Potential candidates for liver resection in liver-confined advanced HCC: a Chinese multicenter observational study

作者全名："Bai, Tingting; Wang, Enxin; Zhao, Shoujie; Han, Dandan; Zhao, Yan; Chen, Hui; Zhu, Jun; Han, Tenghui; Bai, Yang; Lou, Yanju; Zhang, Yongchao; Yang, Man; Zuo, Luo; Fan, Jiahao; Chen, Xing; Jia, Jia; Wu, Wenbin; Ren, Weirong; Zhu, Yejing; Ma, Shouzheng; Xu, Fenghua; Tang, Yuxin; Du, Xilin; Zhao, Junlong; Li, Jing; Qi, Xingshun; Han, Ying; Chen, Dongfeng; Liu, Lei"

作者地址："[Bai, Tingting; Chen, Dongfeng; Liu, Lei] Third Mil Med Univ, Dept Digest Dis, Daping Hosp, Army Med Univ, Chongqing, Peoples R China; [Wang, Enxin; Qi, Xingshun] Air Force Hosp Western Theater Command, Dept Digest Dis, Chengdu, Peoples R China; [Zhao, Shoujie; Liu, Lei] Fourth Mil Med Univ, Dept Digest Dis, Tangdu Hosp, Air Force Med Univ, Xian, Peoples R China; [Han, Dandan] Air Force Hosp Southern Theater Command, Dept Gen Surg, Guangzhou, Peoples R China; [Zhao, Yan] Xi An Jiao Tong Univ, Dept Digest Dis, Affiliated Hosp 1, Xian, Peoples R China; [Chen, Hui; Han, Ying] Fourth Mil Med Univ, Xijing Hosp Digest Dis, Xian, Peoples R China; [Zhu, Jun] Southern Theater Air Force Hosp, Dept Gen Surg, Guangzhou, Peoples R China; [Han, Tenghui] Fourth Mil Med Univ, Air Force Med Univ, Dept Internal Med, Xian, Peoples R China; [Bai, Yang] Gen Hosp Northern Theater Command, Dept Neurosurg, Shenyang, Peoples R China; [Lou, Yanju] Air Force Hosp Western Theater Command, Dept Orthoped Surg, Chengdu, Peoples R China; [Zhang, Yongchao] Air Force Hosp Western Theater Command, Dept Med Affairs, Chengdu, Peoples R China; [Yang, Man] Sun Yat Sen Univ, Ctr Digest Dis, Affiliated Hosp 7, Shenzhen, Peoples R China; [Zuo, Luo] Chengdu Med Coll, Dept Digest Dis, Affiliated Hosp 2, Chengdu, Peoples R China; [Fan, Jiahao] Southwest Med Univ, Dept Digest Dis, Affiliated Hosp, Luzhou, Peoples R China; [Chen, Xing] Qingdao Women & Childrens Hosp, Dept Oncol, Qingdao, Peoples R China; [Jia, Jia] Shaanxi Prov Peoples Hosp, Dept Emergency, Xian, Peoples R China; [Wu, Wenbin] Xian First Hosp, Dept Digest Dis, Xian, Peoples R China; [Ren, Weirong] Henan Univ Sci & Technol, Dept Digest Dis, Sanmenxia Cent Hosp, Sanmenxia, Peoples R China; [Ma, Shouzheng] Fourth Mil Med Univ, Dept Surg, Tangdu Hosp, Air Force Med Univ, Xian, Peoples R China; [Zhao, Junlong] Fourth Mil Med Univ, State Key Lab Canc Biol Med Genet & Dev Biol, Xian, Peoples R China; [Li, Jing] Shanxi Med Univ, Dept Digest Dis, Shanxi Bethune Hosp, Shanxi Acad Med Sci,Tongji Shanxi Hosp,Third Hosp, Taiyuan, Peoples R China; [Li, Jing] Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Wuhan, Peoples R China; [Qi, Xingshun] Gen Hosp Northern Theater Command, Dept Digest Dis, Shenyang, Peoples R China"

通信作者："Chen, DF; Liu, L (通讯作者)，Third Mil Med Univ, Dept Digest Dis, Daping Hosp, Army Med Univ, Chongqing, Peoples R China.; Liu, L (通讯作者)，Fourth Mil Med Univ, Dept Digest Dis, Tangdu Hosp, Air Force Med Univ, Xian, Peoples R China.; Han, Y (通讯作者)，Fourth Mil Med Univ, Xijing Hosp Digest Dis, Xian, Peoples R China.; Li, J (通讯作者)，Shanxi Med Univ, Dept Digest Dis, Shanxi Bethune Hosp, Shanxi Acad Med Sci,Tongji Shanxi Hosp,Third Hosp, Taiyuan, Peoples R China.; Li, J (通讯作者)，Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Wuhan, Peoples R China.; Qi, XS (通讯作者)，Gen Hosp Northern Theater Command, Dept Digest Dis, Shenyang, Peoples R China."

来源：FRONTIERS IN ONCOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001025965300001

JCR分区：Q2

影响因子：3.5

年份：2023

卷号：13

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：hepatocellular carcinoma; liver resection; performance status; overall survival; prognosis

摘要："BackgroundAdvanced hepatocellular carcinoma (HCC) is characterized as symptomatic tumors [performance status (PS) score of 1-2], vascular invasion and extrahepatic spread, but patients with PS1 alone may be eliminated from this stage. Although liver resection is used for liver-confined HCC, its role in patients with PS1 alone remains controversial. Therefore, we aimed to explore its application in such patients and identify potential candidates. MethodsEligible liver-confined HCC patients undergoing liver resection were retrospectively screened in 15 Chinese tertiary hospitals, with limited tumor burden, liver function and PS scores. Cox-regression survival analysis was used to investigate the prognostic factors and develop a risk-scoring system, according to which patients were substratified using fitting curves and the predictive values of PS were explored in each stratification. ResultsFrom January 2010 to October 2021, 1535 consecutive patients were selected. In the whole cohort, PS, AFP, tumor size and albumin were correlated with survival (adjusted P<0.05), based on which risk scores of every patient were calculated and ranged from 0 to 18. Fitting curve analysis demonstrated that the prognostic abilities of PS varied with risk scores and that the patients should be divided into three risk stratifications. Importantly, in the low-risk stratification, PS lost its prognostic value, and patients with PS1 alone achieved a satisfactory 5-year survival rate of 78.0%, which was comparable with that PS0 patients (84.6%). ConclusionSelected patients with PS1 alone and an ideal baseline condition may benefit from liver resection and may migrate forward to BCLC stage A."

基金机构：Chongqing Doctor "Through train" scientific research project [CSTB2022BSXMJCX0012]

基金资助正文：& nbsp;This study was supported by Chongqing Doctor "Through train" scientific research project (CSTB2022BSXMJCX0012).