Tumor necrosis as a poor prognostic predictor on postoperative survival of patients with solitary small hepatocellular carcinoma
Small hepatocellular carcinoma (sHCC) is a special subtype of HCC with the maximum tumor diameter ≤ 3 cm and excellent long-term outcomes. Surgical resection or radiofrequency ablation provides the greatest chance for cure; however, many patients still undergo tumor recurrence after primary treatmen...
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| Veröffentlicht in: | BMC cancer 2020-06, Vol.20 (1), p.607-607, Article 607 |
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| creator | Ling, Yi-Hong Chen, Jie-Wei Wen, Shi-Hong Huang, Chao-Yun Li, Peng Lu, Liang-He Mei, Jie Li, Shao-Hua Wei, Wei Cai, Mu-Yan Guo, Rong-Ping |
| description | Small hepatocellular carcinoma (sHCC) is a special subtype of HCC with the maximum tumor diameter ≤ 3 cm and excellent long-term outcomes. Surgical resection or radiofrequency ablation provides the greatest chance for cure; however, many patients still undergo tumor recurrence after primary treatment. To date, there is no clinical applicable method to assess biological aggressiveness in solitary sHCC.
In the current study, we retrospectively evaluated tumor necrosis of 335 patients with solitary sHCC treated with hepatectomy between December 1998 and 2010 from Sun Yat-sen University Cancer Center.
The presence of tumor necrosis was observed in 157 of 335 (46.9%) sHCC patients. Further correlation analysis showed that tumor necrosis was significantly correlated with tumor size and vascular invasion (P = 0.026, 0.003, respectively). The presence of tumor necrosis was associated closely with poorer cancer-specific overall survival (OS) and recurrence-free survival (RFS) as evidenced by univariate (P |
| doi_str_mv | 10.1186/s12885-020-07097-5 |
| format | Article |
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In the current study, we retrospectively evaluated tumor necrosis of 335 patients with solitary sHCC treated with hepatectomy between December 1998 and 2010 from Sun Yat-sen University Cancer Center.
The presence of tumor necrosis was observed in 157 of 335 (46.9%) sHCC patients. Further correlation analysis showed that tumor necrosis was significantly correlated with tumor size and vascular invasion (P = 0.026, 0.003, respectively). The presence of tumor necrosis was associated closely with poorer cancer-specific overall survival (OS) and recurrence-free survival (RFS) as evidenced by univariate (P < 0.001; hazard ratio, 2.821; 95% CI, 1.643-4.842) and multivariate analysis (P = 0.005; hazard ratio, 2.208; 95% CI, 1.272-3.833). Notably, the combined model by tumor necrosis, vascular invasion and tumor size can significantly stratify the risk for RFS and OS and improve the ability to discriminate sHCC patients' outcomes (P < 0.0001 for both).
Our results provide evidence that tumor necrosis has the potential to be a parameter for cancer aggressiveness in solitary sHCC. The combined prognostic model may be a useful tool to identify solitary sHCC patients with worse outcomes.</description><identifier>ISSN: 1471-2407</identifier><identifier>EISSN: 1471-2407</identifier><identifier>DOI: 10.1186/s12885-020-07097-5</identifier><identifier>PMID: 32600297</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Ablation ; Ablation (Surgery) ; Cancer therapies ; Carcinoma, Hepatocellular - mortality ; Carcinoma, Hepatocellular - pathology ; Carcinoma, Hepatocellular - surgery ; Care and treatment ; Correlation analysis ; Disease-Free Survival ; Feasibility Studies ; Female ; Follow-Up Studies ; Hepatectomy ; Hepatitis ; Hepatocellular carcinoma ; Humans ; Hypoxia ; Liver - pathology ; Liver - surgery ; Liver cancer ; Liver cirrhosis ; Liver Neoplasms - mortality ; Liver Neoplasms - pathology ; Liver Neoplasms - surgery ; Male ; Medical prognosis ; Metastasis ; Middle Aged ; Models, Statistical ; Multivariate analysis ; Necrosis ; Necrosis - epidemiology ; Necrosis - pathology ; Neoplasm Invasiveness - pathology ; Neoplasm Recurrence, Local - epidemiology ; Patient outcomes ; Patients ; Prognosis ; Radiofrequency ablation ; Recurrence (Disease) ; Retrospective Studies ; Risk Assessment - methods ; Risk Factors ; Small hepatocellular carcinoma ; Statistical analysis ; Survival ; Tumor Burden ; Tumor necrosis ; Tumors</subject><ispartof>BMC cancer, 2020-06, Vol.20 (1), p.607-607, Article 607</ispartof><rights>COPYRIGHT 2020 BioMed Central Ltd.