{"title":"交界性可切除肝癌患者术前全身治疗的预后因素及临床意义：JSHBPS项目研究2023，第2部分。","authors":"Junichi Shindoh, Masaru Matsumura, Shohei Komatsu, Takumi Fukumoto, Akihiko Ichida, Kiyoshi Hasegawa, Takamichi Ishii, Etsuro Hatano, Masafumi Nakamura, Masayuki Ohtsuka","doi":"10.1002/jhbp.12138","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To explore factors influencing the prognosis in patients with borderline-resectable hepatocellular carcinoma (BR-HCC) undergoing surgery.</p><p><strong>Methods: </strong>The clinical data of patients with BR-HCC according to the definition in the Expert Consensus Statement 2023 were collected from board-certified HPB training centers and analyzed in detail.</p><p><strong>Results: </strong>Data of a total of 1509 patients with BR-HCC (BR1, n = 718 and BR2, n = 791) who underwent surgery were collected. The 5-year disease-specific survival rate (DSS) and 3-year recurrence-free survival rate (RFS) were determined as 40.8% and 19.7%, respectively. Multivariate analysis identified the oncological resectability category (i.e., BR2 vs. BR1) as a significant prognostic factor, and also the number of criteria fulfilled for classification into BR2 disease as being predictive of the DSS (hazard ratio (HR) [95% CI]: one factor: 1.32 [1.13-1.54]; two to three factors: 1.51 [1.15-1.96]). Preceding systemic therapy was significantly correlated with a longer DSS (HR, 0.41: 95% CI, 0.18-0.91) and RFS (HR, 0.80: 95% CI, 0.66-0.97) in the patients with BR1 disease, while its clinical significance was unclear in the patients with BR2 disease.</p><p><strong>Conclusion: </strong>Multicenter data confirm the clinical relevance of the oncological resectability category and the potential advantage of preceding systemic therapy in a specific group of BR-HCC.</p>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prognostic factors and clinical significance of preoperative systemic therapy in patients with borderline resectable hepatocellular carcinoma: A JSHBPS project study 2023, Part 2.\",\"authors\":\"Junichi Shindoh, Masaru Matsumura, Shohei Komatsu, Takumi Fukumoto, Akihiko Ichida, Kiyoshi Hasegawa, Takamichi Ishii, Etsuro Hatano, Masafumi Nakamura, Masayuki Ohtsuka\",\"doi\":\"10.1002/jhbp.12138\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To explore factors influencing the prognosis in patients with borderline-resectable hepatocellular carcinoma (BR-HCC) undergoing surgery.</p><p><strong>Methods: </strong>The clinical data of patients with BR-HCC according to the definition in the Expert Consensus Statement 2023 were collected from board-certified HPB training centers and analyzed in detail.</p><p><strong>Results: </strong>Data of a total of 1509 patients with BR-HCC (BR1, n = 718 and BR2, n = 791) who underwent surgery were collected. The 5-year disease-specific survival rate (DSS) and 3-year recurrence-free survival rate (RFS) were determined as 40.8% and 19.7%, respectively. Multivariate analysis identified the oncological resectability category (i.e., BR2 vs. BR1) as a significant prognostic factor, and also the number of criteria fulfilled for classification into BR2 disease as being predictive of the DSS (hazard ratio (HR) [95% CI]: one factor: 1.32 [1.13-1.54]; two to three factors: 1.51 [1.15-1.96]). Preceding systemic therapy was significantly correlated with a longer DSS (HR, 0.41: 95% CI, 0.18-0.91) and RFS (HR, 0.80: 95% CI, 0.66-0.97) in the patients with BR1 disease, while its clinical significance was unclear in the patients with BR2 disease.</p><p><strong>Conclusion: </strong>Multicenter data confirm the clinical relevance of the oncological resectability category and the potential advantage of preceding systemic therapy in a specific group of BR-HCC.</p>\",\"PeriodicalId\":16056,\"journal\":{\"name\":\"Journal of Hepato‐Biliary‐Pancreatic Sciences\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2025-03-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Hepato‐Biliary‐Pancreatic Sciences\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/jhbp.12138\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hepato‐Biliary‐Pancreatic Sciences","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jhbp.12138","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：探讨影响肝细胞癌（BR-HCC）手术预后的因素。方法：收集经委员会认证的HPB培训中心符合专家共识声明2023定义的BR-HCC患者的临床资料，并进行详细分析。结果：共收集手术治疗的BR-HCC患者1509例（BR1, n = 718, BR2, n = 791）。5年疾病特异性生存率（DSS）和3年无复发生存率（RFS）分别为40.8%和19.7%。多因素分析发现，肿瘤可切除性类别（即BR2 vs. BR1）是一个重要的预后因素，同时，BR2疾病分类中满足的标准数量也可预测DSS(危险比（HR） [95% CI]：单因素：1.32 [1.13-1.54]；两到三个因素：1.51[1.15-1.96])。既往全身治疗与BR1疾病患者较长的DSS （HR, 0.41: 95% CI, 0.18-0.91）和RFS （HR, 0.80: 95% CI, 0.66-0.97）显著相关，而其在BR2疾病患者中的临床意义尚不清楚。结论：多中心数据证实了肿瘤可切除类别的临床相关性，以及在特定组BR-HCC中预先进行全身治疗的潜在优势。
Prognostic factors and clinical significance of preoperative systemic therapy in patients with borderline resectable hepatocellular carcinoma: A JSHBPS project study 2023, Part 2.
Purpose: To explore factors influencing the prognosis in patients with borderline-resectable hepatocellular carcinoma (BR-HCC) undergoing surgery.
Methods: The clinical data of patients with BR-HCC according to the definition in the Expert Consensus Statement 2023 were collected from board-certified HPB training centers and analyzed in detail.
Results: Data of a total of 1509 patients with BR-HCC (BR1, n = 718 and BR2, n = 791) who underwent surgery were collected. The 5-year disease-specific survival rate (DSS) and 3-year recurrence-free survival rate (RFS) were determined as 40.8% and 19.7%, respectively. Multivariate analysis identified the oncological resectability category (i.e., BR2 vs. BR1) as a significant prognostic factor, and also the number of criteria fulfilled for classification into BR2 disease as being predictive of the DSS (hazard ratio (HR) [95% CI]: one factor: 1.32 [1.13-1.54]; two to three factors: 1.51 [1.15-1.96]). Preceding systemic therapy was significantly correlated with a longer DSS (HR, 0.41: 95% CI, 0.18-0.91) and RFS (HR, 0.80: 95% CI, 0.66-0.97) in the patients with BR1 disease, while its clinical significance was unclear in the patients with BR2 disease.
Conclusion: Multicenter data confirm the clinical relevance of the oncological resectability category and the potential advantage of preceding systemic therapy in a specific group of BR-HCC.
期刊介绍：
The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.
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