Prognostic Role of Time to Surgery in Hepatocellular Carcinoma at Barcelona Clinic Liver Cancer Stage 0-A
Background Postsurgical recurrence is common in early-stage hepatocellular carcinoma (HCC). Prolonged time to surgery (TTS) may lead to tumor progression. However, the impact of TTS on HCC prognosis is controversial in Western studies and unknown in China. We aim to investigate the impact of TTS on...
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Veröffentlicht in: | Annals of surgical oncology 2020-10, Vol.27 (10), p.3740-3753 |
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creator | Wei, Mengchao Chen, Shuling Li, Jiali Li, Bin Shen, Jingxian Peng, Zhenwei Zhou, Qian Zou, Ying He, Xiaofang Li, Shaoqiang Li, Dongming Peng, Baogang Lai, Jiaming Peng, Sui Qin, Beijiao Kuang, Ming |
description | Background
Postsurgical recurrence is common in early-stage hepatocellular carcinoma (HCC). Prolonged time to surgery (TTS) may lead to tumor progression. However, the impact of TTS on HCC prognosis is controversial in Western studies and unknown in China. We aim to investigate the impact of TTS on the prognosis of Chinese HCC patients at Barcelona Clinic Liver Cancer (BCLC) stage 0-A who underwent surgery.
Patients and Methods
We retrospectively enrolled 967 BCLC 0-A HCC patients who underwent surgery at three tertiary centers in China. Primary outcomes were recurrence-free survival (RFS) and overall survival (OS). Restricted cubic spline (RCS) was used to select the cutoff value of TTS. Propensity score matching (PSM) was performed to reduce confounding bias, and a time-dependent Cox model was utilized to investigate factors influencing TTS.
Results
The median TTS of BCLC 0-A HCC patients was 13 days (interquartile range: 10–21 days). For patients with TTS ≤ 70 days, the cutoff value of TTS was 13 days according to RCS. After PSM, corresponding 1-, 3-, and 5-year RFS of the TTS > 13 days and TTS ≤ 13 days groups were 75.6%, 55.3%, 46.4% and 71.2%, 52.3%, 38.8%, respectively (
P
= 0.103). Corresponding 1-, 3-, and 5-year OS of TTS > 13 days and TTS ≤ 13 days groups were 93.7%, 82.8%, 69.6% and 92.4%, 78.5%, 68.4%, respectively (
P
= 0.580). Time-dependent Cox analysis revealed that age and tumor size were factors influencing TTS.
Conclusions
Our study suggests that, for patients with TTS ≤ 70 days, prolonged TTS had no impact on BCLC 0-A Chinese HCC patients receiving surgery. |
doi_str_mv | 10.1245/s10434-020-08499-2 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2439756134</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2439756134</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-894d505aeade6909d1f8ee19367931e1df794b9de87bbfafc272ddb9d2f58be73</originalsourceid><addsrcrecordid>eNp9kE1Lw0AQhhdRrFb_gAdZ8BzdzyR7rEGtUFBsPS-bZFJSkmzdTYT-e7em6s3T7M688ww8CF1RckuZkHeeEsFFRBiJSCqUitgROqMytESc0uPwJnEaKRbLCTr3fkMITTiRp2jCmQiAND5D9auz6876vi7wm20A2wqv6hZwb_FycGtwO1x3eA5b09sCmmZojMOZcUXd2dZg0-P78IHGdgZnTd0FzqL-hH2mK0JZ9mYNmESzC3RSmcbD5aFO0fvjwyqbR4uXp-dstogKnsg-SpUoJZEGTAmxIqqkVQpAFY8TxSnQskqUyFUJaZLnlakKlrCyDA1WyTSHhE_RzcjdOvsxgO_1xg6uCyc1E1wlMqZchBQbU4Wz3juo9NbVrXE7TYne29WjXR3s6m-7moWl6wN6yFsof1d-dIYAHwM-jLog7-_2P9gvIASFNg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2439756134</pqid></control><display><type>article</type><title>Prognostic Role of Time to Surgery in Hepatocellular Carcinoma at Barcelona Clinic Liver Cancer Stage 0-A</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Wei, Mengchao ; Chen, Shuling ; Li, Jiali ; Li, Bin ; Shen, Jingxian ; Peng, Zhenwei ; Zhou, Qian ; Zou, Ying ; He, Xiaofang ; Li, Shaoqiang ; Li, Dongming ; Peng, Baogang ; Lai, Jiaming ; Peng, Sui ; Qin, Beijiao ; Kuang, Ming</creator><creatorcontrib>Wei, Mengchao ; Chen, Shuling ; Li, Jiali ; Li, Bin ; Shen, Jingxian ; Peng, Zhenwei ; Zhou, Qian ; Zou, Ying ; He, Xiaofang ; Li, Shaoqiang ; Li, Dongming ; Peng, Baogang ; Lai, Jiaming ; Peng, Sui ; Qin, Beijiao ; Kuang, Ming</creatorcontrib><description>Background
Postsurgical recurrence is common in early-stage hepatocellular carcinoma (HCC). Prolonged time to surgery (TTS) may lead to tumor progression. However, the impact of TTS on HCC prognosis is controversial in Western studies and unknown in China. We aim to investigate the impact of TTS on the prognosis of Chinese HCC patients at Barcelona Clinic Liver Cancer (BCLC) stage 0-A who underwent surgery.
