单位:[1]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Hepat Surg Ctr,Wuhan,Peoples R China外科学系肝脏外科华中科技大学同济医学院附属同济医院[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华中科技大学同济医学院附属同济医院普通妇科[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器官移植研究所华中科技大学同济医学院附属同济医院器官移植[6]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Hepat Surg Ctr,1095 Jie Fang Da Dao,Wuhan,Peoples R China外科学系肝脏外科华中科技大学同济医学院附属同济医院
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.
基金:
National Science and Technology Major Project of China [2017CFB258]; Natural Science Foundation of Hubei Province of China
第一作者单位:[1]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Hepat Surg Ctr,Wuhan,Peoples R China
通讯作者:
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
推荐引用方式(GB/T 7714):
Liang Bin-Yong,Gu Jin,Xiong Min,et al.Histological Severity of Cirrhosis Influences Surgical Outcomes of Hepatocellular Carcinoma After Curative Hepatectomy[J].JOURNAL OF HEPATOCELLULAR CARCINOMA.2022,9:633-647.doi:10.2147/JHC.S368302.
APA:
Liang, Bin-Yong,Gu, Jin,Xiong, Min,Zhang, Er-Lei,Zhang, Zun-Yi...&Huang, Zhi-Yong.(2022).Histological Severity of Cirrhosis Influences Surgical Outcomes of Hepatocellular Carcinoma After Curative Hepatectomy.JOURNAL OF HEPATOCELLULAR CARCINOMA,9,
MLA:
Liang, Bin-Yong,et al."Histological Severity of Cirrhosis Influences Surgical Outcomes of Hepatocellular Carcinoma After Curative Hepatectomy".JOURNAL OF HEPATOCELLULAR CARCINOMA 9.(2022):633-647