Vascular Invasion in Hepatocellular Carcinoma

Lee, Yun-Hsuan; Hsu, Chia-Yang; Huang, Yi‐Hsiang; Hsia, Cheng Yuan; Chiou, Yi–You; Su, Chien–Wei; Lin, Han‐Chieh; Huo, Teh–Ia

doi:10.1097/mcg.0b013e3182a8a254

Cited by 73 publications

(37 citation statements)

References 35 publications

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“…Vascular invasion was defined as the presence of a thrombus adjacent to the tumor in the portal system or the hepatic vein system with a vague boundary confirmed by at least two imaging modalities [40]. The clinical and radiological data, including age, gender, white blood cell counts (WBC), platelet counts (PLT), neutrophil counts, lymphocyte counts, AFP levels, alanine transaminase (ALT) levels, aspartate aminotransferase (AST) levels, total bilirubin (TBIL) levels, indirect bilirubin (IBIL) levels, alkaline phosphatase (ALP) levels, albumin (ALB) levels, C-reactive protein (CRP) levels, hepatitis B surface antigen (HbsAg) levels, hepatitis B virus deoxyribonucleic acid (HBV-DNA) load, tumor size, tumor number and vascular invasion, were collected and analyzed.…”

Section: Methodsmentioning

confidence: 99%

Inflammation scores predict the survival of patients with hepatocellular carcinoma who were treated with transarterial chemoembolization and recombinant human type-5 adenovirus H101

Lin

2017

PLoS ONE

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BackgroundThe systemic inflammatory response plays an important role in cancer development and progression. An original inflammation-based staging system for predicting survival in patients undergoing transarterial chemoembolization (TACE) combined with recombinant human type-5 adenovirus H101 is not available. This study aimed to validate the prognostic value of inflammation scores for patients with hepatocellular carcinoma (HCC) who were treated with TACE combined with H101.MethodsThe data from 216 patients with HCC who underwent TACE combined with H101 from January 2007 to July 2015 were retrospectively collected, and the association of the inflammation scores with overall survival (OS) was analyzed. Univariate and multivariate analyses were performed to identify variables associated with OS. The prognostic value of the inflammation scores, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), neutrophil/ platelet-to-lymphocyte ratio (NLR-PLR), modified Glasgow Prognostic Score (mGPS), prognostic nutritional index (PNI), prognostic index (PI), tumor-node-metastasis (TNM), Barcelona Clinic Liver Cancer (BCLC) and Cancer of the Liver Italian Program (CLIP) staging systems were analyzed and compared using the areas under the receiver operating characteristic curves (AUROCs).ResultsThe estimated 1-, 2-, and 3-year OS rates were 61.3%, 44.2%, and 40.5% for the entire study cohort, respectively; the median OS was 17 months. According to the multivariate Cox proportional hazards model, the pretreatment NLR, tumor diameter and pretreatment alpha-fetoprotein (AFP) levels were independent predictors of OS. The CLIP score had superior discriminative abilities compared with other staging systems, and the NLR-PLR score consistently displayed a higher AUROC value than the other inflammation-based prognostic scores. The combination of the NLR-PLR and CLIP scores exhibited a superior prognostic ability for OS compared to the NLR-PLR or CLIP scores alone.ConclusionsThe NLR-PLR score is a more powerful predictive system than the other inflammation-based scores for patients with HCC who were treated with TACE and H101. The predictive ability may be improved by utilizing a combination of the NLR-PLR and CLIP scores.

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Section: Methodsmentioning

confidence: 99%

Inflammation scores predict the survival of patients with hepatocellular carcinoma who were treated with transarterial chemoembolization and recombinant human type-5 adenovirus H101

Lin

2017

PLoS ONE

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“…[25] Moreover, patients with vascular invasion have a high frequency of fatal recurrence, multiple intrahepatic tumors, and extrahepatic metastasis. [6] In theory, due to the rich blood supply in HCC, treatment with PA-TACE might kill or decrease the remaining tumor cells, eliminate micro-metastases to some extent, and improve long-term survival outcome. Our study suggested that vascular invasion and larger tumor diameter in HCC patients are more important and stronger risk factors for predicting prognosis, although PA-TACE could partially improve survival.…”

Section: Discussionmentioning

confidence: 99%

“…[4–5] In addition, MVI displays aggressive tumor behavior and is closely correlated with larger tumor burden. [6] However, there is still no recommended postsurgical treatment strategy for HCC patients with MVI, which renders the postsurgical management of these patients a major challenge.…”

Section: Introductionmentioning

confidence: 99%

Postsurgical treatment with adjuvant transarterial chemoembolization in patients with hepatitis B-related hepatocellular carcinoma

