Local tumor destruction and liver resection increase overall survival in intermediate/advanced hepatocellular carcinoma patients: evidence from a population-based study

Frontiers in Endocrinology

Endocrinology

Minjie Duan¹  Yang Zhang¹  Christy Huang²  Scott Lowe³  Guangliang Liu⁴  Xiaozhu Liu⁴  Dazhi Ke⁵  Yi Zhang⁵  Taiyu He⁶  Junyi Cao⁷  Jian Huang⁸ 

[1] College of Medical Informatics, Chongqing Medical University, Chongqing, China;College of Osteopathic Medicine, California Health Sciences University, Clovis, CA, United States;College of Osteopathic Medicine, Kansas City University, Kansas, MO, United States;Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China;Department of General Practice, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China;Department of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, the Second Affiliated Hospital, Chongqing Medical University, Chongqing, China;Department of Medical Quality Control, The First People’s Hospital of Zigong City, Zigong, China;Graduate School, Guangxi University of Chinese Medicine, Nanning, China;

关键词: liver resection;    local tumor destruction;    hepatocellular carcinoma;    survival;    nomogram;   

DOI  :  10.3389/fendo.2023.1191822

 received in 2023-03-22, accepted in 2023-07-03,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundLiver resection (LR) and local tumor destruction (LTD) are effective treatments, but not commonly recommended for patients with intermediate/advanced hepatocellular carcinoma (HCC). This study aimed to explore whether LR/LTD could improve overall survival (OS) of these patients, and to identify the patients who will most likely benefit from LR/LTD.MethodsData of patients with intermediate/advanced HCC between 2001 and 2018 were extracted from Surveillance, Epidemiology, and End Results database. OS was compared between HCC patients who received LR/LTD and those who did not. A nomogram was constructed for predicting OS, and it was then validated.ResultsA total of 535 eligible patients were included, among which 128 received LR/LTD while 407 did not. Significantly higher OS in patients who received LR/LTD was observed (P<0.001). Based on independent prognostic factors obtained from univariate and multivariate analyses, a nomogram was constructed. The C-indices of nomogram were higher than those of the TNM staging system (training cohort: 0.74 vs. 0.59; validation cohort: 0.78 vs. 0.61). Similarly, areas under receiver operating characteristic curves and calibration curves indicated good accuracy of the nomogram. Decision curve analysis curves revealed good clinical practicability of the nomogram. Furthermore, low-risk patients (nomogram score: 0-221.9) had higher OS compared with high-risk patients (nomogram score: higher than 221.9) (P<0.001).ConclusionLR/LTD significantly improves OS in patients with intermediate/advanced HCC. The nomogram developed in the present study shows high predicating value for OS in patients with intermediate/advanced HCC, which might be useful in selecting patients who are most suitable for LR/LTD.

【 授权许可】

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Copyright © 2023 Zhang, Zhang, He, Liu, Duan, Huang, Huang, Lowe, Ke, Liu and Cao