Postoperative Adjuvant TACE-associated Nomogram for Predicting the Prognosis of Resectable Hepatocellular Carcinoma with Portal Vein Tumor Thrombus After Liver Resection

Overview

Journal Int J Biol Sci

Specialty Biology

Date 2020 Nov 9

PMID 33162826

Citations 18

Authors

Fuchen Liu

Xinggang Guo

Wei Dong

Wenli Zhang

Shuxun Wei

Shutong Zhang

Xiuli Zhu

Weiping Zhou

Jinmin Zhang

Hui Liu

Affiliations

Soon will be listed here.

Abstract

To explore the effects of postoperative adjuvant transarterial chemoembolization (PA-TACE) on the prognosis of HCC patients with Portal Vein Tumor Thrombus (PVTT) undergoing resection, and to develop a PA-TACE-related nomogram for predicting survival individually. Two hundred and ninety-three consecutive HCC patients with PVTT under R0 hepatectomy were recruited. Forty-seven cases had recurrence within one month after surgery. The remaining 246 cases consisted of 90 PA-TACE and 156 non-PA-TACE cases. COX regression analysis was performed for overall survival (OS) or recurrence-free survival (RFS) of these 246 cases, allowing the derivation of independent factors that were integrated into the nomogram. C-index, calibration curves, and risk stratification were performed to evaluate the performance and discriminative power of the nomograms. In 246 patients without recurrence within one month after surgery, the OS and RFS for the PA-TACE group were significantly better than those for the non-PA-TACE group (P<0.0001, P<0.0001, respectively). After Cox regression analysis of OS or RFS, PA-TACE-related nomogram models were constructed. The C-index of the PA-TACE-related nomogram for OS and RFS was 0.72 and 0.73, respectively. Calibration curves revealed a good agreement between predictions and observations for the nomograms. Based on the nomogram-related risk stratification, Kaplan-Meier curves showed powerful discriminative ability. PA-TACE therapy improved the survival of HCC patients with PVTT undergoing hepatectomy. Accurate nomogram models were developed for predicting the individual survival and recurrence of these patients.

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References

Mehrabi A, Golriz M, Khajeh E, Ghamarnejad O, Probst P, Fonouni H . Meta-analysis of the prognostic role of perioperative platelet count in posthepatectomy liver failure and mortality. Br J Surg. 2018; 105(10):1254-1261. DOI: 10.1002/bjs.10906. View

Zhang Z, Lai E, Zhang C, Yu H, Liu Z, Wan B . The strategies for treating primary hepatocellular carcinoma with portal vein tumor thrombus. Int J Surg. 2015; 20:8-16. DOI: 10.1016/j.ijsu.2015.05.009. View

Xie D, Ren Z, Zhou J, Fan J, Gao Q . 2019 Chinese clinical guidelines for the management of hepatocellular carcinoma: updates and insights. Hepatobiliary Surg Nutr. 2020; 9(4):452-463. PMC: 7423548. DOI: 10.21037/hbsn-20-480. View

Kokudo T, Hasegawa K, Matsuyama Y, Takayama T, Izumi N, Kadoya M . Survival benefit of liver resection for hepatocellular carcinoma associated with portal vein invasion. J Hepatol. 2016; 65(5):938-943. DOI: 10.1016/j.jhep.2016.05.044. View

Cheng S, Chen M, Cai J, Sun J, Guo R, Bi X . Chinese Expert Consensus on Multidisciplinary Diagnosis and Treatment of Hepatocellular Carcinoma with Portal Vein Tumor Thrombus (2018 Edition). Liver Cancer. 2020; 9(1):28-40. PMC: 7024893. DOI: 10.1159/000503685. View

Huang G, Lau W, Wang Z, Pan Z, Yuan S, Shen F . Antiviral therapy improves postoperative survival in patients with hepatocellular carcinoma: a randomized controlled trial. Ann Surg. 2014; 261(1):56-66. DOI: 10.1097/SLA.0000000000000858. View

Finn R, Qin S, Ikeda M, Galle P, Ducreux M, Kim T . Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma. N Engl J Med. 2020; 382(20):1894-1905. DOI: 10.1056/NEJMoa1915745. View

. EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma. J Hepatol. 2018; 69(1):182-236. DOI: 10.1016/j.jhep.2018.03.019. View

Camp R, Dolled-Filhart M, Rimm D . X-tile: a new bio-informatics tool for biomarker assessment and outcome-based cut-point optimization. Clin Cancer Res. 2004; 10(21):7252-9. DOI: 10.1158/1078-0432.CCR-04-0713. View

10.

