AIM:To identify the clinicopathological risk factors correlated with residual tumor in hepatocellular carcinoma (HCC) patients after resection. METHODS:From January 2001 to April 2007,766 HCC patients who had undergon...AIM:To identify the clinicopathological risk factors correlated with residual tumor in hepatocellular carcinoma (HCC) patients after resection. METHODS:From January 2001 to April 2007,766 HCC patients who had undergone resection were included in this research. Lipiodol angiography was performed within 2 mo after surgery and followed by post-Lipiodol computed tomography (CT) 4 wk later for all 766 patients to monitor tumor in the remnant liver. Tumor detected within the first 3-mo postoperative period was defined as residual tumor. Patients were divided into 2 groups:disease or disease-free within the first 3 mo after surgery. Risk factors for residual tumor were investigated among various clinicopathological variables. RESULTS:A total of 63 (8.22%) patients were found to have residual tumor after surgery. Three independent factors associated with residual tumor were identified by multivariate analysis:preoperative serum α-fetoprotein (AFP) level [odds ratio (OR) = 1.68 (95% confidence interval (CI):1.20-2.36)],tumor size [OR = 1.73 (95% CI:1.29-2.31)] and microvascular invasion [OR = 1.91 (95% CI:1.12-3.24)]. CONCLUSION:Residual tumor is related to AFP level,tumor size and microvascular invasion. Patients at high risk should undergo closer follow-up and could be candidates for multimodality therapy.展开更多
Objective This study aims to investigate the etiological relationship among hepatitis B virus （HBV）, hepatitis C virus （HCV）, and alcohol as risk factors in a cohort of hepatocellular carcinoma （HCC） patients fr...Objective This study aims to investigate the etiological relationship among hepatitis B virus （HBV）, hepatitis C virus （HCV）, and alcohol as risk factors in a cohort of hepatocellular carcinoma （HCC） patients from India. The clinical and biochemical profiles and tumor characteristics in the HCC cases were also evaluated. Methods A total of 357 consecutive cases of HCC fulfilling the diagnostic criteria from the Barcelona-2000 EASL conference were included in the study. The blood samples were evaluated for serological evidence of HBV and HCV infection, viral load, and genotypes using serological tests, reverse transcription-polymerase chain reaction, and restriction fragment length polymorphism. Results The male/female ratio for the HCC cases was 5.87：1. Majority of the HCC patients （33.9%） were 50 to 59 years of age, with a mean age of 4±13.23 years. More than half the cases （60.8%） had underlying cirrhosis at presentation. Among the HCC patients, 68.9% were HBV related, 21.3% were HCV related, 18.8%, were alcoholic, and 18.2% were of cryptogenic origin. The presence of any marker positive for HBV increased the risk for developing HCC by almost 27 times [OR： 27.33; （12.87-60.0）]. An increased risk of 10.6 times was observed for HCC development for cases positive for ally HCV marker [OR： 10.55; （3.13-42.73）]. Heavy alcohol consumption along with HCV RNA positivity in cirrhotic patients was found to be a risk for developing HCC by 3 folds ]OR： 3.17; （0.37-70.71）]. Conclusions Patients of chronic HBV infection followed by chronic HCV infection were at higher risk of developing HCC in India. Chronic alcohol consumption was found to be a risk factor in cirrhotic cases only when it was associated with HCV RNA positivity. Most of the patients had a large tumor size （〉5 cm） with multiple liver nodules, indicating an advanced stage of the disease thus making curative therapies difficult.展开更多
Objective: To explore the clinicopathological features, surgical treatment techniques, and prognostic risk factors of intrahepatic cholangiocarcinoma(ICC).Methods: A total of 104 ICC cases were collected from January ...Objective: To explore the clinicopathological features, surgical treatment techniques, and prognostic risk factors of intrahepatic cholangiocarcinoma(ICC).Methods: A total of 104 ICC cases were collected from January 2008 to December 2013 at Tianjin Medical University Cancer Institute and Hospital and divided into the hepatic hilum lymphadenectomy(HLL, 21 cases), extended hepatic hilum lymphadenectomy(EHLL, 12 cases), and non-lymphadenectomy(NL, 71 cases) groups. The clinical data of the patients were retrospectively analyzed, and the prognostic differences were compared among different groups.Results: The 1-, 