Wan Yee Lau1,2, Kang Wang1, Xiu-Ping Zhang1,3, Le-Qun Li4, Tian-Fu Wen5, Min-Shan Chen6, Wei-Dong Jia7,8, Li Xu6, Jie Shi1, Wei-Xing Guo1, Ju-Xian Sun1, Zhen-Hua Chen1, Lei Guo1, Xu-Biao Wei1, Chong-De Lu1, Jie Xue1, Li-Ping Zhou1, Ya-Xing Zheng1, Meng Wang1, Meng-Chao Wu1, Shu-Qun Cheng1. 1. Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, China. 2. Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China. 3. Faculty of Hepato-Pancreato-Biliary Surgery, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China. 4. Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China. 5. Department of Liver Surgery & Transplantation Center, West China Hospital of Sichuan University, Chengdu, China. 6. Department of Hepatobiliary Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China. 7. Department of General Surgery, Affiliated Provincial Hospital, Anhui Medical University, Hefei, China. 8. Anhui Province Key Laboratory of Hepatopancreatobiliary Surgery, Hefei, China.
Abstract
BACKGROUND: A new staging system for patients with hepatocellular carcinoma (HCC) associated with portal vein tumor thrombus (PVTT) was developed by incorporating the good points of the BCLC classification of HCC, and by improving on the currently existing classifications of HCC associated with PVTT. METHODS: Univariate and multivariate analysis with Wald χ2 test were used to determinate the clinical prognostic factors for overall survival (OS) in patients with HCC and PVTT in the training cohort. Then the conditional inference trees analysis was applied to establish a new staging system. RESULTS: A training cohort of 2,179 patients from the Eastern Hepatobiliary Surgery Hospital and a validation cohort of 1,550 patients from four major liver centers in China were enrolled into establishing and validating a new staging system. The system was established by incorporating liver function, general health status, tumor resectability, extrahepatic metastasis and extent of PVTT. This staging system had a good discriminatory ability to separate patients into different stages and substages. The median OS for the two cohorts were 57.1 (37.2-76.9), 12.1 (11.0-13.2), 5.7 (5.1-6.2), 4.0 (3.3-4.6) and 2.5 (1.7-3.3) months for the stages 0 to IV, respectively (P<0.001) in the training cohort. The corresponding figures for the validation cohort were 6.4 (4.9-7.9), 2.8 (1.3-4.4), 10.8 (9.3-12.4), and 1.5 (1.3-1.7) months for the stages II to IV, respectively (P<0.001). The mean survival for stage 0 to 1 were 37.6 (35.9-39.2) and 30.4 (27.4-33.4), respectively (P<0.001). CONCLUSIONS: A new staging system was established which provided a good discriminatory ability to separate patients into different stages and substages after treatment. It can be used to supplement the other HCC staging systems. 2021 Hepatobiliary Surgery and Nutrition. All rights reserved.
BACKGROUND: A new staging system for patients with hepatocellular carcinoma (HCC) associated with portal vein tumor thrombus (PVTT) was developed by incorporating the good points of the BCLC classification of HCC, and by improving on the currently existing classifications of HCC associated with PVTT. METHODS: Univariate and multivariate analysis with Wald χ2 test were used to determinate the clinical prognostic factors for overall survival (OS) in patients with HCC and PVTT in the training cohort. Then the conditional inference trees analysis was applied to establish a new staging system. RESULTS: A training cohort of 2,179 patients from the Eastern Hepatobiliary Surgery Hospital and a validation cohort of 1,550 patients from four major liver centers in China were enrolled into establishing and validating a new staging system. The system was established by incorporating liver function, general health status, tumor resectability, extrahepatic metastasis and extent of PVTT. This staging system had a good discriminatory ability to separate patients into different stages and substages. The median OS for the two cohorts were 57.1 (37.2-76.9), 12.1 (11.0-13.2), 5.7 (5.1-6.2), 4.0 (3.3-4.6) and 2.5 (1.7-3.3) months for the stages 0 to IV, respectively (P<0.001) in the training cohort. The corresponding figures for the validation cohort were 6.4 (4.9-7.9), 2.8 (1.3-4.4), 10.8 (9.3-12.4), and 1.5 (1.3-1.7) months for the stages II to IV, respectively (P<0.001). The mean survival for stage 0 to 1 were 37.6 (35.9-39.2) and 30.4 (27.4-33.4), respectively (P<0.001). CONCLUSIONS: A new staging system was established which provided a good discriminatory ability to separate patients into different stages and substages after treatment. It can be used to supplement the other HCC staging systems. 2021 Hepatobiliary Surgery and Nutrition. All rights reserved.
Authors: Jie Shi; Eric C H Lai; Nan Li; Wei-Xing Guo; Jie Xue; Wan-Yee Lau; Meng-Chao Wu; Shu-Qun Cheng Journal: J Hepatobiliary Pancreat Sci Date: 2011-01 Impact factor: 7.027
Authors: Thomas W T Leung; Amanda M Y Tang; Benny Zee; W Y Lau; Paul B S Lai; K L Leung; Joseph T F Lau; Simon C H Yu; Philip J Johnson Journal: Cancer Date: 2002-03-15 Impact factor: 6.860
Authors: Josep M Llovet; Sergio Ricci; Vincenzo Mazzaferro; Philip Hilgard; Edward Gane; Jean-Frédéric Blanc; Andre Cosme de Oliveira; Armando Santoro; Jean-Luc Raoul; Alejandro Forner; Myron Schwartz; Camillo Porta; Stefan Zeuzem; Luigi Bolondi; Tim F Greten; Peter R Galle; Jean-François Seitz; Ivan Borbath; Dieter Häussinger; Tom Giannaris; Minghua Shan; Marius Moscovici; Dimitris Voliotis; Jordi Bruix Journal: N Engl J Med Date: 2008-07-24 Impact factor: 91.245
Authors: Kang Wang; Wei Xing Guo; Min Shan Chen; Yi Lei Mao; Bei Cheng Sun; Jie Shi; Yao Jun Zhang; Yan Meng; Ye Fa Yang; Wen Ming Cong; Meng Chao Wu; Wan Yee Lau; Shu Qun Cheng Journal: Medicine (Baltimore) Date: 2016-03 Impact factor: 1.889