Tumor Necrosis Impacts Prognosis of Patients Undergoing Curative-Intent Hepatocellular Carcinoma
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ORIGINAL ARTICLE – HEPATOBILIARY TUMORS
Tumor Necrosis Impacts Prognosis of Patients Undergoing Curative-Intent Hepatocellular Carcinoma Tao Wei, MD, PhD1,2, Xu-Feng Zhang, MD1,3, Fabio Bagante, MD3,4, Francesca Ratti, MD5, Hugo P. Marques, MD6, Silvia Silva, MD6, Olivier Soubrane, MD7, Vincent Lam, MD8, George A. Poultsides, MD9, Irinel Popescu, MD10, Razvan Grigorie, MD, PhD10, Sorin Alexandrescu, MD10, Guillaume Martel, MD11, Aklile Workneh, MD11, Alfredo Guglielmi, MD4, Tom Hugh, MD12, Luca Aldrighetti, MD5, Itaru Endo, MD, PhD13, and Timothy M. Pawlik, MD, MPH, PhD, FACS, FRACS (Hon.)3 1
Department of Hepatobiliary Surgery and Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China; 2Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; 3Department of Surgery, Division of Surgical Oncology, Professor of Surgery, Oncology, Health Services Management and Policy, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH; 4Department of Surgery, University of Verona, Verona, Italy; 5Department of Surgery, Ospedale San Raffaele, Milan, Italy; 6Department of Surgery, Curry Cabral Hospital, Lisbon, Portugal; 7Department of Hepatobiliopancreatic Surgery, APHP, Beaujon Hospital, Clichy, France; 8Department of Surgery, Westmead Hospital, Sydney, Australia; 9Department of Surgery, Stanford University, Stanford, CA; 10Department of Surgery, Fundeni Clinical Institute, Bucharest, Romania; 11Department of Surgery, University of Ottawa, Ottawa, Canada; 12Department of Surgery, School of Medicine, The University of Sydney, Sydney, Australia; 13Yokohama City University School of Medicine, Yokohama, Japan
ABSTRACT Background. The impact of tumor necrosis relative to prognosis among patients undergoing curative-intent resection for hepatocellular carcinoma (HCC) remains illdefined. Methods. Patients who underwent curative-intent resection for HCC without any prior treatment between 2000 and 2017 were identified from an international multi-institutional database. Tumor necrosis was graded as absent,
Tao Wei and Xu-Feng Zhang contributed equally to this work.
Electronic supplementary material The online version of this article (https://doi.org/10.1245/s10434-020-09390-w) contains supplementary material, which is available to authorized users. Ó Society of Surgical Oncology 2020 First Received: 12 July 2020 Accepted: 5 October 2020 T. M. Pawlik, MD, MPH, PhD, FACS, FRACS (Hon.) e-mail: [email protected]
moderate (\ 50% area), or extensive (C 50% area) on histological examination. The relationship between tumor necrosis, clinicopathologic characteristics, and long-term survival were analyzed. Results. Among 919 patients who underwent curative-intent resection for HCC, the median tumor size was 5.0 cm (IQR, 3.0–8.5). Tumor necrosis was present in 367 (39.9%) pa
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