肿瘤负荷评分作为接受肝切除术的中晚期和局部晚期肝细胞癌患者的预后因素：扩展可切除性标准的尝试。

IF 2.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hpb Pub Date : 2024-09-01 DOI:10.1016/j.hpb.2024.05.021

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引用次数: 0

摘要

背景：目前，对于仅属于巴塞罗那临床肝癌（BCLC）A期的肝细胞癌（HCC），建议将手术作为治愈性治疗方案。本研究旨在根据肿瘤负担评分（TBS）对不同的 BCLC 组别进行分类，以确定哪些患者可以从切除术中获益：该研究对 2010 年 1 月至 2022 年 7 月期间所有接受 HCC 手术的患者的前瞻性数据库进行了回顾性分析。TBS定义为：TBS2 =（肿瘤最大直径）2 +（肿瘤数量）2：根据最新的 BCLC 分期（A = 219、B = 45、C = 27），对接受切除手术的 291 名患者进行了分期。患者被分为低（7.3）TBS。中位随访时间为 36.2 个月，低 TBS 组 A 期和 B 期患者的中位 OS 分别为 107.4 个月和 42.7 个月。BCLC C期患者的中位生存期没有达到。在高TBS患者中，BCLC A、B和C期的中位OS分别为42.3个月、25.72个月和16.9个月：结论：TBS是影响HCC患者生存的重要因素。结论：TBS 是影响 HCC 患者生存期的重要因素。TBS 可用于对 BCLC B 期和 C 期患者进行分层，帮助选择可从手术切除中获益的患者，从而在发病率可接受的情况下获得良好的长期生存。

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Tumor burden score as a prognostic factor in patients with intermediate and locally advanced hepatocellular carcinoma undergoing liver resection: an attempt to extend resectability criteria

Background

Surgery is currently recommended as a curative treatment option for hepatocellular carcinomas (HCC) belonging to Barcelona Clinic Liver Cancer (BCLC) stage A only. This study aims to classify various BCLC groups as per Tumor Burden Score (TBS) in an attempt to identify patients who could benefit from resection.

Materials and methods

A retrospective analysis of a prospectively maintained database of all patients operated for HCC between January 2010 and July 2022 was performed. TBS was defined as, TBS² = (maximum tumor diameter)² + (number of tumors)².

Results

Two hundred and ninety-one patients who underwent resection were staged as per the latest BCLC (A = 219, B = 45, C = 27) staging. Patients were segregated into low (<7.3) and high (>7.3) TBS. With a median follow-up of 36.2 months, the median OS for stages, A and B in the low TBS group was 107.4 and 42.7 months respectively. Median OS was not reached for patients in the BCLC C stage. In patients with high TBS, the median OS for BCLC A, B and C was 42.3, 25.72, and 16.9 months respectively.

Conclusion

TBS is a significant factor influencing survival in patients of HCC. TBS can be used to stratify patients in BCLC B and C stages and help select patients who would benefit from surgical resection to achieve good long-term survival with acceptable morbidity.

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来源期刊

Hpb GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.60

自引率

3.40%

发文量

244

审稿时长

57 days

期刊介绍： HPB is an international forum for clinical, scientific and educational communication. Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice. Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice. HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields. Abstracted and Indexed in: MEDLINE® EMBASE PubMed Science Citation Index Expanded Academic Search (EBSCO) HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).