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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 10/2020

01-10-2020 | Liver Resection | Hepatobiliary Tumors

Prognostic Role of Time to Surgery in Hepatocellular Carcinoma at Barcelona Clinic Liver Cancer Stage 0-A

Authors: Mengchao Wei, MD, Shuling Chen, MD, Jiali Li, MD, Bin Li, MSc, Jingxian Shen, MD, Zhenwei Peng, MD, Qian Zhou, MSc, Ying Zou, MM, Xiaofang He, MD, Shaoqiang Li, MD, Dongming Li, MD, Baogang Peng, MD, Jiaming Lai, MD, Sui Peng, MD, Beijiao Qin, MB, Ming Kuang, MD

Published in: Annals of Surgical Oncology | Issue 10/2020

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Abstract

Background

Postsurgical recurrence is common in early-stage hepatocellular carcinoma (HCC). Prolonged time to surgery (TTS) may lead to tumor progression. However, the impact of TTS on HCC prognosis is controversial in Western studies and unknown in China. We aim to investigate the impact of TTS on the prognosis of Chinese HCC patients at Barcelona Clinic Liver Cancer (BCLC) stage 0-A who underwent surgery.

Patients and Methods

We retrospectively enrolled 967 BCLC 0-A HCC patients who underwent surgery at three tertiary centers in China. Primary outcomes were recurrence-free survival (RFS) and overall survival (OS). Restricted cubic spline (RCS) was used to select the cutoff value of TTS. Propensity score matching (PSM) was performed to reduce confounding bias, and a time-dependent Cox model was utilized to investigate factors influencing TTS.

Results

The median TTS of BCLC 0-A HCC patients was 13 days (interquartile range: 10–21 days). For patients with TTS ≤ 70 days, the cutoff value of TTS was 13 days according to RCS. After PSM, corresponding 1-, 3-, and 5-year RFS of the TTS > 13 days and TTS ≤ 13 days groups were 75.6%, 55.3%, 46.4% and 71.2%, 52.3%, 38.8%, respectively (P = 0.103). Corresponding 1-, 3-, and 5-year OS of TTS > 13 days and TTS ≤ 13 days groups were 93.7%, 82.8%, 69.6% and 92.4%, 78.5%, 68.4%, respectively (P = 0.580). Time-dependent Cox analysis revealed that age and tumor size were factors influencing TTS.

Conclusions

Our study suggests that, for patients with TTS ≤ 70 days, prolonged TTS had no impact on BCLC 0-A Chinese HCC patients receiving surgery.
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Metadata
Title
Prognostic Role of Time to Surgery in Hepatocellular Carcinoma at Barcelona Clinic Liver Cancer Stage 0-A
Authors
Mengchao Wei, MD
Shuling Chen, MD
Jiali Li, MD
Bin Li, MSc
Jingxian Shen, MD
Zhenwei Peng, MD
Qian Zhou, MSc
Ying Zou, MM
Xiaofang He, MD
Shaoqiang Li, MD
Dongming Li, MD
Baogang Peng, MD
Jiaming Lai, MD
Sui Peng, MD
Beijiao Qin, MB
Ming Kuang, MD
Publication date
01-10-2020
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 10/2020
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-020-08499-2

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