Actual long-term survival in HCC patients with portal vein tumor thrombus after liver resection: a nationwide study
- PDF / 1,562,765 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 101 Downloads / 174 Views
ORIGINAL ARTICLE
Actual long‑term survival in HCC patients with portal vein tumor thrombus after liver resection: a nationwide study Zhen‑Hua Chen1,24 · Xiu‑Ping Zhang1,22,24 · Yu‑Gang Lu2 · Le‑Qun Li3,24 · Min‑Shan Chen4,24 · Tian‑Fu Wen5,24 · Wei‑Dong Jia6,7,24 · Dong Zhou8,24 · Jing Li9,24 · Ding‑Hua Yang10,24 · Zuo‑Jun Zhen11,24 · Yi‑Jun Xia12,24 · Rui‑Fang Fan13,24 · Yang‑Qing Huang14,24 · Yu Zhang15,24 · Xiao‑Jing Wu16,24 · Yi‑Ren Hu17,24 · Yu‑Fu Tang18,24 · Jian‑Hua Lin19,24 · Fan Zhang20,24 · Cheng‑Qian Zhong21,24 · Wei‑Xing Guo1,24 · Jie Shi1,24 · Joseph Lau1,23,24 · Shu‑Qun Cheng1,24 Received: 7 November 2019 / Accepted: 9 March 2020 © Asian Pacific Association for the Study of the Liver 2020
Abstract Background Liver resection for hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) offers a chance of cure, although survival is often limited. The actual 3-year survival and its associated prognostic factors have not been reported. Methods A nationwide database of HCC patients with PVTT who underwent liver resection with ‘curative’ intent was analyzed. The clinicopathologic characteristics, the perioperative, and survival outcomes for the actual long-term survivors were compared with the non-long-term survivors (patients who died within 3 years of surgery). Univariable and multivariable regression analyses were performed to identify predictive factors associated with long-term survival outcomes. Results The study included 1590 patients with an actuarial 3-year survival of 16.6%, while the actual 3-year survival rate was 11.7%. There were 171 patients who survived for at least 3 years after surgery and 1290 who died within 3 years of surgery. Multivariable regression analysis revealed that total bilirubin > 17.1 μmol/l, AFP > 400 ng/ml, types of hepatectomy, extent of PVTT, intraoperative blood loss > 400 ml, tumor diameter > 5 cm, tumor encapsulation, R0 resection, liver cirrhosis, adjuvant TACE, postoperative early recurrence ( 17.1 μmol/l were significantly higher in the nonlong-term survivor group than the long-term survivor group (28.4% vs. 19.9%, p = 0.019; 36.4% vs. 26.3%, p = 0.009, respectively). In addition, there was a significant difference in the level of AFP between the two groups of patients (p = 0.001). No significant differences were found in the levels of HBV-DNA, ALB, ALT, AST, blood glucose, platelet count, and esophageal and gastric varices between the two groups of patients.
Operative and pathologic data The data on the operative management are shown in Table 1. The percentages of anatomical resection, ascites, lymph node invasion, intraoperative chemotherapy, and
13
Hepatology International
Fig. 1 Cumulative incidence of OS and RFS curves in the entire cohort
intraoperative blood transfusion were comparable between the two groups. Significantly more of the long-term survivors underwent major hepatectomy (59.6% vs. 46.0%, p = 0.001). There were higher rates of type I and II PVTT in the long-term survivors group than the non-long-term survivor gr
Data Loading...
