Importance of tumor size as a prognostic factor after partial liver resection for solitary hepatocellular carcinoma: Implications on the current AJCC staging system

2015 ◽  
Vol 113 (1) ◽  
pp. 89-93 ◽  
Author(s):  
Brian K. P. Goh ◽  
Jin-Yao Teo ◽  
Chung-Yip Chan ◽  
Ser-Yee Lee ◽  
Premaraj Jeyaraj ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Prognostic Factor ◽  
Tumor Size ◽  
Staging System ◽  
Partial Liver Resection ◽  
Ajcc Staging System ◽  
Solitary Hepatocellular Carcinoma ◽  
Ajcc Staging

scholarly journals Impact of Tumor Size as a Prognostic Factor After One Stage Liver Resection for Solitary Hepatocellular Carcinoma in Cirrhotic Patients

2020 ◽  
Vol 8 (4) ◽  
pp. 123
Author(s):  
Alhassan Mohamed Hassan ◽  
Amir Fawzy Abdelhamid ◽  
Hosam Barakat Barakat ◽  
Soliman Mohamed Soliman ◽  
Hossamaldin Mohamed Soliman ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Prognostic Factor ◽  
Tumor Size ◽  
One Stage ◽  
Cirrhotic Patients ◽  
Solitary Hepatocellular Carcinoma

Simplified Staging for Hepatocellular Carcinoma

2002 ◽  
Vol 20 (6) ◽  
pp. 1527-1536 ◽  
Author(s):  
Jean-Nicolas Vauthey ◽  
Gregory Y. Lauwers ◽  
Nestor F. Esnaola ◽  
Kim-Anh Do ◽  
Jacques Belghiti ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Tumor Size ◽  
Vascular Invasion ◽  
Staging System ◽  
Microvascular Invasion ◽  
Multiple Tumors ◽  
Ajcc Staging System ◽  
Ajcc Staging ◽  
Single Tumor ◽  
Severe Fibrosis

PURPOSE: The current American Joint Committee on Cancer (AJCC) staging system for hepatocellular carcinoma (HCC) fails to stratify patients adequately with respect to prognosis. PATIENTS AND METHODS: The ability of the currently proposed tumor (T) categories to effectively stratify the survival of 557 patients who underwent complete resection for HCC at four centers was examined. Independent predictors of survival were combined into a new staging system. RESULTS: Using the current AJCC T classification, patients with T1 and T2 tumors had similar 5-year survivals (P = .6). In addition, the survival of patients with multiple bilobar tumors (T4) matched that of T3 patients (P = .5). Independent predictors of death were major vascular invasion (P < .001), microvascular invasion (P = .001), severe fibrosis/cirrhosis of the host liver (P = .001), multiple tumors (P = .007), and tumor size greater than 5 cm (P = .01). Based on our results, a simplified stratification is proposed: (a) patients with a single tumor and no microvascular invasion, (b) patients with a single tumor and microvascular invasion or multiple tumors, none more than 5 cm, and (c) patients with either multiple tumors, any more than 5 cm, or tumor with major vascular invasion (P < .001). Severe fibrosis/cirrhosis had a negative impact on survival within all categories. The survival of patients with lymph node involvement matched that of patients with major vascular invasion (P = .3). CONCLUSION: The current AJCC staging system for HCC is unnecessarily complex. We propose a simplified model of stratification that is based on vascular invasion, tumor number, and tumor size and incorporates the effect of fibrosis on survival.

scholarly journals Evaluation of the new AJCC staging system for resectable hepatocellular carcinoma

2011 ◽  
Vol 9 (1) ◽  
pp. 114 ◽  
Author(s):  
Chih H Cheng ◽  
Chen F Lee ◽  
Tsung H Wu ◽  
Kun M Chan ◽  
Hong S Chou ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Staging System ◽  
Ajcc Staging System ◽  
Ajcc Staging

scholarly journals The diversity between curatively resected pancreatic head and body-tail cancers based on the 8th edition of AJCC staging system: a multicenter cohort study

2019 ◽  
Author(s):  
Weiwei Sheng ◽  
Ming Dong ◽  
Guosen Wang ◽  
Xiaoyang Shi ◽  
Wei Gao ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Tumor Size ◽  
Pancreatic Head ◽  
Staging System ◽  
Multicenter Cohort Study ◽  
Ajcc Stage ◽  
Multicenter Cohort ◽  
Ajcc Staging System ◽  
Ajcc Staging ◽  
8Th Edition

