Brian I Carr1, Vito Guerra. 1. Izmir Biomedicine and Genome Center, Dokuz Eylul University, Izmir, Turkey.
Abstract
BACKGROUND: Prognosis in hepatocellular carcinoma (HCC) is influenced by both liver and tumor factors, which have been considered independent influences. However, recent evidence has shown that the underlying liver also has prognostic information. AIMS: To investigate possible relationships between liver function parameters and HCC aggressiveness indices. METHODS: A large HCC patient database with baseline clinical information and survival data was retrospectively examined. RESULTS: Data on 756 HCC patients with normal bilirubin were examined for a relationship between serum liver enzymes and 4 HCC aggressiveness indices of maximum tumor diameter, portal vein invasion, tumor multifocality or serum alpha-fetoprotein levels. An association was found between elevated enzyme levels and increased HCC aggressiveness. An aggressiveness index was constructed from the 4 indices and expressed as a sum of their scores, which in turn reflected 3 survival groups. In a Cox model, the hazard ratios for each of the groups were significantly different. CONCLUSIONS: Statistically significant correlations were found between standard liver function parameters and HCC aggressiveness. A composite aggressiveness index was constructed, yielding 3 groups with different survival probabilities. These findings support the concept of the importance of the underlying liver in relation to HCC biology.
BACKGROUND: Prognosis in hepatocellular carcinoma (HCC) is influenced by both liver and tumor factors, which have been considered independent influences. However, recent evidence has shown that the underlying liver also has prognostic information. AIMS: To investigate possible relationships between liver function parameters and HCC aggressiveness indices. METHODS: A large HCC patient database with baseline clinical information and survival data was retrospectively examined. RESULTS: Data on 756 HCC patients with normal bilirubin were examined for a relationship between serum liver enzymes and 4 HCC aggressiveness indices of maximum tumor diameter, portal vein invasion, tumor multifocality or serum alpha-fetoprotein levels. An association was found between elevated enzyme levels and increased HCC aggressiveness. An aggressiveness index was constructed from the 4 indices and expressed as a sum of their scores, which in turn reflected 3 survival groups. In a Cox model, the hazard ratios for each of the groups were significantly different. CONCLUSIONS: Statistically significant correlations were found between standard liver function parameters and HCC aggressiveness. A composite aggressiveness index was constructed, yielding 3 groups with different survival probabilities. These findings support the concept of the importance of the underlying liver in relation to HCC biology.
Authors: Brian I Carr; Vito Guerra; Edoardo G Giannini; Fabio Farinati; Francesca Ciccarese; Gian Ludovico Rapaccini; Maria Di Marco; Luisa Benvegnù; Marco Zoli; Franco Borzio; Eugenio Caturelli; Alberto Masotto; Franco Trevisani Journal: J Integr Oncol Date: 2016-09-05
Authors: Giovanni Marasco; Francesco Poggioli; Antonio Colecchia; Giuseppe Cabibbo; Filippo Pelizzaro; Edoardo Giovanni Giannini; Sara Marinelli; Gian Ludovico Rapaccini; Eugenio Caturelli; Mariella Di Marco; Elisabetta Biasini; Fabio Marra; Filomena Morisco; Francesco Giuseppe Foschi; Marco Zoli; Antonio Gasbarrini; Gianluca Svegliati Baroni; Alberto Masotto; Rodolfo Sacco; Giovanni Raimondo; Francesco Azzaroli; Andrea Mega; Gianpaolo Vidili; Maurizia Rossana Brunetto; Gerardo Nardone; Luigina Vanessa Alemanni; Elton Dajti; Federico Ravaioli; Davide Festi; Franco Trevisani; On Behalf Of The Italian Liver Cancer Ita Li Ca Group Journal: Cancers (Basel) Date: 2021-05-29 Impact factor: 6.639
Authors: Dong S; Wang L; Guo Y B; Ying H F; Shen X H; Meng Z Q; Chen Hao; Chen Q W; Li Z S Journal: World J Surg Oncol Date: 2017-07-03 Impact factor: 2.754