BACKGROUND/AIMS: Prognostic analysis on hepatocellular carcinoma (HCC) in patients undergoing hepatectomy is necessary to determine the clinical value of hepatectomy on prognosis. METHODS: Survival and disease-free survival were analyzed in 104 HCC patients undergoing hepatectomy using clinicopathologic factors by univariate and multivariate analyses. The value of the International Union Against Cancer (UICC) TNM classification on prognosis was assessed in the patients. RESULTS: In multivariate analysis, portal vein invasion was the most influential factor. The difference between stage 1 and 2 or stage 3 and 4A using UICC's TNM classification was not significant with respect to survival or disease-free survival. The UICC's classification was modified as follows; stage 1, solitary tumor without vascular invasion; stage 2, solitary or multiple tumor(s) involving adjacent to vessel branch; stage 3, tumor(s) involving major vessel branch or with regional lymph nodal metastasis; and stage 4, tumor(s) with distant metastasis. The differences between each stage in the modified classification were significant with respect to disease-free survival. CONCLUSIONS: The UICC's TNM classification was not of prognostic significance. Further studies on survival in patients with HCC are necessary to evaluate the value of the UICC's TNM classification; some modification may be necessary.
BACKGROUND/AIMS: Prognostic analysis on hepatocellular carcinoma (HCC) in patients undergoing hepatectomy is necessary to determine the clinical value of hepatectomy on prognosis. METHODS: Survival and disease-free survival were analyzed in 104 HCC patients undergoing hepatectomy using clinicopathologic factors by univariate and multivariate analyses. The value of the International Union Against Cancer (UICC) TNM classification on prognosis was assessed in the patients. RESULTS: In multivariate analysis, portal vein invasion was the most influential factor. The difference between stage 1 and 2 or stage 3 and 4A using UICC's TNM classification was not significant with respect to survival or disease-free survival. The UICC's classification was modified as follows; stage 1, solitary tumor without vascular invasion; stage 2, solitary or multiple tumor(s) involving adjacent to vessel branch; stage 3, tumor(s) involving major vessel branch or with regional lymph nodal metastasis; and stage 4, tumor(s) with distant metastasis. The differences between each stage in the modified classification were significant with respect to disease-free survival. CONCLUSIONS: The UICC's TNM classification was not of prognostic significance. Further studies on survival in patients with HCC are necessary to evaluate the value of the UICC's TNM classification; some modification may be necessary.
Authors: A D Pinna; S Iwatsuki; R G Lee; S Todo; J R Madariaga; J W Marsh; A Casavilla; I Dvorchik; J J Fung; T E Starzl Journal: Hepatology Date: 1997-10 Impact factor: 17.425
Authors: R Tateishi; H Yoshida; S Shiina; H Imamura; K Hasegawa; T Teratani; S Obi; S Sato; Y Koike; T Fujishima; M Makuuchi; M Omata Journal: Gut Date: 2005-03 Impact factor: 23.059
Authors: Gaya Spolverato; Alessandro Vitale; Aslam Ejaz; Yuhree Kim; Shishir K Maithel; David P Cosgrove; Timothy M Pawlik Journal: World J Surg Date: 2015-06 Impact factor: 3.352