</rights><rights>2020. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c628t-b71bcfbe4af7dbbb6634a0e3ff0f7b6b7b0ea931aab2eb91038aff09566dc8183</citedby><cites>FETCH-LOGICAL-c628t-b71bcfbe4af7dbbb6634a0e3ff0f7b6b7b0ea931aab2eb91038aff09566dc8183</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7325084/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7325084/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32600297$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ling, Yi-Hong</creatorcontrib><creatorcontrib>Chen, Jie-Wei</creatorcontrib><creatorcontrib>Wen, Shi-Hong</creatorcontrib><creatorcontrib>Huang, Chao-Yun</creatorcontrib><creatorcontrib>Li, Peng</creatorcontrib><creatorcontrib>Lu, Liang-He</creatorcontrib><creatorcontrib>Mei, Jie</creatorcontrib><creatorcontrib>Li, Shao-Hua</creatorcontrib><creatorcontrib>Wei, Wei</creatorcontrib><creatorcontrib>Cai, Mu-Yan</creatorcontrib><creatorcontrib>Guo, Rong-Ping</creatorcontrib><title>Tumor necrosis as a poor prognostic predictor on postoperative survival of patients with solitary small hepatocellular carcinoma</title><title>BMC cancer</title><addtitle>BMC Cancer</addtitle><description>Small hepatocellular carcinoma (sHCC) is a special subtype of HCC with the maximum tumor diameter ≤ 3 cm and excellent long-term outcomes. Surgical resection or radiofrequency ablation provides the greatest chance for cure; however, many patients still undergo tumor recurrence after primary treatment. To date, there is no clinical applicable method to assess biological aggressiveness in solitary sHCC.
In the current study, we retrospectively evaluated tumor necrosis of 335 patients with solitary sHCC treated with hepatectomy between December 1998 and 2010 from Sun Yat-sen University Cancer Center.
The presence of tumor necrosis was observed in 157 of 335 (46.9%) sHCC patients. Further correlation analysis showed that tumor necrosis was significantly correlated with tumor size and vascular invasion (P = 0.026, 0.003, respectively). The presence of tumor necrosis was associated closely with poorer cancer-specific overall survival (OS) and recurrence-free survival (RFS) as evidenced by univariate (P < 0.001; hazard ratio, 2.821; 95% CI, 1.643-4.842) and multivariate analysis (P = 0.005; hazard ratio, 2.208; 95% CI, 1.272-3.833). Notably, the combined model by tumor necrosis, vascular invasion and tumor size can significantly stratify the risk for RFS and OS and improve the ability to discriminate sHCC patients' outcomes (P < 0.0001 for both).
Our results provide evidence that tumor necrosis has the potential to be a parameter for cancer aggressiveness in solitary sHCC. The combined prognostic model may be a useful tool to identify solitary sHCC patients with worse outcomes.</description><subject>Ablation</subject><subject>Ablation (Surgery)</subject><subject>Cancer therapies</subject><subject>Carcinoma, Hepatocellular - mortality</subject><subject>Carcinoma, Hepatocellular - pathology</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>Care and treatment</subject><subject>Correlation analysis</subject><subject>Disease-Free Survival</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hepatectomy</subject><subject>Hepatitis</subject><subject>Hepatocellular carcinoma</subject><subject>Humans</subject><subject>Hypoxia</subject><subject>Liver - pathology</subject><subject>Liver - surgery</subject><subject>Liver cancer</subject><subject>Liver cirrhosis</subject><subject>Liver Neoplasms - mortality</subject><subject>Liver Neoplasms - pathology</subject><subject>Liver Neoplasms - surgery</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Models, Statistical</subject><subject>Multivariate analysis</subject><subject>Necrosis</subject><subject>Necrosis - epidemiology</subject><subject>Necrosis - pathology</subject><subject>Neoplasm Invasiveness - pathology</subject><subject>Neoplasm Recurrence, Local - epidemiology</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Radiofrequency ablation</subject><subject>Recurrence (Disease)</subject><subject>Retrospective Studies</subject><subject>Risk Assessment - methods</subject><subject>Risk Factors</subject><subject>Small hepatocellular carcinoma</subject><subject>Statistical analysis</subject><subject>Survival</subject><subject>Tumor Burden</subject><subject>Tumor necrosis</subject><subject>Tumors</subject><issn>1471-2407</issn><issn>1471-2407</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>DOA</sourceid><recordid>eNptUl2L1DAULaK46-of8EEKguhD13y1SV-EZfFjYEHQ9TncpOlMlrapSTrqmz_dOzvrMiOSQsK5557eezhF8ZySc0pV8zZRplRdEUYqIkkrq_pBcUqFpBUTRD48eJ8UT1K6IYRKRdTj4oSzhhDWytPi9_UyhlhOzsaQfCoBv3IOCM0xrKeQsrf4dJ23GcEwYTHlMLsI2W9dmZa49VsYytCXM0Juyqn84fOmTGHwGeKvMo0wDOXGYTlYNwzLALG0EK2fwghPi0c9DMk9u7vPim8f3l9ffqquPn9cXV5cVbZhKldGUmN74wT0sjPGNA0XQBzve9JL0xhpiIOWUwDDnGkp4Qqw1tZN01lFFT8rVnvdLsCNnqMfcTYdwOtbIMS1hojLDk47KYRVxDBW16LuhGqFbbnihJPa1oaj1ru91ryY0XUWl44wHIkeVya_0euw1ZKzmiiBAq_vBGL4vriU9ejTzhuYXFiSZoK2ROEYDVJf_kO9CUuc0CpkMSFRkh-w1oAL-KkP-F-7E9UX6B-jTNS7uc__w8LTudHbMLneI37U8OaoATnZ_cxrWFLSq69fjrmvDrgbB0PeYAaW7MOUjolsT9xFLkXX3xtHid4FW--DrTHY-jbYusamF4eW37f8TTL_A9bJ9Ew</recordid><startdate>20200629</startdate><enddate>20200629</enddate><creator>Ling, Yi-Hong</creator><creator>Chen, Jie-Wei</creator><creator>Wen, Shi-Hong</creator><creator>Huang, Chao-Yun</creator><creator>Li, Peng</creator><creator>Lu, Liang-He</creator><creator>Mei, Jie</creator><creator>Li, Shao-Hua</creator><creator>Wei, Wei</creator><creator>Cai, Mu-Yan</creator><creator>Guo, Rong-Ping</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ISR</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20200629</creationdate><title>Tumor necrosis as a poor prognostic predictor on postoperative survival of patients with solitary small hepatocellular carcinoma</title><author>Ling, Yi-Hong ; Chen, Jie-Wei ; Wen, Shi-Hong ; Huang, Chao-Yun ; Li, Peng ; Lu, Liang-He ; Mei, Jie ; Li, Shao-Hua ; Wei, Wei ; Cai, Mu-Yan ; Guo, Rong-Ping</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c628t-b71bcfbe4af7dbbb6634a0e3ff0f7b6b7b0ea931aab2eb91038aff09566dc8183</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Ablation</topic><topic>Ablation (Surgery)</topic><topic>Cancer therapies</topic><topic>Carcinoma, Hepatocellular - mortality</topic><topic>Carcinoma, Hepatocellular - pathology</topic><topic>Carcinoma, Hepatocellular - surgery</topic><topic>Care and treatment</topic><topic>Correlation analysis</topic><topic>Disease-Free Survival</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hepatectomy</topic><topic>Hepatitis</topic><topic>Hepatocellular carcinoma</topic><topic>Humans</topic><topic>Hypoxia</topic><topic>Liver - pathology</topic><topic>Liver - surgery</topic><topic>Liver cancer</topic><topic>Liver cirrhosis</topic><topic>Liver Neoplasms - mortality</topic><topic>Liver Neoplasms - pathology</topic><topic>Liver Neoplasms - surgery</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Models, Statistical</topic><topic>Multivariate analysis</topic><topic>Necrosis</topic><topic>Necrosis - epidemiology</topic><topic>Necrosis - pathology</topic><topic>Neoplasm Invasiveness - pathology</topic><topic>Neoplasm Recurrence, Local - epidemiology</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Radiofrequency ablation</topic><topic>Recurrence (Disease)</topic><topic>Retrospective Studies</topic><topic>Risk Assessment - methods</topic><topic>Risk Factors</topic><topic>Small hepatocellular carcinoma</topic><topic>Statistical analysis</topic><topic>Survival</topic><topic>Tumor Burden</topic><topic>Tumor necrosis</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ling, Yi-Hong</creatorcontrib><creatorcontrib>Chen, Jie-Wei</creatorcontrib><creatorcontrib>Wen, Shi-Hong</creatorcontrib><creatorcontrib>Huang, Chao-Yun</creatorcontrib><creatorcontrib>Li, Peng</creatorcontrib><creatorcontrib>Lu, Liang-He</creatorcontrib><creatorcontrib>Mei, Jie</creatorcontrib><creatorcontrib>Li, Shao-Hua</creatorcontrib><creatorcontrib>Wei, Wei</creatorcontrib><creatorcontrib>Cai, Mu-Yan</creatorcontrib><creatorcontrib>Guo, Rong-Ping</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Proquest