Prediction of early recurrence of hepatocellular carcinoma within the Milan criteria after radical resection

Abstract

Approximately 50% hepatocellular carcinoma patients meeting the Milan criteria utilized to develop an improved prognostic model for predicting the recurrence in these patients. Using univariate and multivariate analysis, cytokeratin-19 and glypican-3 expression patterns, tumor number and histological grading from eight putative prognostic factors comprised the risk factor scoring model to predict the tumor recurrence. In the training cohort, the area under roc curve (AUC) value of the model was 0.715 [95% confidence interval (CI) = 0.645−0.786, P<0.001], which was the highest among all the parameters. The performance of the model was assessed using an independent validation cohort, wherein the AUC value was 0.760 (95% CI=0.647−0.874, P<0.001), which was higher than the other factors. The results indicated that model had high performance with adequate discrimination ability. Moreover, it significantly improved the predictive capacity for the recurrence in patients with hepatocellular carcinoma within the Milan criteria after radical resection.

Extrapolating Prognostic Factors of Primary Curative Resection to Postresection Recurrences Hepatocellular Carcinoma Treatable by Radiofrequency Ablation

“…Typically in HCC, most deaths are due to tumor recurrence or local progression [ 13 ]. Although factors of primary curative resection, including detailed clinical and pathological information of primary tumors, have been shown as prognostic factors related to overall survival and recurrence of primary curative resection [ 8 – 10 ], few studies have focused on the relationship between these factors and prognosis for recurrent HCC patients undergoing RFA. The prognostic significance of factors of primary curative resection, which are available for recurrent HCC patients without additional traumatic examination, would be very attractive for use in the clinic.…”

“…Factors of primary curative resection are available for recurrent HCC patients without additional traumatic examination, including detailed clinical and pathological information of primary tumors, which have been shown as prognostic factors related to overall survival and recurrence of primary curative resection [ 8 – 10 ]. However, their clinical merits in recurrent HCC patients undergoing RFA have yet to be proven.…”

Heterogeneity analysis of triphasic CT scan perfusion parameters in differential diagnosis of hepatocellular carcinoma and hemangioma

“…Early detection plays a critical role for the successful local tumor surgery. [ 5 , 35 , 36 ] In the case of typical hemangioma, imaging features are highly credible for the accurate diagnosis. [ 28 ] Nevertheless, atypical features in the cases of atypical hemangioma may result in confusion with other lesions and/or misdiagnosis.…”

Prediction of Early Recurrence of Solitary Hepatocellular Carcinoma after Orthotopic Liver Transplantation

“…All the enrolled cases were divided into three groups: CK19+/GPC3+ group, which included tumor cells that co-expressed CK19 and GPC3; CK19−/GPC3+ group, which included tumor cells that expressed GPC3 alone; and CK19−/GPC3− group, which included tumor cells without expression of both CK19 GPC3 25 . Positive immunoreactivity of normal bile duct epithelium was confirmed as internal positive control for CK19, while yolk sac tumor tissue was used as a positive control sample for GPC3 24 . Negative controls were carried out by substitution of the primary antibodies with non-immunized serum, which resulted in no signal detection.…”

“…In well differentiated HCC, GPC3 expression was weak or absent 22,23 . Therefore, according to the specific expression spectrum of CK19 and GPC3 in the differentiation process of HPC towards mature hepatocyte, the phenotypes of CK19+/GPC3+, CK19−/GPC3+, and CK19−/GPC3− can roughly correspond to the HPC, immature hepatocyte, and terminally differentiated hepatocyte, respectively 24 . The hierarchal HCC subtypes in turn might have been transformed from the varied differentiation stages of hepatic parenchymal cells and can fall into the above three discussed immune-phenotype groups.…”