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Histological Severity of Cirrhosis Influences Surgical Outcomes of Hepatocellular Carcinoma After Curative Hepatectomy

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单位: [1]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Hepat Surg Ctr,Wuhan,Peoples R China [2]Zhejiang Univ, Affiliated Hosp 2, Sch Med, Dept Hepatobiliary & Pancreat Surg, Hangzhou, Peoples R China [3]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Dept Gynecol,Wuhan,Peoples R China [4]Chinese Univ Hong Kong, Prince Wales Hosp, Fac Med, Shatin, Hong Kong, Peoples R China [5]Huazhong Univ Sci & Technol,Tongji Hosp,Inst Organ Transplantat,Tongji Med Coll,Wuhan,Peoples R China [6]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Hepat Surg Ctr,1095 Jie Fang Da Dao,Wuhan,Peoples R China
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关键词: hepatocellular carcinoma Laennec staging system prognosis nomogram hepatectomy

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Background: Hepatocellular carcinoma (HCC) is frequently associated with cirrhosis. The present study investigated the impact of histological severity of cirrhosis on surgical outcomes for HCC and further developed novel nomograms to predict postoperative recurrence and survival. Methods: A total of 1524 consecutive patients undergoing curative hepatectomy for HCC between 1999 and 2015 were retrospectively studied. Cirrhotic severity was histologically staged according to the Laennec staging system. Short- and long-term outcomes were investigated. Recurrence-free survival (RFS) and overall survival (OS) predictive nomograms were constructed based on the results of multivariate analysis. The predictive accuracy of the nomograms was measured by the concordance index Results: Patients in the severe cirrhosis group had significantly higher morbidity and mortality rates than patients in the no, mild, and moderate cirrhosis groups. The 5-year RFS and OS rates were 36.8% and 64.5%, respectively, in the no cirrhosis group, compared to 34.8% and 60.4% in the mild cirrhosis group, 17.3% and 43.4% in the moderate cirrhosis group, and 6.1% and 20.1% in the severe cirrhosis group. Long-term survival outcomes were significantly worse as cirrhotic severity was increased. The C-index was 0.727 for the RFS nomogram and 0.746 for the OS nomogram. Calibration curves showed good agreement between actual observations and nomogram predictions. The 2 nomograms had a superior discriminatory ability to predict RFS and OS compared to other staging systems. Conclusion: Histological severity of cirrhosis significantly affected surgical outcomes in HCC patients undergoing curative hepatectomy. The novel nomograms, including histological severity of cirrhosis, showed an accurate prediction of postoperative recurrence and survival.

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出版当年[2021]版:
大类 | 3 区 医学
小类 | 3 区 肿瘤学
最新[2025]版:
大类 | 3 区 医学
小类 | 3 区 肿瘤学
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Q2 ONCOLOGY
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Q2 ONCOLOGY

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第一作者单位: [1]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Hepat Surg Ctr,Wuhan,Peoples R China
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通讯机构: [1]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Hepat Surg Ctr,Wuhan,Peoples R China [6]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Hepat Surg Ctr,1095 Jie Fang Da Dao,Wuhan,Peoples R China
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