Zhang X, Gao Y, Chen Z, Chen M, Li L, Wen T . An Eastern Hepatobiliary Surgery Hospital/Portal Vein Tumor Thrombus Scoring System as an Aid to Decision Making on Hepatectomy for Hepatocellular Carcinoma Patients With Portal Vein Tumor Thrombus: A Multicenter Study. Hepatology. 2018; 69(5):2076-2090. DOI: 10.1002/hep.30490. View

11.

Cao F, Shen L, Qi H, Xie L, Song Z, Chen S . Tree-based classification system incorporating the HVTT-PVTT score for personalized management of hepatocellular carcinoma patients with macroscopic vascular invasion. Aging (Albany NY). 2019; 11(21):9544-9555. PMC: 6874465. DOI: 10.18632/aging.102403. View

12.

Rahbari N, Garden O, Padbury R, Brooke-Smith M, Crawford M, Adam R . Posthepatectomy liver failure: a definition and grading by the International Study Group of Liver Surgery (ISGLS). Surgery. 2011; 149(5):713-24. DOI: 10.1016/j.surg.2010.10.001. View

13.

Zhao H, Chen C, Gu S, Yan X, Jia W, Mao L . Anatomical versus non-anatomical resection for solitary hepatocellular carcinoma without macroscopic vascular invasion: A propensity score matching analysis. J Gastroenterol Hepatol. 2016; 32(4):870-878. DOI: 10.1111/jgh.13603. View

14.

Colecchia A, Scaioli E, Montrone L, Vestito A, Di Biase A, Pieri M . Pre-operative liver biopsy in cirrhotic patients with early hepatocellular carcinoma represents a safe and accurate diagnostic tool for tumour grading assessment. J Hepatol. 2010; 54(2):300-5. DOI: 10.1016/j.jhep.2010.06.037. View

15.

Liu P, Huo T, Miksad R . Hepatocellular Carcinoma with Portal Vein Tumor Involvement: Best Management Strategies. Semin Liver Dis. 2018; 38(3):242-251. DOI: 10.1055/s-0038-1666805. View

16.

Mullen J, Ribero D, Reddy S, Donadon M, Zorzi D, Gautam S . Hepatic insufficiency and mortality in 1,059 noncirrhotic patients undergoing major hepatectomy. J Am Coll Surg. 2007; 204(5):854-62. DOI: 10.1016/j.jamcollsurg.2006.12.032. View

17.

Peng B, He Q, Li J, Zhou F . Adjuvant transcatheter arterial chemoembolization improves efficacy of hepatectomy for patients with hepatocellular carcinoma and portal vein tumor thrombus. Am J Surg. 2009; 198(3):313-8. DOI: 10.1016/j.amjsurg.2008.09.026. View

18.

Glantzounis G, Paliouras A, Stylianidi M, Milionis H, Tzimas P, Roukos D . The role of liver resection in the management of intermediate and advanced stage hepatocellular carcinoma. A systematic review. Eur J Surg Oncol. 2017; 44(2):195-208. DOI: 10.1016/j.ejso.2017.11.022. View

19.

Forner A, Reig M, Bruix J . Hepatocellular carcinoma. Lancet. 2018; 391(10127):1301-1314. DOI: 10.1016/S0140-6736(18)30010-2. View

20.

Barbier L, Cesaretti M, Dondero F, Cauchy F, Khoy-Ear L, Aoyagi T . Liver Transplantation With Older Donors: A Comparison With Younger Donors in a Context of Organ Shortage. Transplantation. 2016; 100(11):2410-2415. DOI: 10.1097/TP.0000000000001401. View