Jill Gwiasda1, Aron Schulte2, Alexander Kaltenborn2, Wolf Ramackers3, Moritz Kleine3, Oliver Beetz3, Jürgen Klempnauer3, Nikos Emmanouilidis3, Harald Schrem4. 1. Core Facility Quality Management & Health Technology Assessment in Transplantation, Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Electronic address: gwiasda.jill@mh-hannover.de. 2. Core Facility Quality Management & Health Technology Assessment in Transplantation, Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. 3. Department of General, Visceral and Transplantation Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. 4. Core Facility Quality Management & Health Technology Assessment in Transplantation, Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; Department of General, Visceral and Transplantation Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
Abstract
BACKGROUND AND OBJECTIVES: This study evaluates predictive factors for observed long-term survival of more than 5 and 10 years for patients after liver resection for hepatocellular carcinoma and compares their life expectancy to the normal national population matched for sex, year of birth and age at resection. METHODS: 230 patients after primary liver resection for HCC (01.01.1995-31.12.2004) were analyzed. Multivariable logistic regression models were determined based on Cox regression results and their prognostic capability evaluated with areas under the receiver operating characteristic curve (AUROCs). RESULTS: Life years after surgery in deceased patients compared to the normal national population matched for sex, year of birth and age at resection was reduced by median 21.7 years. Independent predictive factors for 10-year survival were age at resection (p < 0.001; OR = 0.898; 95%-CI: 0.846-0.954), UICC 7 tumor staging (p = 0.003; OR = 0.344; 95%-CI: 0.126-0.941) and ASAT (GOT) in U/l divided by Quick in percent multiplied by the extent of liver resection graded in points labelled as the resection severity index (p < 0.001; OR = 0.136; 95%-CI: 0.022-0.843) enabling prediction of 10-year survival with an AUROC of 0.884. The same factors plus revision surgery (yes/no) predict 5-year survival (AUROC 0.736). CONCLUSIONS: Liver resection enables predictable long-term survival >5 and > 10 years. The proposed resection severity index quantifies the prognostic relevance of liver cellular damage, synthesis and loss of parenchyma for long-term survival.
BACKGROUND AND OBJECTIVES: This study evaluates predictive factors for observed long-term survival of more than 5 and 10 years for patients after liver resection for hepatocellular carcinoma and compares their life expectancy to the normal national population matched for sex, year of birth and age at resection. METHODS: 230 patients after primary liver resection for HCC (01.01.1995-31.12.2004) were analyzed. Multivariable logistic regression models were determined based on Cox regression results and their prognostic capability evaluated with areas under the receiver operating characteristic curve (AUROCs). RESULTS: Life years after surgery in deceased patients compared to the normal national population matched for sex, year of birth and age at resection was reduced by median 21.7 years. Independent predictive factors for 10-year survival were age at resection (p < 0.001; OR = 0.898; 95%-CI: 0.846-0.954), UICC 7 tumor staging (p = 0.003; OR = 0.344; 95%-CI: 0.126-0.941) and ASAT (GOT) in U/l divided by Quick in percent multiplied by the extent of liver resection graded in points labelled as the resection severity index (p < 0.001; OR = 0.136; 95%-CI: 0.022-0.843) enabling prediction of 10-year survival with an AUROC of 0.884. The same factors plus revision surgery (yes/no) predict 5-year survival (AUROC 0.736). CONCLUSIONS: Liver resection enables predictable long-term survival >5 and > 10 years. The proposed resection severity index quantifies the prognostic relevance of liver cellular damage, synthesis and loss of parenchyma for long-term survival.
Authors: Andrew K Y Fung; Nicole M Y Cheng; Charing C N Chong; Kit-Fai Lee; John Wong; Sunny Y S Cheung; Hon-Ting Lok; Paul B S Lai; Kelvin K C Ng Journal: Medicine (Baltimore) Date: 2020-11-25 Impact factor: 1.889
Authors: Oliver Beetz; Michael Klein; Harald Schrem; Jill Gwiasda; Florian W R Vondran; Felix Oldhafer; Sebastian Cammann; Jürgen Klempnauer; Karl J Oldhafer; Moritz Kleine Journal: BMC Surg Date: 2018-08-13 Impact factor: 2.102
Authors: Markus Bo Schoenberg; Julian Nikolaus Bucher; Dominik Koch; Nikolaus Börner; Sebastian Hesse; Enrico Narciso De Toni; Max Seidensticker; Martin Kurt Angele; Christoph Klein; Alexandr V Bazhin; Jens Werner; Markus Otto Guba Journal: Ann Transl Med Date: 2020-04