Jun Zhao1, J Mao2, W Li3. 1. Department of General Surgery, Lanzhou University Second Hospital, Lanzhou, China. 2. Department of General Surgery, Lanzhou University Second Hospital, Lanzhou, China. Electronic address: maoj@lzu.edu.cn. 3. Department of Liver Surgery & Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China.
Abstract
BACKGROUND: Association of tumor grade and the prognosis of hepatocellular carcinoma (HCC) patients after liver transplantation (LT) had not been clearly illustrated. The objective of the current study was to investigate the impact of tumor grade on the long-term survival of patients with HCC receiving LT. METHODS: Data from Surveillance, Epidemiology, and End Results Program (SEER) 18 registry for 2004-2015 was extracted for the present study. Propensity score matching was performed to eliminate possible bias. In addition, multivariable analysis was utilized to adjust for confounding factors. The primary endpoints were overall survival (OS) and disease-specific survival (DSS). RESULTS: A total of 802 patients diagnosed with HCC receiving LT between 2004-2015 included in the SEER registry were analyzed in the study. In the multivariable adjusted cohort (OS: n = 802; DSS: n = 640), a worse prognosis was observed in OS (HR, 1.57; 95% CI, 1.13-2.19; P = .008) and DSS (HR, 2.62; 95% CI, 1.44-4.77; P = .002) for patients with moderate/poor-differentiated tumors compared to patients with well-differentiated tumors. In stratified analyses, the salutary effects of well-differentiation on OS and DSS were consistent across all examined subgroups. In the propensity-matched cohort, the univariable analysis showed that patients with moderate/poor-differentiated tumors still had worse OS (HR 1.60, 95% CI 1.12-2.28, P = .010) and DSS (HR 2.54, 95% CI 1.36-4.74, P = .003) compared to patients with well-differentiated tumors. CONCLUSION: Tumor grade of differentiation had a statistically significant effect on the long-term prognosis of HCC after LT.
BACKGROUND: Association of tumor grade and the prognosis of hepatocellular carcinoma (HCC) patients after liver transplantation (LT) had not been clearly illustrated. The objective of the current study was to investigate the impact of tumor grade on the long-term survival of patients with HCC receiving LT. METHODS: Data from Surveillance, Epidemiology, and End Results Program (SEER) 18 registry for 2004-2015 was extracted for the present study. Propensity score matching was performed to eliminate possible bias. In addition, multivariable analysis was utilized to adjust for confounding factors. The primary endpoints were overall survival (OS) and disease-specific survival (DSS). RESULTS: A total of 802 patients diagnosed with HCC receiving LT between 2004-2015 included in the SEER registry were analyzed in the study. In the multivariable adjusted cohort (OS: n = 802; DSS: n = 640), a worse prognosis was observed in OS (HR, 1.57; 95% CI, 1.13-2.19; P = .008) and DSS (HR, 2.62; 95% CI, 1.44-4.77; P = .002) for patients with moderate/poor-differentiated tumors compared to patients with well-differentiated tumors. In stratified analyses, the salutary effects of well-differentiation on OS and DSS were consistent across all examined subgroups. In the propensity-matched cohort, the univariable analysis showed that patients with moderate/poor-differentiated tumors still had worse OS (HR 1.60, 95% CI 1.12-2.28, P = .010) and DSS (HR 2.54, 95% CI 1.36-4.74, P = .003) compared to patients with well-differentiated tumors. CONCLUSION:Tumor grade of differentiation had a statistically significant effect on the long-term prognosis of HCC after LT.