Detailed Abstract
[Plenary Session - Liver (Liver Disease/Surgery)]
[PL 4] Prognostic significance of nodular number in patients undergoing hepatic resection of intermediate-stage hepatocellular carcinoma (BCLC Stage B): An international multicenter observational study
Zhong-Qi FAN1 , Xing LV1 , Ming-Da WANG2 , Xiao XU3 , Ya-Hao ZHOU4 , Xian-Ming WANG5 , Ting-Hao CHEN6 , Jie LI7 , Cheng-Wu ZHANG8 , Hong WANG9 , Yao-Ming ZHANG10 , Yong-Kang DIAO2 , Lan-Qing YAO2 , Chao LI1 , Wei QIU1 , Xiao-Dong SUN1 , Guo-Yue LV1 , Tian YANG*1
1 Department Of Hepatobiliary And Pancreatic Surgery, General Surgery Center, First Hospital Of Jilin University, CHINA
2 Department Of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), CHINA
3 Department Of Hepatobiliary Surgery, Affiliated Hospital Of Nantong University, CHINA
4 Department Of Hepatobiliary Surgery, Pu’er People’s Hospital, CHINA
5 Department Of General Surgery, First Affiliated Hospital Of Shandong First Medical University, CHINA
6 Department Of General Surgery, Ziyang First People’s Hospital, CHINA
7 Department Of Hepatobiliary Surgery, Fuyang People's Hospital, CHINA
8 Department Of General Surgery, Cancer Center, Division Of Hepatobiliary And Pancreatic Surgery, Zhejiang Provincial People’s Hospital, CHINA
9 Department Of General Surgery, Liuyang People’s Hospital, CHINA
10 The Second Department Of Hepatobiliary Surgery, Meizhou People's Hospital, CHINA
Background : Expanding the indication for hepatic resection relative to Barcelona Clinic Liver Cancer (BCLC) intermediate-stage hepatocellular carcinoma (HCC) (i.e., multinodular HCC exceeding Milan criteria) remains controversial. We sought to identify the prognostic impact of nodular HCC number among patients undergoing hepatic resection for BCLC intermediate-stage HCC.
Methods : Using a multicenter database, patients who underwent curative-intent resection for BCLC intermediate-stage HCC were reviewed. Patients were categorized into the binodular and tri(+)nodular (≥3 nodules) groups based on nodular number. Long-term overall survival (OS) and recurrence-free survival (RFS) were compared. Univariate and multivariate Cox-regression analyses were used to identify the risk factors associated with OS and RFS after hepatic resection of BCLC intermediate-stage HCC. Additional analyses were performed to examine outcomes among patients with binodular versus uninodular large HCC (single nodule > 5 cm; BCLC early stage).
Results : Among 338 patients with BCLC intermediate-stage HCC, 187(55.3%) and 151(44.7%) had binodular and tri(+)nodular diseases, respectively. Median OS and RFS among patients with binodular HCC were 49.6 and 22.2 months, respectively, which were significantly better than the outcomes among patients with tri(+)nodular HCC (33.5 and 13.7 months, P=0.036 and 0.009, respectively), yet comparable to patients with uninodular large HCC (59.8 and 26.8 months, P=0.144 and 0.311, respectively). Multivariate analyses demonstrated that binodular HCC was independently associated with better OS and RFS after hepatic resection of BCLC intermediate-stage HCC.
Conclusions : Compared with tri(+)nodular HCC, patients with binodular HCC had a more favorable survival after resection of BCLC intermediate-stage HCC, which was comparable to a specific subset of BCLC early-stage HCC (uninodular large HCC). These data suggested the importance of nodular number relative to prognostic stratification and surgical recommendation for intermediate-stage HCC.
Methods : Using a multicenter database, patients who underwent curative-intent resection for BCLC intermediate-stage HCC were reviewed. Patients were categorized into the binodular and tri(+)nodular (≥3 nodules) groups based on nodular number. Long-term overall survival (OS) and recurrence-free survival (RFS) were compared. Univariate and multivariate Cox-regression analyses were used to identify the risk factors associated with OS and RFS after hepatic resection of BCLC intermediate-stage HCC. Additional analyses were performed to examine outcomes among patients with binodular versus uninodular large HCC (single nodule > 5 cm; BCLC early stage).
Results : Among 338 patients with BCLC intermediate-stage HCC, 187(55.3%) and 151(44.7%) had binodular and tri(+)nodular diseases, respectively. Median OS and RFS among patients with binodular HCC were 49.6 and 22.2 months, respectively, which were significantly better than the outcomes among patients with tri(+)nodular HCC (33.5 and 13.7 months, P=0.036 and 0.009, respectively), yet comparable to patients with uninodular large HCC (59.8 and 26.8 months, P=0.144 and 0.311, respectively). Multivariate analyses demonstrated that binodular HCC was independently associated with better OS and RFS after hepatic resection of BCLC intermediate-stage HCC.
Conclusions : Compared with tri(+)nodular HCC, patients with binodular HCC had a more favorable survival after resection of BCLC intermediate-stage HCC, which was comparable to a specific subset of BCLC early-stage HCC (uninodular large HCC). These data suggested the importance of nodular number relative to prognostic stratification and surgical recommendation for intermediate-stage HCC.
SESSION
Plenary Session
Room A 3/25/2023 11:00 AM - 12:15 PM