Abstract Background: To our knowledge, there are no studies to systematically compare the detailed clinical significance between curatively resected pancreatic head (ph) and body-tail (pbt) ductal adenocarcinoma based on the new 8th edition of AJCC staging system (8 th AJCC stage) that was just applied in clinical practice in 2018. Methods : 351 patients with curatively resected pancreatic adenocarcinoma (PC) from three center hospitals were entered into this multicenter cohort study. Results: Increasing tumor size ( P <0.001), T stage (T1+T2 vs T3+T4, P =0.003), frequent postoperative liver metastasis (PLM) ( P =0.002) and 8 th AJCC stage (IA to VI, P <0.001; I+II vs III+IV, P =0.002) were closely associated with the progression of pbt cancers compared with that in ph cancer patients. Moreover, tumor size≥3cm ( P =0.012), 8 th AJCC stage (III+IV) ( P =0.025) and PLM ( P =0.010) were identified as independent risk factors in pbt cancers in logistic analysis. Patients with pbt cancers had a significantly worse overall survival compared with ph cancer patients ( P =0.007). Moreover, pbt was an independent unfavorable factor in multivariate analysis ( P =0.009). In addition to 8 th AJCC stage, vascular invasion and PLM, increasing tumor size and advanced T stage were also closely associated with the poor prognosis in 131 cases of pbt cancer patients compared with Ph cancer patients. Conclusion: Pbt, as an independent unfavorable factor for the prognosis of PC patients, are much more aggressive than that in ph cancers according to 8 th AJCC staging system. 8 th AJCC staging system are more comprehensive and sensitive to reflect the malignant biology of pbt cancers.

scholarly journals The diversity between curatively resected pancreatic head and body-tail cancers based on the 8th edition of AJCC staging system: a multicenter cohort study

2019 ◽  
Author(s):  
Weiwei Sheng ◽  
Ming Dong ◽  
Guosen Wang ◽  
Xiaoyang Shi ◽  
Wei Gao ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Tumor Size ◽  
Pancreatic Head ◽  
Staging System ◽  
Multicenter Cohort Study ◽  
Ajcc Stage ◽  
Multicenter Cohort ◽  
Ajcc Staging System ◽  
Ajcc Staging ◽  
8Th Edition

Abstract Background: To our knowledge, there are no studies to systematically compare the detailed clinical significance between curatively resected pancreatic head (ph) and body-tail (pbt) ductal adenocarcinoma based on the new 8th edition of AJCC staging system (8th AJCC stage) that was just applied in clinical practice in 2018. Methods: 351 patients with curatively resected pancreatic adenocarcinoma (PC) from three center hospitals were entered into this multicenter cohort study. Results: Increasing tumor size (P<0.001), T stage (T1+T2 vs T3+T4, P=0.003), frequent postoperative liver metastasis (PLM) (P=0.002) and 8th AJCC stage (IA to VI, P<0.001; I+II vs III+IV, P=0.002) were closely associated with the progression of pbt cancers compared with that in ph cancer patients. Moreover, tumor size≥3cm (P=0.012), 8th AJCC stage (III+IV) (P=0.025) and PLM (P=0.010) were identified as independent risk factors in pbt cancers in logistic analysis. Patients with pbt cancers had a significantly worse overall survival compared with ph cancer patients (P=0.007). Moreover, pbt was an independent unfavorable factor in multivariate analysis (P=0.009). In addition to 8th AJCC stage, vascular invasion and PLM, increasing tumor size and advanced T stage were also closely associated with the poor prognosis in 131 cases of pbt cancer patients compared with Ph cancer patients. Conclusion: Pbt, as an independent unfavorable factor for the prognosis of PC patients, are much more aggressive than that in ph cancers according to 8th AJCC staging system. 8th AJCC staging system are more comprehensive and sensitive to reflect the malignant biology of pbt cancers.

