-analysis and cure model analysis

Sub-Classification of Cirrhosis Affects Surgical Outcomes for Early Hepatocellular Carcinoma Independent of Portal Hypertension

Treatment strategies for locally advanced hepatocellular carcinoma

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