Liang

Long

et al. 2016

Medicine

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This study sought to develop a reliable and easy-to-use scoring model to guide the decision to perform postsurgical adjuvant transarterial chemoembolization (PA-TACE) in patients with hepatitis B-related hepatocellular carcinoma (HCC).The study included 235 consecutive patients with hepatitis B-related HCC undergoing PA-TACE at our medical center. Patients were assigned to 2 sets according to the PA-TACE date: initial (2005–2007; n = 130) and internal validation (2008–2009; n = 105) sets. With the aid of a Cox regression model, we developed a risk-scoring model from the independent predictive factors of our initial set designed as a guide for PA-TACE, and the performance of the model was validated with an internal set. External validation was also performed with an independent dataset (n = 84) to assess the discriminatory power of the scoring model.In the multivariate analysis, 4 risk factors (an increase in Child-Pugh score of at least 1 point, hepatitis B virus deoxyribonucleic acid [HBV-DNA] level >104 IU/mL, tumor diameter ≥5 cm, and the presence of vascular invasion) were significantly associated with prognosis. These factors were incorporated into a novel clinicopathological scoring model (assessment for PA-TACE [APT] risk-scoring model) ranging from 0 to 8 that was correlated with prognosis. Different survival outcomes were identified in three groups (0–2 points, 3–6 points, and 7–8 points). The risk-scoring model was further confirmed with 2 independent sets.The novel APT risk-scoring model, merging 4 prognostic factors, may achieve an optimal postsurgical prediction of PA-TACE in HBV-related HCC. The risk for an individual patient with an APT score of ≥7.0 prior to the PA-TACE, who may not profit from further PA-TACE, can be determined, and this may lead to a more appropriate choice of treatment.

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“…Supplementally, identification of the stage of tumor is based on the tumor–node–metastasis (TNM) classification system which was promulgated by the American Joint Committee on Cancer and International Union Against Cancer in 2010 [38] and Barcelona-Clinic-Liver-Cancer (BCLC) stages [39]. Vascular invasion was recognized by the presence of thrombus adjacent to the tumor in portal and hepatic vein system with vague boundary confirmed by at least two imaging modalities [40]. Routine chest CT scan was performed to detect metastatic lesion(s).…”

Section: Methodsmentioning

confidence: 99%

Association of VEGFA polymorphisms with susceptibility and clinical outcome of hepatocellular carcinoma in a Chinese Han population

et al. 2017

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Vascular endothelial growth factor A (VEGFA) is an important angiogenesis regulator, which plays an important role in angiogenesis and progression of tumor, including hepatocellular carcinoma (HCC). We aimed at determining whether single nucleotide polymorphisms of VEGFA gene influence the development and clinical outcomes of HCC. We analyzed four potential functional polymorphisms (936C/T, 634G/C, 1612G/A, 2578C/A) of VEGFA gene in 476 HCC patients and 526 controls using matrix-assisted laser desorption ionization time-of-flight mass spectrometry method. Serum VEGF levels were measured by enzyme-linked immunosorbent assay. The Kaplan-Meier methods with log-rank test and Cox regression models were used to compare survival of resected HCC patients according to the genotype. We found that only the VEGFA 2578C/A polymorphism was significantly associated with decreased risk of HCC (AA/AC vs. CC; adjusted OR = 0.69, 95% CI = 0.51−0.93). Furthermore, the 2578C/A polymorphism was associated with significantly decreased postoperative recurrence (AA/AC vs. CC, adjusted OR = 0.51; 95% CI, 0.29−0.88) and improved overall survival (AA/AC vs. CC, adjusted HR = 0.27, 95% CI = 0.13−0.52) of resected HCC patients. In addition, the VEGF serum levels in HCC patients were significantly higher than those in healthy controls, although no significant association between VEGFA genotype and serum levels of VEGF was observed. These results suggest that the VEGFA 2578 C/A polymorphism may play a potential role in the development and clinical outcome of HCC among Chinese Han population.

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Vascular Invasion in Hepatocellular Carcinoma

Cited by 73 publications

References 35 publications

Inflammation scores predict the survival of patients with hepatocellular carcinoma who were treated with transarterial chemoembolization and recombinant human type-5 adenovirus H101

Inflammation scores predict the survival of patients with hepatocellular carcinoma who were treated with transarterial chemoembolization and recombinant human type-5 adenovirus H101

Postsurgical treatment with adjuvant transarterial chemoembolization in patients with hepatitis B-related hepatocellular carcinoma

Association of VEGFA polymorphisms with susceptibility and clinical outcome of hepatocellular carcinoma in a Chinese Han population

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