Impact of Bile Duct Tumor Thrombus on the Long-Term Surgical Outcomes of Hepatocellular Carcinoma Patients: A Propensity Score Matching Analysis
Background Hepatectomy with tumor thrombectomy is the preferred treatment option for hepatocellular carcinoma (HCC) patients with bile duct tumor thrombus (BDTT); however, the impact of BDTT on their prognosis is unclear. Objective We aimed to investigate the long-term surgical outcomes of HCC patie...
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| Veröffentlicht in: | Annals of surgical oncology 2022-02, Vol.29 (2), p.949-958 |
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| creator | Wu, Jun-Yi Sun, Ju-Xian Wu, Jia-Yi Huang, Xiao-Xiao Bai, Yan-nan Wei, Yong-Gang Zhang, Zhi-Bo Zhou, Jian-Yin Cheng, Shu-Qun Yan, Mao-Lin |
| description | Background
Hepatectomy with tumor thrombectomy is the preferred treatment option for hepatocellular carcinoma (HCC) patients with bile duct tumor thrombus (BDTT); however, the impact of BDTT on their prognosis is unclear.
Objective
We aimed to investigate the long-term surgical outcomes of HCC patients with BDTT.
Methods
The data of HCC patients with and without BDTT who underwent hepatectomy were retrospectively reviewed and the long-term outcomes were compared. For propensity score matching (PSM) analysis, patients were matched in a 1:1 ratio. Subgroup analysis was conducted according to the American Joint Committee on Cancer (AJCC) staging system.
Results
Before PSM, HCC patients with BDTT had more advanced tumor stages and adverse clinicopathological features. Recurrence-free survival (RFS) and overall survival (OS) were significantly higher in the non-BDTT group before PSM (RFS,
p
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| doi_str_mv | 10.1245/s10434-021-10799-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2578154826</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2616134961</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-1b3f9a0c7282852a0a1a383f8687fea16d925c098b79aa485f11424cddb1500b3</originalsourceid><addsrcrecordid>eNp9kctu1DAUhi1ERcvAC7BAltiwCfj4kjjshuHSSlO1Uod1dOJxZlIlcfBlMW_BI-PpFJBYdOPj4_P9v4_0E_IG2AfgUn0MwKSQBeNQAKvqumDPyAWo_CRLDc_znZW6qHmpzsnLEO4Zg0ow9YKcC6lq4Ly8IL-uxhlNpK6jn_vB0i8pN5s0Ok83e-_GNgXqJhr3lq7dtCs21o_0Lvldb3CgNykaN9pwlF_aGaMzdhjSgJ6u0Jt-ciPSW4y9nWL4RJf01rvZTqGPB3pnnLf0GqPZ99OOLiccDqEPr8hZh0Owrx_rgvz49nWzuizWN9-vVst1YUSlYgGt6GpkpuKaa8WRIaDQotOlrjqLUG5rrgyrdVvViFKrDkByabbbFhRjrViQ9yff2bufyYbYjH04bo-TdSk0XFUalNS8zOi7_9B7l3zeN1MllCBknY8F4SfKeBeCt10z-35Ef2iANce8mlNeTc6recirYVn09tE6taPd_pX8CSgD4gSEPJp21v_7-wnb3x4VoI4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2616134961</pqid></control><display><type>article</type><title>Impact of Bile Duct Tumor Thrombus on the Long-Term Surgical Outcomes of Hepatocellular Carcinoma Patients: A Propensity Score Matching Analysis</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Wu, Jun-Yi ; Sun, Ju-Xian ; Wu, Jia-Yi ; Huang, Xiao-Xiao ; Bai, Yan-nan ; Wei, Yong-Gang ; Zhang, Zhi-Bo ; Zhou, Jian-Yin ; Cheng, Shu-Qun ; Yan, Mao-Lin</creator><creatorcontrib>Wu, Jun-Yi ; Sun, Ju-Xian ; Wu, Jia-Yi ; Huang, Xiao-Xiao ; Bai, Yan-nan ; Wei, Yong-Gang ; Zhang, Zhi-Bo ; Zhou, Jian-Yin ; Cheng, Shu-Qun ; Yan, Mao-Lin</creatorcontrib><description>Background
Hepatectomy with tumor thrombectomy is the preferred treatment option for hepatocellular carcinoma (HCC) patients with bile duct tumor thrombus (BDTT); however, the impact of BDTT on their prognosis is unclear.