Patients and Methods
We retrospectively enrolled 967 BCLC 0-A HCC patients who underwent surgery at three tertiary centers in China. Primary outcomes were recurrence-free survival (RFS) and overall survival (OS). Restricted cubic spline (RCS) was used to select the cutoff value of TTS. Propensity score matching (PSM) was performed to reduce confounding bias, and a time-dependent Cox model was utilized to investigate factors influencing TTS.
Results
The median TTS of BCLC 0-A HCC patients was 13 days (interquartile range: 10–21 days). For patients with TTS ≤ 70 days, the cutoff value of TTS was 13 days according to RCS. After PSM, corresponding 1-, 3-, and 5-year RFS of the TTS > 13 days and TTS ≤ 13 days groups were 75.6%, 55.3%, 46.4% and 71.2%, 52.3%, 38.8%, respectively (
P
= 0.103). Corresponding 1-, 3-, and 5-year OS of TTS > 13 days and TTS ≤ 13 days groups were 93.7%, 82.8%, 69.6% and 92.4%, 78.5%, 68.4%, respectively (
P
= 0.580). Time-dependent Cox analysis revealed that age and tumor size were factors influencing TTS.
Conclusions
Our study suggests that, for patients with TTS ≤ 70 days, prolonged TTS had no impact on BCLC 0-A Chinese HCC patients receiving surgery.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-020-08499-2</identifier><identifier>PMID: 32424586</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Carcinoma, Hepatocellular - pathology ; Carcinoma, Hepatocellular - surgery ; China - ethnology ; Hepatobiliary Tumors ; Hepatocellular carcinoma ; Humans ; Liver cancer ; Liver Neoplasms - pathology ; Liver Neoplasms - surgery ; Medical prognosis ; Medicine ; Medicine & Public Health ; Neoplasm Recurrence, Local - pathology ; Neoplasm Recurrence, Local - surgery ; Neoplasm Staging ; Oncology ; Prognosis ; Retrospective Studies ; Spain - epidemiology ; Surgery ; Surgical Oncology ; Survival</subject><ispartof>Annals of surgical oncology, 2020-10, Vol.27 (10), p.3740-3753</ispartof><rights>Society of Surgical Oncology 2020</rights><rights>Society of Surgical Oncology 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-894d505aeade6909d1f8ee19367931e1df794b9de87bbfafc272ddb9d2f58be73</citedby><cites>FETCH-LOGICAL-c375t-894d505aeade6909d1f8ee19367931e1df794b9de87bbfafc272ddb9d2f58be73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-020-08499-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-020-08499-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32424586$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wei, Mengchao</creatorcontrib><creatorcontrib>Chen, Shuling</creatorcontrib><creatorcontrib>Li, Jiali</creatorcontrib><creatorcontrib>Li, Bin</creatorcontrib><creatorcontrib>Shen, Jingxian</creatorcontrib><creatorcontrib>Peng, Zhenwei</creatorcontrib><creatorcontrib>Zhou, Qian</creatorcontrib><creatorcontrib>Zou, Ying</creatorcontrib><creatorcontrib>He, Xiaofang</creatorcontrib><creatorcontrib>Li, Shaoqiang</creatorcontrib><creatorcontrib>Li, Dongming</creatorcontrib><creatorcontrib>Peng, Baogang</creatorcontrib><creatorcontrib>Lai, Jiaming</creatorcontrib><creatorcontrib>Peng, Sui</creatorcontrib><creatorcontrib>Qin, Beijiao</creatorcontrib><creatorcontrib>Kuang, Ming</creatorcontrib><title>Prognostic Role of Time to Surgery in Hepatocellular Carcinoma at Barcelona Clinic Liver Cancer Stage 0-A</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
Postsurgical recurrence is common in early-stage hepatocellular carcinoma (HCC). Prolonged time to surgery (TTS) may lead to tumor progression. However, the impact of TTS on HCC prognosis is controversial in Western studies and unknown in China. We aim to investigate the impact of TTS on the prognosis of Chinese HCC patients at Barcelona Clinic Liver Cancer (BCLC) stage 0-A who underwent surgery.
