A classification model for resectability in hepatocellular carcinoma patients

IF 3.9 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Hepatology Research Pub Date : 2024-09-27 DOI:10.1111/hepr.14108

Ikuo Nakamura, Tomoaki Yoh, Takashi Nishimura, Masayuki Okuno, Tomohiro Okamoto, Hideaki Sueoka, Kenjiro Iida, Masaharu Tada, Takamichi Ishii, Satoru Seo, Yasuhiro Fujimoto, Hiroko Iijima, Seiko Hirono, Etsuro Hatano

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Abstract

Aim

Some patients undergoing liver resection for hepatocellular carcinoma (HCC) have poor outcomes. Therefore, we aimed to propose a new resectability classification for patients with HCC.

Methods

We classified patients into three categories: resectable (R), borderline resectable (BR), and unresectable (UR). Patients (n = 409) who underwent hepatectomy for HCC were assigned to the non-UR (R and BR classes combined; n = 285) and UR-HCC classes (n = 68; training cohort). Patient characteristics in the BR-HCC and R-HCC groups were compared. The new criteria were tested in a validation cohort (n = 295).

Results

Of the 285 patients, 229 and 56 were classified into the R- and BR-HCC classes, respectively, using macrovascular invasion, tumor size, and future liver remnant/modified albumin-bilirubin scores. Patients with BR-HCC demonstrated significantly worse progression-free and overall survival (p < 0.0001 and p < 0.0001, respectively) than patients with R-HCC in the training cohort. Similar results were observed in the validation cohort. Multivariate analysis of the non-UR-HCC group in the training cohort revealed that the tumor number and BR-HCC were independent predictive factors for poor overall survival.

Conclusions

This classification can help select patients with BR-HCC for preoperative treatment before considering surgery.

Abstract Image

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肝细胞癌患者可切除性分类模型。

目的：一些接受肝细胞癌（HCC）肝切除术的患者预后不佳。因此，我们旨在为 HCC 患者提出一种新的可切除性分类方法：我们将患者分为三类：可切除（R）、边缘可切除（BR）和不可切除（UR）。因HCC而接受肝切除术的患者（n = 409）被分配到非UR类（R类和BR类合计；n = 285）和UR-HCC类（n = 68；训练队列）。比较了BR-HCC组和R-HCC组的患者特征。新标准在验证队列（n = 295）中进行了测试：结果：根据大血管侵犯、肿瘤大小和未来残肝/改良白蛋白-胆红素评分，285 名患者中分别有 229 人和 56 人被分为 R-HCC 和 BR-HCC 组。BR-HCC患者的无进展生存期和总生存期明显更差（P 结论：该分类有助于选择BR-HCC患者：这种分类方法有助于选择BR-HCC患者进行术前治疗，然后再考虑手术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hepatology Research 医学-胃肠肝病学

CiteScore

8.30

自引率

14.30%

发文量

124

审稿时长

1 months

期刊介绍： Hepatology Research (formerly International Hepatology Communications) is the official journal of the Japan Society of Hepatology, and publishes original articles, reviews and short comunications dealing with hepatology. Reviews or mini-reviews are especially welcomed from those areas within hepatology undergoing rapid changes. Short communications should contain concise definitive information.