Jianguo Qiu1, Shuting Chen2, Hong Wu2, Chengyou Du3. 1. Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China. Electronic address: qiujianguo456@163.com. 2. Department of Hepatobiliary Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China. 3. Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China. Electronic address: duchengyoucyfyy@163.com.
Abstract
BACKGROUND: A classification system of centrally located liver tumors (CLLTs) was proposed by our group in 2013, which divided CLLTs into four subtypes by focusing on the involvement of resected segments and the anatomical location of lesions relative to the principal hepatic vascular structures. The current study aimed to analyze the clinical characteristics and compare the surgical outcomes of the different CLLTs classification system for patients with hepatocelluar carcinoma (HCC) underwent mesohepatectomy (MH). Moreover, we sought to validate the prognostic value of the new classification system. METHODS: Data from 353 consecutive patients with centrally located HCC who were treated with MH between 2005 and 2013 were prospectively collected and retrospectively reviewed. RESULTS: The 1-, 3-, and 5-y overall recurrence rates were 21.4%, 41.3%, and 55.6%, respectively. The 1-, 3-, and 5-y overall (OS) and corresponding recurrence-free survival rates (RFS) were 82.5%, 61.6%, 40.2%, and 68.8%, 42.5%, 30.7%, respectively. According the CLLTs classification system, 106 patients were classified as type I, 68 as type II, 94 as type III and 85 as type IV. There were no significant differences in RFS rate among the CLLTs groups, however, a significant decrease in OS rates was observed in the type IV classification, respectively. Multivariate analysis reveal that patients with microvascular invasion, portal vein thrombosis, the largest tumor size≥5 cm, tumor number≥3, liver cirrhosis, hepatic inflow occlusion ≥60 min, intraoperative blood loss≥1500 ml, pTNM staging and CLLTs classification of Type IV to be independent adverse factors for long-term survivals. CONCLUSION: The classification system of CLLTs is meant to help clinicians in defining the extent of resection, providing a risk assessment and predicting prognosis. However, it is need to be validated in more HCC patients and medical centers. Copyright Â
BACKGROUND: A classification system of centrally located liver tumors (CLLTs) was proposed by our group in 2013, which divided CLLTs into four subtypes by focusing on the involvement of resected segments and the anatomical location of lesions relative to the principal hepatic vascular structures. The current study aimed to analyze the clinical characteristics and compare the surgical outcomes of the different CLLTs classification system for patients with hepatocelluar carcinoma (HCC) underwent mesohepatectomy (MH). Moreover, we sought to validate the prognostic value of the new classification system. METHODS: Data from 353 consecutive patients with centrally located HCC who were treated with MH between 2005 and 2013 were prospectively collected and retrospectively reviewed. RESULTS: The 1-, 3-, and 5-y overall recurrence rates were 21.4%, 41.3%, and 55.6%, respectively. The 1-, 3-, and 5-y overall (OS) and corresponding recurrence-free survival rates (RFS) were 82.5%, 61.6%, 40.2%, and 68.8%, 42.5%, 30.7%, respectively. According the CLLTs classification system, 106 patients were classified as type I, 68 as type II, 94 as type III and 85 as type IV. There were no significant differences in RFS rate among the CLLTs groups, however, a significant decrease in OS rates was observed in the type IV classification, respectively. Multivariate analysis reveal that patients with microvascular invasion, portal vein thrombosis, the largest tumor size≥5 cm, tumor number≥3, liver cirrhosis, hepatic inflow occlusion ≥60 min, intraoperative blood loss≥1500 ml, pTNM staging and CLLTs classification of Type IV to be independent adverse factors for long-term survivals. CONCLUSION: The classification system of CLLTs is meant to help clinicians in defining the extent of resection, providing a risk assessment and predicting prognosis. However, it is need to be validated in more HCC patients and medical centers. Copyright Â
Authors: Xuan Zheng; Bo Chen; Jian-Xiong Wu; Angela Y Jia; Wei-Qi Rong; Li-Ming Wang; Fan Wu; Yu-Ting Zhao; Ye-Xiong Li; Wei-Hu Wang Journal: Cancer Manag Res Date: 2018-09-26 Impact factor: 3.989