Hu XS, Yang HY, Leng C, Zhang ZW. Postoperative outcomes and recurrence patterns of intermediate-stage hepatocellular carcinoma dictated by the sum of tumor size and number. World J Gastroenterol 2022; 28(44): 6271-6281 [PMID: 36504552 DOI: 10.3748/wjg.v28.i44.6271]
Corresponding Author of This Article
Chao Leng, PhD, Doctor, Hepatic Surgery Center, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, Hubei Province, China. lengchaojdld@163.com
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Xin-Sheng Hu, Hui-Yuan Yang, Chao Leng, Zhi-Wei Zhang, Hepatic Surgery Center, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
Author contributions: Hu XS performed the research and wrote the paper; Yang HY performed the follow-up; Leng C designed the research and supervised the report; Zhang ZW provided clinical advice and supervised the report; and all authors read and approved the final version.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology (Approval No. TJ-IRB20210918).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chao Leng, PhD, Doctor, Hepatic Surgery Center, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, Hubei Province, China. lengchaojdld@163.com
Received: August 6, 2022 Peer-review started: August 6, 2022 First decision: September 26, 2022 Revised: October 9, 2022 Accepted: November 9, 2022 Article in press: November 9, 2022 Published online: November 28, 2022
ARTICLE HIGHLIGHTS
Research background
Emerging studies have shown that Barcelona Clinic Liver Cancer (BCLC) intermediate-stage hepatocellular carcinoma (HCC) patients had a good prognosis after liver resection (LR), but the subgroups of BCLC-B patients more suitable for LR have yet to be defined.
Research motivation
There is a lack of studies on whether the sum of tumor size and number (N + S) can be used to select BCLC-B patients who are more suitable for LR. The effect of recurrence patterns on long-term survival in BCLC-B patients undergoing LR is also poorly explored.
Research objectives
The present study aimed to identify BCLC-B patients more suitable for LR and to further analyze the reasons why these patients could benefit from LR.
Research methods
BCLC stage A or B multinodular HCC (MNHCC) patients undergoing curative hepatectomy were enrolled. Overall survival (OS), recurrence-free survival (RFS), recurrence-to-death survival (RTDS), recurrence patterns, and treatments after recurrence in BCLC-B patients in each subgroup according to N + S were compared with those in BCLC-A patients.
Research results
N + S could predict not only the OS and RFS in BCLC-B HCC patients undergoing hepatectomy, but also the recurrence patterns and RTDS in these patients. BCLC-B patients with N + S ≤ 10 had mild recurrence patterns, good RTDS and excellent OS similar to those in BCLC-A MNHCC patients.
Research conclusions
N + S can be used to select BCLC-B HCC patients who are more suitable for LR, and LR should be considered in BCLC-B patients with N + S ≤ 10.
Research perspectives
As a measure that can be easily obtained and calculated in clinical practice, N + S can help with the clinical decision-making in the treatment of BCLC-B HCC patients.