2-, and 3-year overall survival(OS) rates of all cases were 72.1%, 56.1%, and 43.7%, respectively. The median survival duration was 34 months. The 1-, 2-, and 3-year OS rates of the HLL group(42.9%, 28.6%, and 28.6%, respectively) were significantly lower than those of the NL group(78.9%, 62.5%, and 47.8%, respectively). Meanwhile, the 1-, 2-, and 3-year OS rates of the EHLL group(75.0%, 56.1%, and 33.3%, respectively) were not significantly different from those of the other two groups.Univariate analysis showed that age, gender, American Joint Committee on Cancer(AJCC) stage, differentiation, ferritin(Fer),carbohydrate antigen19-9(CA19-9) and carcinoembryonicantigen(CEA) levels, lymph node metastasis(LNM), and lymph node dissection(LND) were prognostic factors for the long-term survival of ICC. Meanwhile, multivariate analysis revealed that age,AJCC stage, differentiation, Fer levels, and LNM were independent risk factors for survival.Conclusions: ICC patients will not benefit from lymphadenectomy in the absence of LNM. However, systematic lymphadenectomy may improve ICC outcomes if the location of lymphatic metastasis is known. Age, AJCC stage, differentiation,Fer level, and LNM are independent risk factors for survival in ICC.展开更多
Objective: The aim of this study was to compare the therapeutic efficacy of radiofrequency ablation (RFA) and surgical resection for the patients with hepatocellular carcinoma (HCC). Methods: From January 2002 to June...Objective: The aim of this study was to compare the therapeutic efficacy of radiofrequency ablation (RFA) and surgical resection for the patients with hepatocellular carcinoma (HCC). Methods: From January 2002 to June 2009, 87 HCC patients with 3 or fewer nodules, no more than 3 cm in diameter, and liver function of Child-Pugh class A or B were enrolled. Forty-seven underwent RFA while 40 underwent surgical resection. Follow-up ranged from 6 to 69 months. We compared the overall and disease-free survival rate, recurrence patterns, and the complications between the two groups. Survival prob-abilities were estimated using the Kaplan-Meier method. Results: At the end of the study, 67 patients were alive. The 1-, 2- and 3-year overall cumulative survival rates after RFA and surgical resection were 91.0%, 76.7%, 69.7% and 90.0%, 82.9%, 75.4%, respectively. The difference between the two survival curves was not statistically significant (χ2 = 0.99, P = 0.32). Forty-three patients suffered intrahepatic recurrence, including 25 cases after RFA and 18 cases after surgical resection. The 1-, 2-, and 3-year disease-free survival rates after radiofrequency ablation and surgical resection were 57.3% vs 71.1%, 40.3% vs 45.7%, and 35.3% vs 30.9%. The difference between the two groups was not statistically significant (χ2 = 0.06, P = 0.80). Cox hazard model indicated tumor size and Child-Pugh scoring were significant risk factors for local tumor progression, while tumor numbers was risk factor for intrahepatic distant recurrence. Conclusion: RFA is as effective as surgical resection for the treatment of patients with HCC (≤ 5 cm), especially for those who are not suitable for curative resection.展开更多
文摘AIM:To identify the clinicopathological risk factors correlated with residual tumor in hepatocellular carcinoma (HCC) patients after resection. METHODS:From January 2001 to April 2007,766 HCC patients who had undergone resection were included in this research. Lipiodol angiography was performed within 2 mo after surgery and followed by post-Lipiodol computed tomography (CT) 4 wk later for all 766 patients to monitor tumor in the remnant liver. Tumor detected within the first 3-mo postoperative period was defined as residual tumor. Patients were divided into 2 groups:disease or disease-free within the first 3 mo after surgery. Risk factors for residual tumor were investigated among various clinicopathological variables. RESULTS:A total of 63 (8.22%) patients were found to have residual tumor after surgery. Three independent factors associated with residual tumor were identified by multivariate analysis:preoperative serum α-fetoprotein (AFP) level [odds ratio (OR) = 1.68 (95% confidence interval (CI):1.20-2.36)],tumor size [OR = 1.73 (95% CI:1.29-2.31)] and microvascular invasion [OR = 1.91 (95% CI:1.12-3.24)]. CONCLUSION:Residual tumor is related to AFP level,tumor size and microvascular invasion. Patients at high risk should undergo closer follow-up and could be candidates for multimodality therapy.
