Copyright
©The Author(s) 2021.
World J Gastrointest Surg. Oct 27, 2021; 13(10): 1245-1257
Published online Oct 27, 2021. doi: 10.4240/wjgs.v13.i10.1245
Published online Oct 27, 2021. doi: 10.4240/wjgs.v13.i10.1245
Table 1 Clinical and surgical data
Clinical data | Surgical data | ||||
Age (yr) | 62.8 ± 11.8 | Anatomical hepatectomy | - | 3 | |
+ | 27 | ||||
Sex | Male | 28 | Operation time (min) | 340 | |
Female | 2 | ||||
HBV/HCV | - | 6 | Blood loss (mL) | 690 | |
+ | 24 | ||||
Alb (g/dL) | 3.71 ± 0.08 | Number of tumors in the remnant liver | 1-3 | 12 | |
≥ 4 | 18 | ||||
T-Bil (mg/dL) | 0.88 ± 0.08 | POCR | + | 8 | |
- | 22 | ||||
PT (%) | 90.19 ± 2.75 | ||||
ICGR15 (%) | 17.34 ± 1.96 | ||||
AFP (ng/mL) | 102288 ± 7287 | ||||
PIVKA-II (AU/mL) | 52534 ± 22566 | ||||
Child-pugh class | A | 27 | |||
B | 3 | ||||
Number of tumors | St | 0 | |||
Mt | 30 | ||||
Tumor size (cm) | 10.13 ± 1.02 | ||||
Differentiation | Wel | 1 | |||
Mod | 16 | ||||
Por | 13 | ||||
pN | - | 28 | |||
+ | 2 | ||||
Macrovascular invasion | - | 5 | |||
+ | 25 | ||||
BCLC stage | B | 12 | |||
C | 18 | ||||
Distant metastasis | - | 27 | |||
+ | 3 |
Table 2 Peri-surgical treatment
Preoperative treatment | ||
No treatment | 24 | |
TAI | 4 | |
TAI + ERT | 1 | |
TAI + TKI1 + ERT | 1 | |
Postoperative treatment | Total | POCR (+) |
TAI + hepatectomy + lung resection + chemo | 1 | 1 |
Hepatectomy + chemo + TAI + ERT | 1 | 1 |
Lung resection + LAT + TAI + chemo + ERT | 1 | 1 |
Lung resection + LAT | 1 | 0 |
Brain tumor resection + TAI + TKI2 + chemo + ERT | 1 | 0 |
LAT + TAI + ERT | 2 | 2 |
TAI + TKI3 + chemo ( + ERT) | 3 | 0 |
TAI + TKI4 | 2 | 0 |
TAI + chemo ( + ERT) | 6 | 1 |
TAI ( + ERT) | 9 | 2 |
ERT | 1 | 0 |
No treatment | 1 | 0 |
Unknown | 1 | 0 |
Total | 30 | 8 |
Table 3 Univariate analyses
Clinicopathological data | Surgical data | ||||||||
Category | n | MST (m) | P value | Category | n | MST (m) | P value | ||
Age (yr) | ≥ 60 | 18 | 17.9 | 0.9267 | Anatomical hepatectomy | - | 3 | 39.0 | 0.2162 |
< 60 | 12 | 29.7 | + | 27 | 16.9 | ||||
Sex | Male | 28 | 17.9 | 0.1584 | Operation time (min) | < 340 | 15 | 28.4 | 0.4177 |
Female | 2 | - | ≥ 340 | 15 | 14.8 | ||||
HBV/HCV | - | 6 | 15.0 | 0.2674 | Blood loss (mL) | < 690 | 15 | 29.7 | 0.6355 |
+ | 24 | 29.7 | ≥ 690 | 15 | 16.4 | ||||
Alb (g/dL) | ≥ 3.7 | 15 | 33.5 | 0.3444 | Number of tumors in the remnant liver | 1-3 | 12 | 56.5 | 0.0283a |
< 3.7 | 15 | 17.4 | ≥ 4 | 18 | 14.8 | ||||
T-Bil (mg/dL) | ≤ 0.8 | 19 | 28.4 | 0.5131 | POCR | + | 8 | 56.6 | 0.0041a |
> 0.8 | 11 | 16.5 | - | 22 | 14.8 | ||||
PT (%) | ≥ 90 | 17 | 17.9 | 0.7839 | |||||
< 90 | 13 | 28.4 | |||||||
ICGR15 (%) | ≥ 15 | 12 | 29.7 | 0.6790 | |||||
< 15 | 18 | 16.5 | |||||||
AFP (ng/mL) | < 200 | 16 | 29.7 | 0.5569 | |||||
≥ 200 | 14 | 17.9 | |||||||
PIVKA-II (AU/mL) | < 100 | 3 | 73.2 | 0.0584 | |||||
≥ 100 | 27 | 16.9 | |||||||
Child-pugh class | A | 27 | 29.7 | < 0.0001 | |||||
B | 3 | 6.4 | |||||||
Tumor size (cm) | ≥ 10 cm | 15 | 12.2 | 0.0485 | |||||
