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
Hauptverfasser: 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
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container_end_page 3753
container_issue 10
container_start_page 3740
container_title Annals of surgical oncology
container_volume 27
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
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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 &gt; 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 &gt; 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 &amp; 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 &gt; 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 &gt; 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 &amp; 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 &amp; 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 &amp; 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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 &gt; 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 &gt; 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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