文摘Objective This study aims to investigate the etiological relationship among hepatitis B virus （HBV）, hepatitis C virus （HCV）, and alcohol as risk factors in a cohort of hepatocellular carcinoma （HCC） patients from India. The clinical and biochemical profiles and tumor characteristics in the HCC cases were also evaluated. Methods A total of 357 consecutive cases of HCC fulfilling the diagnostic criteria from the Barcelona-2000 EASL conference were included in the study. The blood samples were evaluated for serological evidence of HBV and HCV infection, viral load, and genotypes using serological tests, reverse transcription-polymerase chain reaction, and restriction fragment length polymorphism. Results The male/female ratio for the HCC cases was 5.87：1. Majority of the HCC patients （33.9%） were 50 to 59 years of age, with a mean age of 4±13.23 years. More than half the cases （60.8%） had underlying cirrhosis at presentation. Among the HCC patients, 68.9% were HBV related, 21.3% were HCV related, 18.8%, were alcoholic, and 18.2% were of cryptogenic origin. The presence of any marker positive for HBV increased the risk for developing HCC by almost 27 times [OR： 27.33; （12.87-60.0）]. An increased risk of 10.6 times was observed for HCC development for cases positive for ally HCV marker [OR： 10.55; （3.13-42.73）]. Heavy alcohol consumption along with HCV RNA positivity in cirrhotic patients was found to be a risk for developing HCC by 3 folds ]OR： 3.17; （0.37-70.71）]. Conclusions Patients of chronic HBV infection followed by chronic HCV infection were at higher risk of developing HCC in India. Chronic alcohol consumption was found to be a risk factor in cirrhotic cases only when it was associated with HCV RNA positivity. Most of the patients had a large tumor size （〉5 cm） with multiple liver nodules, indicating an advanced stage of the disease thus making curative therapies difficult.
文摘Objective: To explore the clinicopathological features, surgical treatment techniques, and prognostic risk factors of intrahepatic cholangiocarcinoma(ICC).Methods: A total of 104 ICC cases were collected from January 2008 to December 2013 at Tianjin Medical University Cancer Institute and Hospital and divided into the hepatic hilum lymphadenectomy(HLL, 21 cases), extended hepatic hilum lymphadenectomy(EHLL, 12 cases), and non-lymphadenectomy(NL, 71 cases) groups. The clinical data of the patients were retrospectively analyzed, and the prognostic differences were compared among different groups.Results: The 1-, 2-, and 3-year overall survival(OS) rates of all cases were 72.1%, 56.1%, and 43.7%, respectively. The median survival duration was 34 months. The 1-, 2-, and 3-year OS rates of the HLL group(42.9%, 28.6%, and 28.6%, respectively) were significantly lower than those of the NL group(78.9%, 62.5%, and 47.8%, respectively). Meanwhile, the 1-, 2-, and 3-year OS rates of the EHLL group(75.0%, 56.1%, and 33.3%, respectively) were not significantly different from those of the other two groups.Univariate analysis showed that age, gender, American Joint Committee on Cancer(AJCC) stage, differentiation, ferritin(Fer),carbohydrate antigen19-9(CA19-9) and carcinoembryonicantigen(CEA) levels, lymph node metastasis(LNM), and lymph node dissection(LND) were prognostic factors for the long-term survival of ICC. Meanwhile, multivariate analysis revealed that age,AJCC stage, differentiation, Fer levels, and LNM were independent risk factors for survival.Conclusions: ICC patients will not benefit from lymphadenectomy in the absence of LNM. However, systematic lymphadenectomy may improve ICC outcomes if the location of lymphatic metastasis is known. Age, AJCC stage, differentiation,Fer level, and LNM are independent risk factors for survival in ICC.
文摘Objective: The aim of this study was to compare the therapeutic efficacy of radiofrequency ablation (RFA) and surgical resection for the patients with hepatocellular carcinoma (HCC). Methods: From January 2002 to June 2009, 87 HCC patients with 3 or fewer nodules, no more than 3 cm in diameter, and liver function of Child-Pugh class A or B were enrolled. Forty-seven underwent RFA while 40 underwent surgical resection. Follow-up ranged from 6 to 69 months. We compared the overall and disease-free survival rate, recurrence patterns, and the complications between the two groups. Survival prob-abilities were estimated using the Kaplan-Meier method. Results: At the end of the study, 67 patients were alive. The 1-, 2- and 3-year overall cumulative survival rates after RFA and surgical resection were 91.0%, 76.7%, 69.7% and 90.0%, 82.9%, 75.4%, respectively. The difference between the two survival curves was not statistically significant (χ2 = 0.99, P = 0.32). Forty-three patients suffered intrahepatic recurrence, including 25 cases after RFA and 18 cases after surgical resection. The 1-, 2-, and 3-year disease-free survival rates after radiofrequency ablation and surgical resection were 57.3% vs 71.1%, 40.3% vs 45.7%, and 35.3% vs 30.9%. The difference between the two groups was not statistically significant (χ2 = 0.06, P = 0.80). Cox hazard model indicated tumor size and Child-Pugh scoring were significant risk factors for local tumor progression, while tumor numbers was risk factor for intrahepatic distant recurrence. Conclusion: RFA is as effective as surgical resection for the treatment of patients with HCC (≤ 5 cm), especially for those who are not suitable for curative resection.
