Prediction of long‑term survival rates in patients undergoing curative resection for solitary hepatocellular carcinoma

Abstract

Abstract. The present study developed a novel laboratory-based algorithm to predict long-term survival rates in patients undergoing curative resection for solitary hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). The present study included 426 patients with solitary HBV-related HCC who underwent surgery for primary tumors at a single center between 2003 and 2012. Demographic characteristics, laboratory analysis, clinical pathology and immunohistochemistry of topoisomerase II-a and Ki67 were analyzed. A simple prognostic risk calculator was developed using regression coefficients from multivariate models. A prognostic risk calculator incorporating tumor encapsulation, neutrophil-to-lymphocyte ratio, vascular invasion, α-fetoprotein level, Edmondson-Steiner classification, Topo II-α, prognostic nutritional index and Child-Pugh grade was constructed. The prognostic model demonstrated good discrimination with a C-index prior to adjustment of 0.81 (95% confidence interval: 0.78-0.84) and a bootstrap-corrected C-index of 0.81. Kaplan-Meier curves demonstrated that the probabilities of overall survival rates in the low-risk group were increased compared with those in the high-risk group. The areas under the receiver operating characteristic curve using the method were greater compared with those under the 7th Tumor-Node-Metastasis system and Cancer of the Liver Italian Program scoring system [0.83 vs. 0.62 and 0.77 (P<0.001), respectively]. The simple prognostic model of the present study accurately predicted survival rates in patients. Such a prognostic risk calculator for staging patients undergoing curative resection for solitary HBV-related HCC facilitates clinical surveillance and therapy.

The proliferation of atypical hepatocytes and CDT1 expression in noncancerous tissue are associated with the postoperative recurrence of hepatocellular carcinoma

“…However, although the number of positive cells in these noncancerous hepatocytes was lower than in cancer cells, the expression of CDT1 in the nuclei was morphologically similar. Positivity rate for Ki-67 (labeling index), a cell proliferation marker, has been reported in various cancer tissues (32)(33)(34)(35)(36)(37), but several studies have indicated that Ki-67 labeling index is not a poor prognostic factor in HCC (38)(39)(40). Therefore, it has not been established as a prognostic marker for HCC.…”

Effect of KI-67 positive cellular index on prognosis after hepatectomy in Barcelona Clinic Liver Cancer stage A and B hepatocellular carcinoma with microvascular invasion

“… 24 , 25 The influence of KI-67 on HCC prognosis has been debated, but several investigations suggest KI-67 is not a poor prognostic factor. 22 , 26 , 27 The aim of this study was to explore the risk patterns of recurrence for patients who underwent hepatic resection for BCLC stage A and B HCC and to validate the relationship between KI-67 positive cellular index and RFS for BCLC stage A and B HCC patients.…”

Development and Validation of Prognostic Nomograms Predicting Recurrence and Survival in Patients with Solitary Hepatocellular Carcinoma Following Curative Liver Resection

“…While the BCLC system is the most extensively adopted HCC staging approach, there are challenges in the staging of solitary HCCs with a diameter of more than 5 cm In this present study, the clinicopathological features of solitary HCCs, inclusive of tumor diameter, tumor capsule, and macrovascular invasion emerged as signi cant predictors for both DFS and OS. These features are well-known underlying risk factors and are evidently also associated with HCC recurrence and poor prognosis [10,21,23]. Macrovascular invasion refers to thrombosis bordering the tumor in the portal vein with a blurred boundary, with at least one imaging modality con rming this nding in all patients [24].…”