Objective
We aimed to investigate the long-term surgical outcomes of HCC patients with BDTT.
Methods
The data of HCC patients with and without BDTT who underwent hepatectomy were retrospectively reviewed and the long-term outcomes were compared. For propensity score matching (PSM) analysis, patients were matched in a 1:1 ratio. Subgroup analysis was conducted according to the American Joint Committee on Cancer (AJCC) staging system.
Results
Before PSM, HCC patients with BDTT had more advanced tumor stages and adverse clinicopathological features. Recurrence-free survival (RFS) and overall survival (OS) were significantly higher in the non-BDTT group before PSM (RFS,
p
< 0.001; OS,
p
< 0.001), while after PSM, the BDTT group had significantly poorer RFS (
p
= 0.025). There was no difference in OS between the groups (
p
= 0.588). Subgroup analysis showed that RFS and OS in AJCC stage I–II patients were significantly poorer in the BDTT group; no differences were found in the AJCC stage III group before or after PSM. When the presence of BDTT was recommended to increase the AJCC staging system by one stage in AJCC stage I–II patients, the predictive ability for RFS and OS was higher.
Conclusions
BDTT was associated with significantly poorer long-term surgical outcomes in AJCC stage I–II patients. A modified AJCC staging system including BDTT status in stage I–II might have a better prognostic ability.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-021-10799-0</identifier><identifier>PMID: 34591226</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Bile Duct Neoplasms - surgery ; Bile ducts ; Blood clots ; Carcinoma, Hepatocellular - surgery ; Hepatectomy ; Hepatobiliary Tumors ; Hepatocellular carcinoma ; Humans ; Liver cancer ; Liver Neoplasms - surgery ; Medical prognosis ; Medicine ; Medicine & Public Health ; Oncology ; Patients ; Propensity Score ; Retrospective Studies ; Surgery ; Surgical Oncology ; Surgical outcomes ; Survival ; Thrombosis ; Thrombosis - etiology ; Thrombosis - surgery ; Treatment Outcome ; Tumors</subject><ispartof>Annals of surgical oncology, 2022-02, Vol.29 (2), p.949-958</ispartof><rights>Society of Surgical Oncology 2022. corrected publication 2022</rights><rights>2021. Society of Surgical Oncology.</rights><rights>Society of Surgical Oncology 2022. corrected publication 2022.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-1b3f9a0c7282852a0a1a383f8687fea16d925c098b79aa485f11424cddb1500b3</citedby><cites>FETCH-LOGICAL-c375t-1b3f9a0c7282852a0a1a383f8687fea16d925c098b79aa485f11424cddb1500b3</cites><orcidid>0000-0001-5371-8989</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-021-10799-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-021-10799-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34591226$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wu, Jun-Yi</creatorcontrib><creatorcontrib>Sun, Ju-Xian</creatorcontrib><creatorcontrib>Wu, Jia-Yi</creatorcontrib><creatorcontrib>Huang, Xiao-Xiao</creatorcontrib><creatorcontrib>Bai, Yan-nan</creatorcontrib><creatorcontrib>Wei, Yong-Gang</creatorcontrib><creatorcontrib>Zhang, Zhi-Bo</creatorcontrib><creatorcontrib>Zhou, Jian-Yin</creatorcontrib><creatorcontrib>Cheng, Shu-Qun</creatorcontrib><creatorcontrib>Yan, Mao-Lin</creatorcontrib><title>Impact of Bile Duct Tumor Thrombus on the Long-Term Surgical Outcomes of Hepatocellular Carcinoma Patients: A Propensity Score Matching Analysis</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
Hepatectomy with tumor thrombectomy is the preferred treatment option for hepatocellular carcinoma (HCC) patients with bile duct tumor thrombus (BDTT); however, the impact of BDTT on their prognosis is unclear.
Objective
We aimed to investigate the long-term surgical outcomes of HCC patients with BDTT.
Methods
The data of HCC patients with and without BDTT who underwent hepatectomy were retrospectively reviewed and the long-term outcomes were compared. For propensity score matching (PSM) analysis, patients were matched in a 1:1 ratio. Subgroup analysis was conducted according to the American Joint Committee on Cancer (AJCC) staging system.
