Prognostic Accuracy of the ADV Score Following Resection of Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis
- PDF / 2,397,097 Bytes
- 15 Pages / 595.276 x 790.866 pts Page_size
- 76 Downloads / 178 Views
ORIGINAL ARTICLE
Prognostic Accuracy of the ADV Score Following Resection of Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis Shin Hwang 1 & Deok-Bog Moon 1 & Ki-Hun Kim 1 & Chul-Soo Ahn 1 & Gi-Won Song 1 & Dong-Hwan Jung 1 & Gil-Chun Park 1 & Sung-Gyu Lee 1 Received: 20 April 2020 / Accepted: 6 September 2020 # 2020 The Society for Surgery of the Alimentary Tract
Abstract Background We assessed the prognostic accuracy of ADV score (α-fetoprotein [AFP]-des-γ-carboxyprothrombin [DCP]-tumor volume [TV] score) following resection of hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT). Methods This was a retrospective observational study. This study included 147 patients who underwent hepatic resection for HCC with PVTT. They were followed up for ≥ 66 months or until patient death. Results The grades of PVTT were Vp1 in 121 (14.3%), Vp2 in 41 (27.9%), Vp3 in 71 (48.3%), and Vp4 in14 (9.5%) cases. Preoperative HCC treatment was performed in 48 (32.7%) patients. R0 and R1 resections were performed in 119 (81.0%) and 28 (19.0%) cases, respectively. The 5-year tumor recurrence, HCC-specific survival, and post-recurrence survival rates were 79.2%, 43.5%, and 25.4%, respectively. Neither PVTT grade nor history of preoperative HCC treatment was a significant prognostic indicator. Stratification in accordance with ADV scores of 1log- and 3log-intervals resulted in high prognostic accuracy in predicting tumor recurrence and patient survival. Following cluster analysis, the cutoff for ADV score was determined at 9log and was more prognostically significant in terms of tumor recurrence and patient survival than surgical curability or microvascular invasion. Further comparisons revealed that prognostic prediction with an ADV score cutoff at 9log was more accurate than that using the Eastern Hepatobiliary Surgery Hospital-PVTT score. Conclusions ADV score is an integrated surrogate biomarker for post-resection prognosis in HCC with PVTT. Our prognostic prediction model using ADV scores provides reliable post-resection prognosis for patients with various grades of these tumors. Keywords Hepatocellular carcinoma . Resection . Recurrence . Microvascular invasion . Tumor biology
Abbreviations ADV (Alpha-fetoprotein)×(des-γ-carboxyprothrombin)× (tumor volume) AFP Alpha-fetoprotein BCLC Barcelona Clinic Liver Cancer DCP Des-γ-carboxyprothrombin HCC Hepatocellular carcinoma TV Tumor volume
* Shin Hwang [email protected] 1
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea
Introduction Hepatocellular carcinoma (HCC) can involve the intrahepatic vasculature, in which the portal vein (PV) is frequently affected. Portal vein tumor thrombosis (PVTT) is encountered in a considerable proportion of HCC patients at their initial diagnosis. The primary cause of such frequent PV involvement is that the intrahepatic PV branches work as the outflow pathways of a growing HCC lesion which is fed by the hepatic arterial blood flow,
Data Loading...