Patients and Methods
We retrospectively enrolled 967 BCLC 0-A HCC patients who underwent surgery at three tertiary centers in China. Primary outcomes were recurrence-free survival (RFS) and overall survival (OS). Restricted cubic spline (RCS) was used to select the cutoff value of TTS. Propensity score matching (PSM) was performed to reduce confounding bias, and a time-dependent Cox model was utilized to investigate factors influencing TTS.
Results
The median TTS of BCLC 0-A HCC patients was 13 days (interquartile range: 10–21 days). For patients with TTS ≤ 70 days, the cutoff value of TTS was 13 days according to RCS. After PSM, corresponding 1-, 3-, and 5-year RFS of the TTS > 13 days and TTS ≤ 13 days groups were 75.6%, 55.3%, 46.4% and 71.2%, 52.3%, 38.8%, respectively (
P
= 0.103). Corresponding 1-, 3-, and 5-year OS of TTS > 13 days and TTS ≤ 13 days groups were 93.7%, 82.8%, 69.6% and 92.4%, 78.5%, 68.4%, respectively (
P
= 0.580). Time-dependent Cox analysis revealed that age and tumor size were factors influencing TTS.
Conclusions
Our study suggests that, for patients with TTS ≤ 70 days, prolonged TTS had no impact on BCLC 0-A Chinese HCC patients receiving surgery.</description><subject>Carcinoma, Hepatocellular - pathology</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>China - ethnology</subject><subject>Hepatobiliary Tumors</subject><subject>Hepatocellular carcinoma</subject><subject>Humans</subject><subject>Liver cancer</subject><subject>Liver Neoplasms - pathology</subject><subject>Liver Neoplasms - surgery</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Recurrence, Local - surgery</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Spain - epidemiology</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Survival</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kE1Lw0AQhhdRrFb_gAdZ8BzdzyR7rEGtUFBsPS-bZFJSkmzdTYT-e7em6s3T7M688ww8CF1RckuZkHeeEsFFRBiJSCqUitgROqMytESc0uPwJnEaKRbLCTr3fkMITTiRp2jCmQiAND5D9auz6876vi7wm20A2wqv6hZwb_FycGtwO1x3eA5b09sCmmZojMOZcUXd2dZg0-P78IHGdgZnTd0FzqL-hH2mK0JZ9mYNmESzC3RSmcbD5aFO0fvjwyqbR4uXp-dstogKnsg-SpUoJZEGTAmxIqqkVQpAFY8TxSnQskqUyFUJaZLnlakKlrCyDA1WyTSHhE_RzcjdOvsxgO_1xg6uCyc1E1wlMqZchBQbU4Wz3juo9NbVrXE7TYne29WjXR3s6m-7moWl6wN6yFsof1d-dIYAHwM-jLog7-_2P9gvIASFNg</recordid><startdate>20201001</startdate><enddate>20201001</enddate><creator>Wei, Mengchao</creator><creator>Chen, Shuling</creator><creator>Li, Jiali</creator><creator>Li, Bin</creator><creator>Shen, Jingxian</creator><creator>Peng, Zhenwei</creator><creator>Zhou, Qian</creator><creator>Zou, Ying</creator><creator>He, Xiaofang</creator><creator>Li, Shaoqiang</creator><creator>Li, Dongming</creator><creator>Peng, Baogang</creator><creator>Lai, Jiaming</creator><creator>Peng, Sui</creator><creator>Qin, Beijiao</creator><creator>Kuang, Ming</creator><general>Springer International Publishing</general><general>Springer Nature B.V</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>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope></search><sort><creationdate>20201001</creationdate><title>Prognostic Role of Time to Surgery in Hepatocellular Carcinoma at Barcelona Clinic Liver Cancer Stage 0-A</title><author>Wei, Mengchao ; Chen, Shuling ; Li, Jiali ; Li, Bin ; Shen, Jingxian ; Peng, Zhenwei ; Zhou, Qian ; Zou, Ying ; He, Xiaofang ; Li, Shaoqiang ; Li, Dongming ; Peng, Baogang ; Lai, Jiaming ; Peng, Sui ; Qin, Beijiao ; Kuang, Ming</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-894d505aeade6909d1f8ee19367931e1df794b9de87bbfafc272ddb9d2f58be73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Carcinoma, Hepatocellular - pathology</topic><topic>Carcinoma, Hepatocellular - surgery</topic><topic>China - ethnology</topic><topic>Hepatobiliary Tumors</topic><topic>Hepatocellular carcinoma</topic><topic>Humans</topic><topic>Liver cancer</topic><topic>Liver Neoplasms - pathology</topic><topic>Liver Neoplasms - surgery</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neoplasm Recurrence, Local - surgery</topic><topic>Neoplasm Staging</topic><topic>Oncology</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Spain - epidemiology</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Survival</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wei, Mengchao</creatorcontrib><creatorcontrib>Chen, Shuling</creatorcontrib><creatorcontrib>Li, Jiali</creatorcontrib><creatorcontrib>Li, Bin</creatorcontrib><creatorcontrib>Shen, Jingxian</creatorcontrib><creatorcontrib>Peng, Zhenwei</creatorcontrib><creatorcontrib>Zhou, Qian</creatorcontrib><creatorcontrib>Zou, Ying</creatorcontrib><creatorcontrib>He, Xiaofang</creatorcontrib><creatorcontrib>Li, Shaoqiang</creatorcontrib><creatorcontrib>Li, Dongming</creatorcontrib><creatorcontrib>Peng, Baogang</creatorcontrib><creatorcontrib>Lai, Jiaming</creatorcontrib><creatorcontrib>Peng, Sui</creatorcontrib><creatorcontrib>Qin, Beijiao</creatorcontrib><creatorcontrib>Kuang, Ming</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</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 Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</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>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wei, Mengchao</au><au>Chen, Shuling</au><au>Li, Jiali</au><au>Li, Bin</au><au>Shen, Jingxian</au><au>Peng, Zhenwei</au><au>Zhou, Qian</au><au>Zou, Ying</au><au>He, Xiaofang</au><au>Li, Shaoqiang</au><au>Li, Dongming</au><au>Peng, Baogang</au><au>Lai, Jiaming</au><au>Peng, Sui</au><au>Qin, Beijiao</au><au>Kuang, Ming</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic Role of Time to Surgery in Hepatocellular Carcinoma at Barcelona Clinic Liver Cancer Stage 0-A</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2020-10-01</date><risdate>2020</risdate><volume>27</volume><issue>10</issue><spage>3740</spage><epage>3753</epage><pages>3740-3753</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Background
Postsurgical recurrence is common in early-stage hepatocellular carcinoma (HCC). Prolonged time to surgery (TTS) may lead to tumor progression. However, the impact of TTS on HCC prognosis is controversial in Western studies and unknown in China. We aim to investigate the impact of TTS on the prognosis of Chinese HCC patients at Barcelona Clinic Liver Cancer (BCLC) stage 0-A who underwent surgery.
Patients and Methods
We retrospectively enrolled 967 BCLC 0-A HCC patients who underwent surgery at three tertiary centers in China. Primary outcomes were recurrence-free survival (RFS) and overall survival (OS). Restricted cubic spline (RCS) was used to select the cutoff value of TTS. Propensity score matching (PSM) was performed to reduce confounding bias, and a time-dependent Cox model was utilized to investigate factors influencing TTS.
Results
The median TTS of BCLC 0-A HCC patients was 13 days (interquartile range: 10–21 days). For patients with TTS ≤ 70 days, the cutoff value of TTS was 13 days according to RCS. After PSM, corresponding 1-, 3-, and 5-year RFS of the TTS > 13 days and TTS ≤ 13 days groups were 75.6%, 55.3%, 46.4% and 71.2%, 52.3%, 38.8%, respectively (
P
= 0.103). Corresponding 1-, 3-, and 5-year OS of TTS > 13 days and TTS ≤ 13 days groups were 93.7%, 82.8%, 69.6% and 92.4%, 78.5%, 68.4%, respectively (
P
= 0.580). Time-dependent Cox analysis revealed that age and tumor size were factors influencing TTS.
Conclusions
Our study suggests that, for patients with TTS ≤ 70 days, prolonged TTS had no impact on BCLC 0-A Chinese HCC patients receiving surgery.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>32424586</pmid><doi>10.1245/s10434-020-08499-2</doi><tpages>14</tpages></addata></record> |
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subjects | Carcinoma, Hepatocellular - pathology Carcinoma, Hepatocellular - surgery China - ethnology Hepatobiliary Tumors Hepatocellular carcinoma Humans Liver cancer Liver Neoplasms - pathology Liver Neoplasms - surgery Medical prognosis Medicine Medicine & Public Health Neoplasm Recurrence, Local - pathology Neoplasm Recurrence, Local - surgery Neoplasm Staging Oncology Prognosis Retrospective Studies Spain - epidemiology Surgery Surgical Oncology Survival |
title | Prognostic Role of Time to Surgery in Hepatocellular Carcinoma at Barcelona Clinic Liver Cancer Stage 0-A |
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