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01-08-2018 | Original Scientific Report

Prognostic Prediction Models for Resection of Large Hepatocellular Carcinoma: A Korean Multicenter Study

Authors: Shin Hwang, Jae-Won Joh, Hee Jung Wang, Dong Goo Kim, Kyung Sik Kim, Kyung-Suk Suh, Seong Hoon Kim, Hee Chul Yu, Chol Kyoon Cho, Young-Joo Lee, Ki-Hun Kim, Jong Man Kim, Bong-Wan Kim, Sung-Gyu Lee

Published in: World Journal of Surgery | Issue 8/2018

Abstract

Background

We developed a prognostic prediction model (PPM) using 4 factors for hepatic resection (HR) of large hepatic cellular carcinoma (HCC). Multiplication of α-fetoprotein (AFP), des-γ-carboxy prothrombin, and tumor volume (TV) (ADV score) is a surrogate marker for post-resection prognosis. This study intended to validate the predictive power of 4-factor PPM and to develop new ADV score-based PPM.

Methods

A total of 526 patients who underwent HR for solitary HCC ≥ 8 cm were selected from 9 Korean institutions between 2008 and 2014.

Results

Median tumor diameter and TV were 11.0 cm and 398 mL, respectively. Tumor recurrence and patient survival rates were 53.0 and 78.4% at 1 year and 70.2 and 49.3% at 5 years, respectively. Independent risk factors for both tumor recurrence and patient survival included AFP ≥ 100 ng/mL, hypermetabolic FDG-positron emission tomography (PET), microvascular invasion and satellite nodules, which comprised 4 factors of the PPM. Five subgroups based on the number of involved risk factors exhibited significant differences in tumor recurrence and patient survival. ADV score cutoff was set at 7log (ADV7log) after cluster prognostic analysis. Patient grouping according to combination of ADV7log and FDG-PET findings (ADV7log-PET) exhibited significant differences in tumor recurrence and patient survival, comparable to those of the 4-factor PPM.

Conclusions

Two PPMs using 4 risk factors and ADV7log-PET could reliably predict the risk of early HCC recurrence and long-term survival outcomes in patients who underwent HR for large HCC. We believe that these PPMs can guide surgical treatment for large HCCs from preoperative HR planning to post-resection follow-up.

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Title: Prognostic Prediction Models for Resection of Large Hepatocellular Carcinoma: A Korean Multicenter Study
Authors: Shin Hwang
Jae-Won Joh
Hee Jung Wang
Dong Goo Kim
Kyung Sik Kim
Kyung-Suk Suh
Seong Hoon Kim
Hee Chul Yu
Chol Kyoon Cho
Young-Joo Lee
Ki-Hun Kim
Jong Man Kim
Bong-Wan Kim
Sung-Gyu Lee
Publication date: 01-08-2018
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 8/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-018-4468-2

At a glance: The STEP trials

Springer Medicine

Prognostic Prediction Models for Resection of Large Hepatocellular Carcinoma: A Korean Multicenter Study

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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