A Jemal

Binkui Li

Guihua Chen

Guohui Li

HB El-Serag

I Ikai

J Henderson

Jinqing Li

JL Raoul

JM Llovet

JN Vauthey

K Hasegawa

KK Ng

KM Kee

L Wilkens

Liru He

M Chirica

M Malinchoc

M Minagawa

M Shimada

MK Gospodarowicz

N Portolani

Q Li

RT Poon

S Okada

T Ishizawa

T Sonoyama

TM Pawlik

V Usatoff

Wan Yee Lau

WY Lau

WY Tung

Y Akashi

Y Kawano

Yaqi Zhang

Yunfei Yuan

BMC Cancer

English

PubMed

Abstract
          
            Background
            Locally advanced (pT3-4N0M0) hepatocellular carcinoma (HCC) is a heterogeneous group of tumors, which consists of four different categories, including HCC with "multiple tumors more than 5 cm", "major vascular invasion", "invasion of adjacent organs", and "perforation of visceral peritoneum". The aim of our study was to verify whether the 2002 version of the Tumor-Node-Metastasis staging system could predict surgical outcomes in patients with locally advanced HCC.
          
          
            Methods
            We retrospectively reviewed 298 patients with pT3-4N0M0 HCC who underwent hepatic resection from 1993 to 2000 in an academic tertiary hospital. Overall survival (OS) and cumulative recurrence rate (CRR) of the four categories of locally advanced HCC patients were compared.
          
          
            Results
            In multivariate analysis, major vascular invasion was identified as the most significant factor (HR = 3.291, 95% CI 2.362-4.584, P &lt; 0.001) followed by cirrhosis status on OS, and was found to be the only independent factor of CRR (HR = 2.242, 95% CI 1.811-3.358, P &lt; 0.001) in patients with locally advanced HCC. Among the four categories of locally advanced HCC, OS was significantly worse, and CRR was significantly higher in patients with HCC with major vascular invasion (pT3) than with multiple tumors more than 5 cm (pT3); or tumor invasion of adjacent organs (pT4); or perforation of visceral peritoneum (pT4). No significant differences were observed in OS or CRR between the latter three groups of patients.
          
          
            Conclusions
            HCC with major vascular invasion, which are classified as pT3 under the current TNM staging, have the worst prognosis when compared with the other categories of pT3-4 disease. There is a need to redefine the T classification and to stratify locally advanced HCC.
          </jats:sec

Crossref

Application of tumor-node-metastasis staging 2002 version in locally advanced hepatocellular carcinoma: is it predictive of surgical outcome?

Springer - Publisher Connector

Aoki K: Prognostic factors in patients with hepatocellular carcinoma receiving systemic chemotherapy. Hepatology

Clonality analysis for multicentric origin and intrahepatic metastasis in recurrent and primary hepatocellular carcinoma.

Different risk factors and prognosis for early and late intrahepatic recurrence after resection of hepatocellular carcinoma. Cancer

eds: UICC TNM Classification of Malignant Tumors.

et al: Hepatectomy for hepatocellular carcinoma with major portal or hepatic vein invasion: results of a multicenter study. Surgery

et al: Is hepatic resection for large or multinodular hepatocellular carcinoma justified? Results from a multiinstitutional database. Ann Surg Oncol

et al: Simplified staging for hepatocellular carcinoma.

et al: Sorafenib in advanced hepatocellular carcinoma.

et al: Validation of clinical AJCC/UICC TNM staging system for hepatocellular carcinoma: analysis of 5,613 cases from a medical center in southern Taiwan.

Fleming ID, eds: AJCC cancer staging manual.

Gramlich T: AHPBA/AJCC consensus conference on staging of hepatocellular carcinoma: consensus statement. HPB

Inoue K: Prognosis of unresectable hepatocellular carcinoma: an evaluation based on multivariate analysis of 90 cases. Hepatology

Intrahepatic recurrence after curative resection of hepatocellular carcinoma: long-term results of treatment and prognostic factors. Ann Surg

Kitano S: Prognosis of patients with intrahepatic recurrence after hepatic resection for hepatocellular carcinoma: a retrospective study. Eur J Surg Oncol

KL: Hepatocellular carcinoma: epidemiology and molecular carcinogenesis. Gastroenterology

Kokudo N: Surgical treatment of hepatocellular carcinoma. Surg Today

Kreipe H: Differentiation of multicentric origin from intra-organ metastatic spread of hepatocellular carcinomas by comparative genomic hybridization.

Li AK: Resection of hepatocellular carcinoma with diaphragmatic invasion.

Liver resection in advanced hepatocellular carcinoma. Hepatogastroenterology

Molecular targeted therapies in hepatocellular carcinoma. Hepatology

Neither multiple tumors nor portal hypertension are surgical contraindications for hepatocellular carcinoma. Gastroenterology

Novel advancements in the management of hepatocellular carcinoma in

Prognosis after hepatic resection for stage IVA hepatocellular carcinoma: a need for reclassification. Ann Surg

Randomized controlled trial for hepatocellular carcinoma with portal vein thrombosis: intra-arterial iodine-131-iodized oil versus medical support.

Results of hepatic resection for hepatocellular carcinoma invading major portal and/or hepatic veins. Surg Oncol Clin N Am

SM: Early and late recurrence after liver resection for hepatocellular carcinoma: prognostic and therapeutic implications. Ann Surg

Sobin LH: The process for continuous improvement of the TNM classification. Cancer

Soubrane O: Treatment of stage IVA hepatocellular carcinoma: should we reappraise the role of surgery? Arch Surg

Staging of hepatocellular carcinoma: assessment of the Japanese TNM and AJCC/ UICC TNM systems in a cohort of 13,772 patients in Japan. Ann Surg

Surgical intervention for patients with stage IV-A hepatocellular carcinoma without lymph node metastasis: proposal as a standard therapy. Ann Surg

ter Borg PC: A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. Hepatology

WY: Surgical resection of primary hepatocellular carcinoma extending to adjacent organ(s).

Yamagishi H: Predictors of postoperative diffuse intrahepatic recurrence of hepatocellular carcinoma. Hepatogastroenterology

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Application of tumor-node-metastasis staging 2002 version in locally advanced hepatocellular carcinoma: is it predictive of surgical outcome?

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