Prognostic Accuracy of the Eighth Edition of TNM Classification Compared with the Seventh and Sixth Edition for Perihilar Cholangiocarcinoma

2020 ◽  
Author(s):  
Hans Michael Hau ◽  
Felix Meyer ◽  
Sebastian Rademacher ◽  
Robert Sucher ◽  
Daniel Seehofer
Keyword(s):  
Liver Resection ◽  
Tnm Classification ◽  
Staging System ◽  
Perihilar Cholangiocarcinoma ◽  
7Th Edition ◽  
Prognostic Accuracy ◽  
Staging Systems ◽  
Ajcc Staging System ◽  
Ajcc Staging ◽  
8Th Edition

Abstract Background This study was conducted to evaluate and compare the prognostic value and performance of the 6th, 7th, and 8th editions of the American Joint Committee on Cancer (AJCC) staging system when applied to patients undergoing surgery for perihilar cholangiocarcinoma (PHC). Methods Patients undergoing liver resection with curative intention for PHC between 2002 and 2019 were identified from a prospective database. Histopathological parameters and stage of the PHC were assessed according to the 6th, 7th, and 8th editions of the tumor node metastasis (TNM) classification. The prognostic accuracy between staging systems was compared using the area under the receiver operating characteristic curve (AUC) model. Results Data for a total of 95 patients undergoing liver resection for PHC were analyzed. The median overall survival time was 21 months (95% CI 8.1–33.9), and the 3- and 5-year survival rates were 46.1% and 36.2%, respectively. Staging according to the 8th edition versus the 7th edition resulted in reclassification of 25 patients (26.3%). The log-rank p-values for the 7th and 8th edition were highly statistically significant (p ≤ 0.01) compared to the 6th edition (p = 0.035). The AJCC 8th edition staging system had a slightly better discrimination ability, with an AUC of 0.69 (95% CI: 0.52–0.84) compared to 0.61 (95% CI: 0.51–0.73) for the 7th edition. Multivariate survival analysis revealed male gender, age > 65 years, positive resection margins, presence of distant metastases, poorly tumor differentiation, lymph node involvement such as no caudate lobe resection as independent predictors of poor survival (p < 0.05). Conclusion The newly released 8th edition of the AJCC staging system demonstrated a poor to moderate ability to predict prognosis of patients undergoing liver resection for perihilar cholangiocarcinoma; the result was only slightly better than the previous 7th edition. Further refinements are needed to improve the prognostic ability of the AJCC staging system for perihilar cholangiocarcinoma and to identify other prognostic factors that can potentially improve individual patient prognostication.

scholarly journals Diagnostic and prognostic values of upregulated SPC25 in patients with hepatocellular carcinoma

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e9535
Author(s):  
Xiaolin Yang ◽  
Hongzhi Sun ◽  
Ying Song ◽  
Li Yang ◽  
Haibo Liu
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Roc Curve ◽  
Cox Regression ◽  
Expression Patterns ◽  
Staging System ◽  
Cancer Genome ◽  
Ajcc Staging System ◽  
Ajcc Staging ◽  
Neoplastic Tissues

Background Spindle pole body component 25 (SPC25) plays a vital role in many cellular processes, such as tumorigenesis. However, the clinical significance of SPC25 in hepatocellular carcinoma (HCC) has not been investigated. This study aimed to explore the expression patterns of SPC25 in HCC and non-neoplastic tissues and to investigate the diagnostic and prognostic values of SPC25. Method The expression of SPC25 was examined in 374 HCC issues and 50 non-neoplastic tissues from The Cancer Genome Atlas (TCGA) cohort. The diagnostic and prognostic values of SPC25 were analyzed via receiver operating characteristic (ROC) curve and survival analyses, respectively. Univariate and multivariate Cox regression analyses were used to identify the prognostic factors and to establish a nomogram. The diagnostic and prognostic values were further validated in an external cohort from the International Cancer Genome Consortium (ICGC) database. Results The expression of SPC25 in HCC tissues was significantly higher than that in normal tissues in both cohorts (all P < 0.001). The ROC curve analysis indicated that SPC25 expression has high diagnostic value in HCC with area under the curve (AUC) value of 0.969 (95% confidence interval [CI] [0.948–0.984]) and 0.945 (95% CI [0.920–0.965]) for TCGA and ICGC cohorts, respectively. Patients with HCC exhibiting high SPC25 expression were associated with worse prognosis than those exhibiting low SPC25 expression in both cohorts (all P < 0.001). SPC25 was independently associated with overall survival in both cohorts (all P < 0.001). The concordance indices of the nomogram for predicting overall survival in TCGA and ICGC cohorts were 0.647 and 0.805, respectively, which were higher than those of the American Joint Committee on Cancer (AJCC) staging system. Conclusion SPC25 was upregulated in HCC and independently predicted poor overall survival of patients with HCC. Therefore, SPC25 is an effective diagnostic and prognostic biomarker for HCC. An SPC25-based nomogram was more accurate and useful than the AJCC staging system to predict prognosis of HCC.

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