BACKGROUND Post-hepatectomy liver failure(PHLF)is a common consequence of radical partial hepatectomy in hepatocellular carcinoma(HCC).AIMS To investigate the relationship between preoperative antiviral therapy and PH...BACKGROUND Post-hepatectomy liver failure(PHLF)is a common consequence of radical partial hepatectomy in hepatocellular carcinoma(HCC).AIMS To investigate the relationship between preoperative antiviral therapy and PHLF,as well as assess the potential efficacy of hepatitis B virus(HBV)DNA level in predicting PHLF.METHODS A retrospective study was performed involving 1301 HCC patients with HBV who underwent radical hepatectomy.Receiver operating characteristic(ROC)analysis was used to assess the capacity of HBV DNA to predict PHLF and establish the optimal cutoff value for subsequent analyses.Logistic regression analyses were performed to assess the independent risk factors of PHLF.The increase in the area under the ROC curve,categorical net reclassification improvement(NRI),and integrated discrimination improvement(IDI)were used to quantify the efficacy of HBV DNA level for predicting PHLF.The P<0.05 was considered statistically significant.RESULTS Logistic regression analyses showed that preoperative antiviral therapy was independently associated with a reduced risk of PHLF(P<0.05).HBV DNA level with an optimal cutoff value of 269 IU/mL(P<0.001)was an independent risk factor of PHLF.All the reference models by adding the variable of HBV DNA level had an improvement in area under the curve,categorical NRI,and IDI,particularly for the fibrosis-4 model,with values of 0.729(95%CI:0.705-0.754),1.382(95%CI:1.341-1.423),and 0.112(95%CI:0.110-0.114),respectively.All the above findings were statistically significant.CONCLUSION In summary,preoperative antiviral treatment can reduce the incidence of PHLF,whereas an increased preoperative HBV DNA level has a correlative relationship with an increased susceptibility to PHLF.展开更多
Gastric adenocarcinoma(GAC)is estimated as the fifteenth most common cancer in the USA.Incidence rate has been gradually decreasing,but prognosis remains dismal.For patients with locally advanced GAC(stage>T1B and&...Gastric adenocarcinoma(GAC)is estimated as the fifteenth most common cancer in the USA.Incidence rate has been gradually decreasing,but prognosis remains dismal.For patients with locally advanced GAC(stage>T1B and<T4B),multimodality therapies,such as surgery,chemotherapy,and radiation therapy,are needed.Perioperative chemotherapy or postoperative chemoradiation/chemotherapy is recommended.For metastatic GAC patients,combination of two cytotoxics(platinum compound and fluoropyrimidine)has become a common place in the USA,and when HER2 is positive,trastuzumab is added.When GAC progresses after the first line therapy,additional biomarkers(microsatellite instability and programmed death ligand 1)should be tested so that checkpoint inhibitors can be used.Overall,the options for advanced GAC patients are limited and more research is needed.展开更多
基金Supported by Science and Technology Innovation 2030-Major Project,No.2021ZD0140406 and No.2021ZD0140401.
文摘BACKGROUND Post-hepatectomy liver failure(PHLF)is a common consequence of radical partial hepatectomy in hepatocellular carcinoma(HCC).AIMS To investigate the relationship between preoperative antiviral therapy and PHLF,as well as assess the potential efficacy of hepatitis B virus(HBV)DNA level in predicting PHLF.METHODS A retrospective study was performed involving 1301 HCC patients with HBV who underwent radical hepatectomy.Receiver operating characteristic(ROC)analysis was used to assess the capacity of HBV DNA to predict PHLF and establish the optimal cutoff value for subsequent analyses.Logistic regression analyses were performed to assess the independent risk factors of PHLF.The increase in the area under the ROC curve,categorical net reclassification improvement(NRI),and integrated discrimination improvement(IDI)were used to quantify the efficacy of HBV DNA level for predicting PHLF.The P<0.05 was considered statistically significant.RESULTS Logistic regression analyses showed that preoperative antiviral therapy was independently associated with a reduced risk of PHLF(P<0.05).HBV DNA level with an optimal cutoff value of 269 IU/mL(P<0.001)was an independent risk factor of PHLF.All the reference models by adding the variable of HBV DNA level had an improvement in area under the curve,categorical NRI,and IDI,particularly for the fibrosis-4 model,with values of 0.729(95%CI:0.705-0.754),1.382(95%CI:1.341-1.423),and 0.112(95%CI:0.110-0.114),respectively.All the above findings were statistically significant.CONCLUSION In summary,preoperative antiviral treatment can reduce the incidence of PHLF,whereas an increased preoperative HBV DNA level has a correlative relationship with an increased susceptibility to PHLF.
文摘Gastric adenocarcinoma(GAC)is estimated as the fifteenth most common cancer in the USA.Incidence rate has been gradually decreasing,but prognosis remains dismal.For patients with locally advanced GAC(stage>T1B and<T4B),multimodality therapies,such as surgery,chemotherapy,and radiation therapy,are needed.Perioperative chemotherapy or postoperative chemoradiation/chemotherapy is recommended.For metastatic GAC patients,combination of two cytotoxics(platinum compound and fluoropyrimidine)has become a common place in the USA,and when HER2 is positive,trastuzumab is added.When GAC progresses after the first line therapy,additional biomarkers(microsatellite instability and programmed death ligand 1)should be tested so that checkpoint inhibitors can be used.Overall,the options for advanced GAC patients are limited and more research is needed.
