Analysis of Prognosis Factors of Hepatocellular Carcinoma Within Milan Criteria after Liver Resection_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 CHENXiang , LIChuan ,  WENTian-fu , YANLü-nan , YANGJia-yin , XUMing-qing , WANGWen-tao , LIBo

Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China;

Corresponding author：

WENTian-fu, Email: tianfu1962@163.com

Keywords：

Hepatocellular carcinoma; Milan criteria; Liver resection; Prognosis; Influencing factor

DOI：

10.7507/1007-9424.20150306

Video：

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Objective To identify the risk factors of postoperative recurrence and survival for patients with hepatocellular carcinoma within Milan criteria following liver resection. Methods Data of 267 patients with hepatocellular carcinoma within Milan criteria who received liver resection between 2007 and 2013 in our hospital were retrospectively analyzed. Results Among the 267 patients, 123 patients suffered from recurrence and 51 patients died. The mean time to recurrence were (16.9±14.5) months (2.7-75.1 months), whereas the mean time to death were (27.5±16.4) months (6.1-75.4 months). The recurrence-free survival rates in 1-, 3-, and 5-year after operation was 76.8%, 56.3%, and 47.6%, respectively; whereas the overall survival rates in 1-, 3-, and 5-year after operation was 96.6%, 82.5%, and 74.5%, respectively. Multivariate analyses suggested the tumor differentiation, microvascular invasion, and multiple tumors were independent risk factors for postoperative recurrence; whereas the tumor differentiation, positive preoperative HBV-DNA load, and preoperative neutrophil-to-lymphocyte ratio adversely influenced the postoperative survival. Conclusions For patients with hepatocellular carcinoma within Milan criteria after liver resection, the tumor differentiation, microvascular invasion, and multiple tumors contribute to postoperative recurrence; whereas the tumor differentiation, positive preoperative HBV-DNA load, and preoperative neutrophil-to-lymphocyte ratio adversely influence the postoperative survival.

Citation： CHENXiang, LIChuan, WENTian-fu, YANLü-nan, YANGJia-yin, XUMing-qing, WANGWen-tao, LIBo. Analysis of Prognosis Factors of Hepatocellular Carcinoma Within Milan Criteria after Liver Resection. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(10): 1175-1178. doi: 10.7507/1007-9424.20150306 Copy