< 10 cm | 15 | 29.7 | |||||||
Differentiation | wel/mod | 17 | 17.9 | 0.5449 | |||||
por | 13 | 28.4 | |||||||
pN | - | 28 | 17.9 | 0.2335 | |||||
+ | 2 | 56.5 | |||||||
Macrovascular invasion | - | 5 | 9.5 | 0.0053 | |||||
+ | 25 | 30.0 | |||||||
BCLC stage | B | 12 | 33.8 | 0.7652 | |||||
C | 18 | 16.9 | |||||||
Distant metastasis | - | 27 | 28.4 | 0.6013 | |||||
+ | 3 | 12.1 |
Table 4 Comparison between the postoperative complete remission (+) and postoperative complete remission (-) groups
Category | POCR (+) | POCR (-) | P value | |
Age | < 60/≥ 60 | 1/7 | 11/11 | 0.0994 |
Sex | Male/female | 7/1 | 21/1 | 0.4690 |
HBV and/or HCV | -/ + | 0/8 | 6/16 | 0.1550 |
Alb (g/dL) | < 3.7/≥ 3.7 | 5/3 | 10/12 | 0.6817 |
T-Bil (mg/dL) | ≤ 0.8/> 0.8 | 6/2 | 13/9 | 0.6722 |
PT (%) | < 90/≥ 90 | 4/4 | 9/13 | 0.6976 |
ICGR15 (%) | < 15/≥ 15 | 4/4 | 14/8 | 0.6779 |
AFP (ng/mL) | < 200/> 200 | 4/4 | 12/10 | 1.0000 |
PIVKA-II | < 100/≥ 100 | 2/6 | 1/21 | 0.1655 |
Child-pugh class | A/B | 8/0 | 19/3 | 0.5448 |
Tumor size (cm) | < 10/≥ 10 | 5/3 | 10/12 | 0.6817 |
Differentiation | wel or mod/por | 5/3 | 12/10 | 1.0000 |
pN | -/ + | 7/1 | 21/1 | 0.4690 |
Macrovascular invasion | -/ + | 0/8 | 5/17 | 0.2868 |
Distant metastasis | -/ + | 8/0 | 19/3 | 0.5448 |
BCLC stage | B/C | 3/5 | 9/13 | 1.0000 |
Anatomical hepatectomy | -/ + | 2/6 | 1/21 | 0.1665 |
Number of tumors in the remnant liver | 1-3/≥ 4 | 7/1 | 5/17 | 0.0025a |
Table 5 Comparison between the postoperative complete remission (-) tyrosine kinase inhibitors (+) and postoperative complete remission (-)tyrosine kinase inhibitors (-) groups
Category | POCR (-)/TKI (+) | POCR (-)/TKI (-) | P value | |
Age | < 60/≥ 60 | 4/2 | 7/9 | 0.6351 |
Sex | Male/female | 6/0 | 15/1 | 1.0000 |
HBV and/or HCV | -/ + | 2/4 | 4/12 | 1.0000 |
Alb (g/dL) | < 3.7/≥ 3.7 | 1/5 | 9/7 | 0.1619 |
T-Bil (mg/dL) | ≤ 0.8/> 0.8 | 4/2 | 9/7 | 1.0000 |
PT (%) | < 90/≥ 90 | 2/4 | 7/9 | 1.0000 |
ICGR15 (%) | < 15/≥ 15 | 4/2 | 10/6 | 1.0000 |
AFP (ng/mL) | < 200/> 200 | 4/2 | 8/8 | 0.6462 |
PIVKA-II | < 100/≥ 100 | 0/6 | 1/15 | 1.0000 |
Child-pugh class | A/B | 6/0 | 13/3 | 0.5325 |
Tumor size (cm) | < 10/≥ 10 | 4/2 | 6/10 | 0.3476 |
Differentiation | Wel or mod/por | 4/2 | 8/8 | 0.6462 |
pN | -/ + | 5/1 | 16/0 | 0.2727 |
Macrovascular invasion | -/ + | 0/6 | 5/11 | 0.2663 |
Distant metastasis | -/ + | 5/1 | 14/2 | 1.0000 |
BCLC stage | B/C | 2/4 | 7/9 | 1.0000 |
Anatomical hepatectomy | -/ + | 0/6 | 1/15 | 1.0000 |
Number of tumors in the remnant liver | 1-3/≥ 4 | 0/6 | 5/11 | 0.2663 |
- Citation: Asahi Y, Kamiyama T, Kakisaka T, Orimo T, Shimada S, Nagatsu A, Aiyama T, Sakamoto Y, Kamachi H, Taketomi A. Outcomes of reduction hepatectomy combined with postoperative multidisciplinary therapy for advanced hepatocellular carcinoma. World J Gastrointest Surg 2021; 13(10): 1245-1257
- URL: https://www.wjgnet.com/1948-9366/full/v13/i10/1245.htm
- DOI: https://dx.doi.org/10.4240/wjgs.v13.i10.1245