Health and Medical Complete</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>BMC cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ling, Yi-Hong</au><au>Chen, Jie-Wei</au><au>Wen, Shi-Hong</au><au>Huang, Chao-Yun</au><au>Li, Peng</au><au>Lu, Liang-He</au><au>Mei, Jie</au><au>Li, Shao-Hua</au><au>Wei, Wei</au><au>Cai, Mu-Yan</au><au>Guo, Rong-Ping</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tumor necrosis as a poor prognostic predictor on postoperative survival of patients with solitary small hepatocellular carcinoma</atitle><jtitle>BMC cancer</jtitle><addtitle>BMC Cancer</addtitle><date>2020-06-29</date><risdate>2020</risdate><volume>20</volume><issue>1</issue><spage>607</spage><epage>607</epage><pages>607-607</pages><artnum>607</artnum><issn>1471-2407</issn><eissn>1471-2407</eissn><abstract>Small hepatocellular carcinoma (sHCC) is a special subtype of HCC with the maximum tumor diameter ≤ 3 cm and excellent long-term outcomes. Surgical resection or radiofrequency ablation provides the greatest chance for cure; however, many patients still undergo tumor recurrence after primary treatment. To date, there is no clinical applicable method to assess biological aggressiveness in solitary sHCC.
In the current study, we retrospectively evaluated tumor necrosis of 335 patients with solitary sHCC treated with hepatectomy between December 1998 and 2010 from Sun Yat-sen University Cancer Center.
The presence of tumor necrosis was observed in 157 of 335 (46.9%) sHCC patients. Further correlation analysis showed that tumor necrosis was significantly correlated with tumor size and vascular invasion (P = 0.026, 0.003, respectively). The presence of tumor necrosis was associated closely with poorer cancer-specific overall survival (OS) and recurrence-free survival (RFS) as evidenced by univariate (P < 0.001; hazard ratio, 2.821; 95% CI, 1.643-4.842) and multivariate analysis (P = 0.005; hazard ratio, 2.208; 95% CI, 1.272-3.833). Notably, the combined model by tumor necrosis, vascular invasion and tumor size can significantly stratify the risk for RFS and OS and improve the ability to discriminate sHCC patients' outcomes (P < 0.0001 for both).
Our results provide evidence that tumor necrosis has the potential to be a parameter for cancer aggressiveness in solitary sHCC. The combined prognostic model may be a useful tool to identify solitary sHCC patients with worse outcomes.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>32600297</pmid><doi>10.1186/s12885-020-07097-5</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | BMC cancer, 2020-06, Vol.20 (1), p.607-607, Article 607 |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; PubMed Central; EZB Electronic Journals Library; SpringerLink Journals - AutoHoldings; PubMed Central Open Access; Springer Nature OA Free Journals |
| subjects | Ablation Ablation (Surgery) Cancer therapies Carcinoma, Hepatocellular - mortality Carcinoma, Hepatocellular - pathology Carcinoma, Hepatocellular - surgery Care and treatment Correlation analysis Disease-Free Survival Feasibility Studies Female Follow-Up Studies Hepatectomy Hepatitis Hepatocellular carcinoma Humans Hypoxia Liver - pathology Liver - surgery Liver cancer Liver cirrhosis Liver Neoplasms - mortality Liver Neoplasms - pathology Liver Neoplasms - surgery Male Medical prognosis Metastasis Middle Aged Models, Statistical Multivariate analysis Necrosis Necrosis - epidemiology Necrosis - pathology Neoplasm Invasiveness - pathology Neoplasm Recurrence, Local - epidemiology Patient outcomes Patients Prognosis Radiofrequency ablation Recurrence (Disease) Retrospective Studies Risk Assessment - methods Risk Factors Small hepatocellular carcinoma Statistical analysis Survival Tumor Burden Tumor necrosis Tumors |
| title | Tumor necrosis as a poor prognostic predictor on postoperative survival of patients with solitary small hepatocellular carcinoma |
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