1.	Llovet JM, Bruix J. Novel advancements in the management of hepatocellular carcinoma in 2008. J Hepatol, 2008, 48 Suppl 1:S20-S37.
2.	Parkin DM, Bray F, Ferlay J, et al. Global cancer statistics, 2002. CA Cancer J Clin, 2005, 55(2):74-108.
3.	Tateishi R, Shiina S, Akahane M, et al. Frequency, risk factors and survival associated with an intrasubsegmental recurrence after radiofrequency ablation for hepatocellular carcinoma. PloS one, 2013, 8(4):e59040.
4.	Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med, 1996, 334(11):693-699.
5.	Li C, Zhu WJ, Wen TF, et al. Child-Pugh A hepatitis B-related cirrhotic patients with a single hepatocellular carcinoma up to 5 cm:liver transplantation vs. resection. J Gastrointest Surg, 2014, 18(8):1469-1476.
6.	Okamura Y, Ashida R, Ito T, et al. Preoperative neutrophil to lymphocyte ratio and prognostic nutritional index predict overall survival after hepatectomy for hepatocellular carcinoma. World J Surg, 2015, 39(6):1501-1509.
7.	Song P, Feng X, Zhang K, et al. Screening for and surveillance of high-risk patients with HBV-related chronic liver disease:promoting the early detection of hepatocellular carcinoma in China. Biosci Trends, 2013, 7(1):1-6.
8.	Shah SA, Cleary SP, Wei AC, et al. Recurrence after liver resection for hepatocellular carcinoma:risk factors, treatment, and outcomes. Surgery, 2007, 141(3):330-339.
9.	Koda M, Murawaki Y, Mitsuda A, et al. Predictive factors for intrahepatic recurrence after percutaneous ethanol injection therapy for small hepatocellular carcinoma. Cancer, 2000, 88(3):529-537.
10.	Zheng SS, Xu X, Wu J, et al. Liver transplantation for hepatocellular carcinoma:Hangzhou experiences. Transplantation, 2008, 85(12):1726-1732.
11.	Yu HC, Cheng JS, Lai KH, et al. Factors for early tumor recurrence of single small hepatocellular carcinoma after percutaneous radiofrequency ablation therapy. World J Gastroenterol, 2005, 11(10):1439-1444.
12.	DuBay D, Sandroussi C, Sandhu L, et al. Liver transplantation for advanced hepatocellular carcinoma using poor tumor differentiation on biopsy as an exclusion criterion. Ann Surg, 2011, 253(1):166-172.
13.	Cheng Z, Yang P, Qu S, et al. Risk factors and management for early and late intrahepatic recurrence of solitary hepatocellular carcinoma after curative resection. HPB (Oxford), 2015, 17(5):422-427.
14.	Fan ST, Poon RT, Yeung C, et al. Outcome after partial hepatectomy for hepatocellular cancer within the Milan criteria. Br J Surg, 2011, 98(9):1292-1300.
15.	Jiang L, Liao A, Wen T, et al. Living donor liver transplantation or resection for Child-Pugh A hepatocellular carcinoma patients with multiple nodules meeting the Milan criteria. Transpl Int, 2014, 27(6):562-569.
16.	An HJ, Jang JW, Bae SH, et al. Sustained low hepatitis B viral load predicts good outcome after curative resection in patients with hepatocellular carcinoma. J Gastroenterol Hepatol, 2010, 25(12):1876-1882.
17.	Yang T, Lu JH, Zhai J, et al. High viral load is associated with poor overall and recurrence-free survival of hepatitis B virus-related hepatocellular carcinoma after curative resection:a prospective cohort study. Eur J Surg Oncol, 2012, 38(8):683-691.
18.	Kubo S, Hirohashi K, Tanaka H, et al. Effect of viral status on recurrence after liver resection for patients with hepatitis B virusrelated hepatocellular carcinoma. Cancer, 2000, 88(5):1016-1024.
19.	Kubo S, Hirohashi K, Tanaka H, et al. Virologic and biochemical changes and prognosis after liver resection for hepatitis B virusrelated hepatocellular carcinoma. Dig Surg, 2001, 18(1):26-33.
20.	Sohn W, Paik YH, Cho JY, et al. Influence of hepatitis B virus reactivation on the recurrence of HBV-related hepatocellular carcinoma after curative resection in patients with low viral load. J Viral Hepat, 2015, 22(6):539-550.
21.	Huang G, Lai EC, Lau WY, et al. Posthepatectomy HBV reactivation in hepatitis B-related hepatocellular carcinoma influences postoperative survival in patients with preoperative low HBV-DNA levels. Ann Surg, 2013, 257(3):490-505.
22.	Huang G, Lau WY, Wang ZG, et al. Antiviral therapy improves postoperative survival in patients with hepatocellular carcinoma:a randomized controlled trial. Ann Surg, 2015, 261(1):56-66.
23.	Galizia G, Lieto E, Zamboli A, et al. Neutrophil to lymphocyte ratio is a strong predictor of tumor recurrence in early colon cancers:a propensity score-matched analysis. Surgery, 2015, 158(1):112-120.
24.	Ohi M, Mori K, Toiyama Y, et al. Preoperative prediction of peritoneal metastasis in gastric cancer as an indicator for neoadjuvant treatment. Anticancer Res, 2015, 35(6):3511-3518.
25.	Sugiura T, Uesaka K, Kanemoto H, et al. Elevated preoperative neutrophil-to-lymphocyte ratio as a predictor of survival after gastroenterostomy in patients with advanced pancreatic adenocarcinoma. Ann Surg Oncol, 2013, 20(13):4330-4337.
26.	Halazun KJ, Hardy MA, Rana AA, et al. Negative impact of neutrophil-lymphocyte ratio on outcome after liver transplantation for hepatocellular carcinoma. Ann Surg, 2009, 250(1):141-151.

