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Tumor Burden Score and Serum Alpha-fetoprotein Subclassify Intermediate-Stage Hepatocellular Carcinoma

2022-12Journal article Open access
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dc.contributor.authorLima, H
dc.contributor.authorEndo, Y
dc.contributor.authorAlaimo, L
dc.contributor.authorMoazzam, Z
dc.contributor.authorMunir, M
dc.contributor.authorShaikh, C
dc.contributor.authorResende, V
dc.contributor.authorGuglielmi, A
dc.contributor.authorPinto Marques, H
dc.contributor.authorCauchy, F
dc.contributor.authorLam, V
dc.contributor.authorPoultsides, G
dc.contributor.authorPopescu, I
dc.contributor.authorAlexandrescu, S
dc.contributor.authorMartel, G
dc.contributor.authorHugh, T
dc.contributor.authorEndo, I
dc.contributor.authorKitago, M
dc.contributor.authorShen, F
dc.contributor.authorPawlik, T
dc.date.accessioned2024-07-30T15:18:14Z
dc.date.available2024-07-30T15:18:14Z
dc.date.issued2022-12
dc.description.abstractBackground: Resection of Barcelona Clinic Liver Cancer (BCLC) intermediate-stage hepatocellular carcinoma (HCC) remains controversial. While not recommended by the BCLC algorithm, some patients may indeed benefit from hepatectomy. We sought to identify that subset of patients who might derive long-term survival benefit from resection. Methods: Intermediate-stage HCC patients who underwent curative-intent resection were identified from an international multi-institutional database. Factors associated with long-term prognosis were identified using multivariate analysis and a risk score was developed and assessed. Results: Among 194 patients, most individuals had two tumors (n = 123, 63.4%) with a median size of 6.0 cm (IQR, 4.0-8.4) for a median tumor burden score (TBS) of 6.5 (IQR, 5.0-9.1); median alpha-fetoprotein (AFP) was 23.9 ng/mL (IQR, 5.0-503.2), and median overall survival (OS) was 69 months (IAR, 60.7-77.3). Factors associated with OS included AFP (referent ≤ 20 ng/mL, > 20 ng/mL: HR 1.78 95%CI, 1.09-2.89) and TBS (referent TBS ≤ 8.0, TBS > 8.0: HR 1.72 95%CI, 1.07-2.75). While 71 (36.6%) patients had neither risk factor, 79 (40.7%) and 44 (22.7%) had 1 or 2, respectively. A simplified score stratified patients relative to recurrence-free survival (RFS) (0: 33.6% vs. 1: 18.0% vs. 2: 14.7%) (AUC 0.60) and recurrence time (i.e., < 6 months after surgery) (0: 21.3% vs. 1: 43.1% vs. 2: 68.6%) (AUC 0.69) (both p < 0.001). Of note, a higher score was also associated with incrementally worse 5-year OS (0: 68.1% vs. 1: 61.0% vs. 2: 29.9%) (AUC 0.62) (p < 0.001). Conclusion: Long-term OS and RFS outcomes varied considerably. Using a simple risk score, patients with low AFP and low TBS were identified as the subset of individuals most likely to benefit from resection.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Gastrointest Surg . 2022 Dec;26(12):2512-2521.pt_PT
dc.identifier.doi10.1007/s11605-022-05469-9pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4964
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringerpt_PT
dc.subjectHCC CIRpt_PT
dc.subjectHumanspt_PT
dc.subjectCarcinoma, Hepatocellular* / pathologypt_PT
dc.subjectHepatectomypt_PT
dc.subjectLiver Neoplasms* / pathologypt_PT
dc.subjectNeoplasm Stagingpt_PT
dc.subjectPrognosispt_PT
dc.subjectRetrospective Studiespt_PT
dc.subjectTumor Burdenpt_PT
dc.subjectalpha-Fetoproteins / analysispt_PT
dc.titleTumor Burden Score and Serum Alpha-fetoprotein Subclassify Intermediate-Stage Hepatocellular Carcinomapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage2521pt_PT
oaire.citation.issue12pt_PT
oaire.citation.startPage2512pt_PT
oaire.citation.titleJournal of Gastrointestinal Surgerypt_PT
oaire.citation.volume26pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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