Results
Before PSM, HCC patients with BDTT had more advanced tumor stages and adverse clinicopathological features. Recurrence-free survival (RFS) and overall survival (OS) were significantly higher in the non-BDTT group before PSM (RFS,
p
< 0.001; OS,
p
< 0.001), while after PSM, the BDTT group had significantly poorer RFS (
p
= 0.025). There was no difference in OS between the groups (
p
= 0.588). Subgroup analysis showed that RFS and OS in AJCC stage I–II patients were significantly poorer in the BDTT group; no differences were found in the AJCC stage III group before or after PSM. When the presence of BDTT was recommended to increase the AJCC staging system by one stage in AJCC stage I–II patients, the predictive ability for RFS and OS was higher.
Conclusions
BDTT was associated with significantly poorer long-term surgical outcomes in AJCC stage I–II patients. A modified AJCC staging system including BDTT status in stage I–II might have a better prognostic ability.</description><subject>Bile Duct Neoplasms - surgery</subject><subject>Bile ducts</subject><subject>Blood clots</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>Hepatectomy</subject><subject>Hepatobiliary Tumors</subject><subject>Hepatocellular carcinoma</subject><subject>Humans</subject><subject>Liver cancer</subject><subject>Liver Neoplasms - surgery</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Oncology</subject><subject>Patients</subject><subject>Propensity Score</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Surgical outcomes</subject><subject>Survival</subject><subject>Thrombosis</subject><subject>Thrombosis - etiology</subject><subject>Thrombosis - surgery</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kctu1DAUhi1ERcvAC7BAltiwCfj4kjjshuHSSlO1Uod1dOJxZlIlcfBlMW_BI-PpFJBYdOPj4_P9v4_0E_IG2AfgUn0MwKSQBeNQAKvqumDPyAWo_CRLDc_znZW6qHmpzsnLEO4Zg0ow9YKcC6lq4Ly8IL-uxhlNpK6jn_vB0i8pN5s0Ok83e-_GNgXqJhr3lq7dtCs21o_0Lvldb3CgNykaN9pwlF_aGaMzdhjSgJ6u0Jt-ciPSW4y9nWL4RJf01rvZTqGPB3pnnLf0GqPZ99OOLiccDqEPr8hZh0Owrx_rgvz49nWzuizWN9-vVst1YUSlYgGt6GpkpuKaa8WRIaDQotOlrjqLUG5rrgyrdVvViFKrDkByabbbFhRjrViQ9yff2bufyYbYjH04bo-TdSk0XFUalNS8zOi7_9B7l3zeN1MllCBknY8F4SfKeBeCt10z-35Ef2iANce8mlNeTc6recirYVn09tE6taPd_pX8CSgD4gSEPJp21v_7-wnb3x4VoI4</recordid><startdate>20220201</startdate><enddate>20220201</enddate><creator>Wu, Jun-Yi</creator><creator>Sun, Ju-Xian</creator><creator>Wu, Jia-Yi</creator><creator>Huang, Xiao-Xiao</creator><creator>Bai, Yan-nan</creator><creator>Wei, Yong-Gang</creator><creator>Zhang, Zhi-Bo</creator><creator>Zhou, Jian-Yin</creator><creator>Cheng, Shu-Qun</creator><creator>Yan, Mao-Lin</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><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5371-8989</orcidid></search><sort><creationdate>20220201</creationdate><title>Impact of Bile Duct Tumor Thrombus on the Long-Term Surgical Outcomes of Hepatocellular Carcinoma Patients: A Propensity Score Matching Analysis</title><author>Wu, Jun-Yi ; Sun, Ju-Xian ; Wu, Jia-Yi ; Huang, Xiao-Xiao ; Bai, Yan-nan ; Wei, Yong-Gang ; Zhang, Zhi-Bo ; Zhou, Jian-Yin ; Cheng, Shu-Qun ; Yan, Mao-Lin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-1b3f9a0c7282852a0a1a383f8687fea16d925c098b79aa485f11424cddb1500b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Bile Duct Neoplasms - surgery</topic><topic>Bile ducts</topic><topic>Blood clots</topic><topic>Carcinoma, Hepatocellular - surgery</topic><topic>Hepatectomy</topic><topic>Hepatobiliary Tumors</topic><topic>Hepatocellular carcinoma</topic><topic>Humans</topic><topic>Liver cancer</topic><topic>Liver Neoplasms - surgery</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Oncology</topic><topic>Patients</topic><topic>Propensity Score</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Surgical outcomes</topic><topic>Survival</topic><topic>Thrombosis</topic><topic>Thrombosis - etiology</topic><topic>Thrombosis - surgery</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wu, Jun-Yi</creatorcontrib><creatorcontrib>Sun, Ju-Xian</creatorcontrib><creatorcontrib>Wu, Jia-Yi</creatorcontrib><creatorcontrib>Huang, Xiao-Xiao</creatorcontrib><creatorcontrib>Bai, Yan-nan</creatorcontrib><creatorcontrib>Wei, Yong-Gang</creatorcontrib><creatorcontrib>Zhang, Zhi-Bo</creatorcontrib><creatorcontrib>Zhou, Jian-Yin</creatorcontrib><creatorcontrib>Cheng, Shu-Qun</creatorcontrib><creatorcontrib>Yan, Mao-Lin</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><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wu, Jun-Yi</au><au>Sun, Ju-Xian</au><au>Wu, Jia-Yi</au><au>Huang, Xiao-Xiao</au><au>Bai, Yan-nan</au><au>Wei, Yong-Gang</au><au>Zhang, Zhi-Bo</au><au>Zhou, Jian-Yin</au><au>Cheng, Shu-Qun</au><au>Yan, Mao-Lin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Bile Duct Tumor Thrombus on the Long-Term Surgical Outcomes of Hepatocellular Carcinoma Patients: A Propensity Score Matching Analysis</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2022-02-01</date><risdate>2022</risdate><volume>29</volume><issue>2</issue><spage>949</spage><epage>958</epage><pages>949-958</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Background
Hepatectomy with tumor thrombectomy is the preferred treatment option for hepatocellular carcinoma (HCC) patients with bile duct tumor thrombus (BDTT); however, the impact of BDTT on their prognosis is unclear.
Objective
We aimed to investigate the long-term surgical outcomes of HCC patients with BDTT.
Methods
The data of HCC patients with and without BDTT who underwent hepatectomy were retrospectively reviewed and the long-term outcomes were compared. For propensity score matching (PSM) analysis, patients were matched in a 1:1 ratio. Subgroup analysis was conducted according to the American Joint Committee on Cancer (AJCC) staging system.
Results
Before PSM, HCC patients with BDTT had more advanced tumor stages and adverse clinicopathological features. Recurrence-free survival (RFS) and overall survival (OS) were significantly higher in the non-BDTT group before PSM (RFS,
p
< 0.001; OS,
p
< 0.001), while after PSM, the BDTT group had significantly poorer RFS (
p
= 0.025). There was no difference in OS between the groups (
p
= 0.588). Subgroup analysis showed that RFS and OS in AJCC stage I–II patients were significantly poorer in the BDTT group; no differences were found in the AJCC stage III group before or after PSM. When the presence of BDTT was recommended to increase the AJCC staging system by one stage in AJCC stage I–II patients, the predictive ability for RFS and OS was higher.
Conclusions
BDTT was associated with significantly poorer long-term surgical outcomes in AJCC stage I–II patients. A modified AJCC staging system including BDTT status in stage I–II might have a better prognostic ability.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>34591226</pmid><doi>10.1245/s10434-021-10799-0</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-5371-8989</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2022-02, Vol.29 (2), p.949-958 |
| issn | 1068-9265 1534-4681 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Bile Duct Neoplasms - surgery Bile ducts Blood clots Carcinoma, Hepatocellular - surgery Hepatectomy Hepatobiliary Tumors Hepatocellular carcinoma Humans Liver cancer Liver Neoplasms - surgery Medical prognosis Medicine Medicine & Public Health Oncology Patients Propensity Score Retrospective Studies Surgery Surgical Oncology Surgical outcomes Survival Thrombosis Thrombosis - etiology Thrombosis - surgery Treatment Outcome Tumors |
| title | Impact of Bile Duct Tumor Thrombus on the Long-Term Surgical Outcomes of Hepatocellular Carcinoma Patients: A Propensity Score Matching Analysis |
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