1. Llovet JM, Bruix J. Novel advancements in the management of hepatocellular carcinoma in 2008. J Hepatol, 2008, 48 Suppl 1:S20-S37.
2. Parkin DM, Bray F, Ferlay J, et al. Global cancer statistics, 2002. CA Cancer J Clin, 2005, 55(2):74-108.
3. Tateishi R, Shiina S, Akahane M, et al. Frequency, risk factors and survival associated with an intrasubsegmental recurrence after radiofrequency ablation for hepatocellular carcinoma. PloS one, 2013, 8(4):e59040.
4. Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med, 1996, 334(11):693-699.
5. Li C, Zhu WJ, Wen TF, et al. Child-Pugh A hepatitis B-related cirrhotic patients with a single hepatocellular carcinoma up to 5 cm:liver transplantation vs. resection. J Gastrointest Surg, 2014, 18(8):1469-1476.
6. Okamura Y, Ashida R, Ito T, et al. Preoperative neutrophil to lymphocyte ratio and prognostic nutritional index predict overall survival after hepatectomy for hepatocellular carcinoma. World J Surg, 2015, 39(6):1501-1509.
7. Song P, Feng X, Zhang K, et al. Screening for and surveillance of high-risk patients with HBV-related chronic liver disease:promoting the early detection of hepatocellular carcinoma in China. Biosci Trends, 2013, 7(1):1-6.
8. Shah SA, Cleary SP, Wei AC, et al. Recurrence after liver resection for hepatocellular carcinoma:risk factors, treatment, and outcomes. Surgery, 2007, 141(3):330-339.
9. Koda M, Murawaki Y, Mitsuda A, et al. Predictive factors for intrahepatic recurrence after percutaneous ethanol injection therapy for small hepatocellular carcinoma. Cancer, 2000, 88(3):529-537.
10. Zheng SS, Xu X, Wu J, et al. Liver transplantation for hepatocellular carcinoma:Hangzhou experiences. Transplantation, 2008, 85(12):1726-1732.
11. Yu HC, Cheng JS, Lai KH, et al. Factors for early tumor recurrence of single small hepatocellular carcinoma after percutaneous radiofrequency ablation therapy. World J Gastroenterol, 2005, 11(10):1439-1444.
12. DuBay D, Sandroussi C, Sandhu L, et al. Liver transplantation for advanced hepatocellular carcinoma using poor tumor differentiation on biopsy as an exclusion criterion. Ann Surg, 2011, 253(1):166-172.
13. Cheng Z, Yang P, Qu S, et al. Risk factors and management for early and late intrahepatic recurrence of solitary hepatocellular carcinoma after curative resection. HPB (Oxford), 2015, 17(5):422-427.
14. Fan ST, Poon RT, Yeung C, et al. Outcome after partial hepatectomy for hepatocellular cancer within the Milan criteria. Br J Surg, 2011, 98(9):1292-1300.
15. Jiang L, Liao A, Wen T, et al. Living donor liver transplantation or resection for Child-Pugh A hepatocellular carcinoma patients with multiple nodules meeting the Milan criteria. Transpl Int, 2014, 27(6):562-569.
16. An HJ, Jang JW, Bae SH, et al. Sustained low hepatitis B viral load predicts good outcome after curative resection in patients with hepatocellular carcinoma. J Gastroenterol Hepatol, 2010, 25(12):1876-1882.
17. Yang T, Lu JH, Zhai J, et al. High viral load is associated with poor overall and recurrence-free survival of hepatitis B virus-related hepatocellular carcinoma after curative resection:a prospective cohort study. Eur J Surg Oncol, 2012, 38(8):683-691.
18. Kubo S, Hirohashi K, Tanaka H, et al. Effect of viral status on recurrence after liver resection for patients with hepatitis B virusrelated hepatocellular carcinoma. Cancer, 2000, 88(5):1016-1024.
19. Kubo S, Hirohashi K, Tanaka H, et al. Virologic and biochemical changes and prognosis after liver resection for hepatitis B virusrelated hepatocellular carcinoma. Dig Surg, 2001, 18(1):26-33.
20. Sohn W, Paik YH, Cho JY, et al. Influence of hepatitis B virus reactivation on the recurrence of HBV-related hepatocellular carcinoma after curative resection in patients with low viral load. J Viral Hepat, 2015, 22(6):539-550.
21. Huang G, Lai EC, Lau WY, et al. Posthepatectomy HBV reactivation in hepatitis B-related hepatocellular carcinoma influences postoperative survival in patients with preoperative low HBV-DNA levels. Ann Surg, 2013, 257(3):490-505.
22. Huang G, Lau WY, Wang ZG, et al. Antiviral therapy improves postoperative survival in patients with hepatocellular carcinoma:a randomized controlled trial. Ann Surg, 2015, 261(1):56-66.
23. Galizia G, Lieto E, Zamboli A, et al. Neutrophil to lymphocyte ratio is a strong predictor of tumor recurrence in early colon cancers:a propensity score-matched analysis. Surgery, 2015, 158(1):112-120.
24. Ohi M, Mori K, Toiyama Y, et al. Preoperative prediction of peritoneal metastasis in gastric cancer as an indicator for neoadjuvant treatment. Anticancer Res, 2015, 35(6):3511-3518.
25. Sugiura T, Uesaka K, Kanemoto H, et al. Elevated preoperative neutrophil-to-lymphocyte ratio as a predictor of survival after gastroenterostomy in patients with advanced pancreatic adenocarcinoma. Ann Surg Oncol, 2013, 20(13):4330-4337.
26. Halazun KJ, Hardy MA, Rana AA, et al. Negative impact of neutrophil-lymphocyte ratio on outcome after liver transplantation for hepatocellular carcinoma. Ann Surg, 2009, 250(1):141-151.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of Prognosis Factors of Hepatocellular Carcinoma Within Milan Criteria after Liver Resection

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