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©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
Quantifying the natural growth rate of hepatocellular carcinoma: A real-world retrospective study in southwestern China
Li Tu, Hong Xie, Qi Li, Ping-Gui Lei, Pei-Ling Zhao, Fan Yang, Chi Gong, Yuan-Lin Yao, Shi Zhou
Li Tu, Department of General Practice, The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, Guizhou Province, China
Hong Xie, Clinical Medicine, Soochow University, Suzhou 215123, Jiangsu Province, China
Hong Xie, Qi Li, Ping-Gui Lei, Department of Radiology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, Guizhou Province, China
Pei-Ling Zhao, Department of Clinical Laboratory Center, The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, Guizhou Province, China
Fan Yang, Key Laboratory of Biology and Medical Engineering, Guizhou Medical University, Guiyang 550025, Guizhou Province, China
Chi Gong, Department of Radiology, Yanhe Tujia Autonomous County People's Hospital, Tongren 565300, Guizhou Province, China
Yuan-Lin Yao, Department of Radiology, The Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital, Kaili 556000, Guizhou Province, China
Shi Zhou, Department of Interventional Radiology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, Guizhou Province, China
Co-corresponding authors: Hong Xie and Shi Zhou.
Author contributions: Tu L, Xie H, Lei PG and Zhou S conceptualized and designed the research; Tu L, Xie H, Li Q, Lei PG, Zhao PL, Yang F, Gong C, and Yao YL acquired clinical and imaging data; Xie H, Yang F and Lei PG analysed the data; Tu L, Xie H, Lei PG and Zhou S wrote and edited the manuscript. All authors reviewed the final manuscript and agreed upon its submission for publication. Both Xie H and Zhou S have played indispensable roles in the experimental design, data interpretation, manuscript preparation and other support during the study, this collaboration between Xie H and Zhou S is crucial for the publication of this manuscript, they were designed as the co-corresponding authors to ensure that their individual contributions are duly recognized and attributed.
Supported by Cultivate Project for the National Natural Science Foundation of China, No. gyfynsfc [2020]-27; and National Natural Science Foundation of China, No. 81960328.
Institutional review board statement: The study was approved by the review board of the Affiliated Hospital of Guizhou Medical University, No. 2022-734.
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 imaging and treatment by written consent.
Conflict-of-interest statement: All the Authors have no conflict of interest related to the manuscript.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
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: Hong Xie, Doctor, Professor, Clinical Medicine, Soochow University, No. 199 Renai Road, Suzhou 215123, Jiangsu Province, China.
doctorxie2007@yeah.net
Received: February 8, 2024
Revised: April 10, 2024
Accepted: April 18, 2024
Published online: May 27, 2024
Processing time: 103 Days and 21.1 Hours
BACKGROUND
In recent years, approximately half of the newly diagnosed cases and mortalities attributed to hepatocellular carcinoma (HCC) have been reported in China. Despite the high incidence of HCC, there remains a paucity of data regarding the natural growth pattern and the determination of optimal surveillance intervals specific to the Chinese population.
AIM
To quantify the natural tumor growth pattern of HCC in regional China.
METHODS
A retrospective analysis was performed on patients from a single institution in Southwest China who had undergone two or more serial dynamic computed tomography or magnetic resonance imaging scans between 2014 and 2020, without having received any anti-cancer therapy. Tumor growth was assessed using tumor volume doubling time (TVDT) and tumor growth rate (TGR), with volumes measured manually by experienced radiologists. Simple univariate linear regression and descriptive analysis were applied to explore associations between growth rates and clinical factors.
RESULTS
This study identifies the median TVDT for HCC as 163.4 d, interquartile range (IQR) 72.1 to 302.3 d, with a daily TGR of 0.42% (IQR 0.206%-0.97%). HCC growth patterns reveal that about one-third of tumors grow indolently with TVDT exceeding 270 d, another one-third of tumors exhibit rapid growth with TVDT under 90 d, and the remaining tumors show intermediate growth rates, with TVDT ranging between 3 to 9 months.
CONCLUSION
The identified TGRs support biannual surveillance and follow-up for HCC patients in certain regions of China. Given the observed heterogeneity in HCC growth, further investigation is warranted.
Core Tip: The present study offers real-world data, revealing a median tumor volume doubling time of 163 d for hepatocellular carcinoma (HCC) patients in Southwest China. These findings endorse the implementation of biannual surveillance and follow-up for this patient population. The observed heterogeneity in HCC growth, with approximately one-third of patients exhibiting indolent, intermediate, or rapid growth, highlights the necessity for individualized management and targeted treatment strategies based on specific tumor growth rate. Further research is essential to elucidate the mechanisms driving this growth heterogeneity and to inform clinical practice.
