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Clinicopathological Determinants of Survival After Hepatic Resection of Hepatocellular Carcinoma in 97 Patients-Experience From an Australian Hepatobiliary Unit.
J Gastrointest Surg. 2010 Jun 29;
Authors: Chua TC, Saxena A, Chu F, Liauw W, Zhao J, Morris DL
BACKGROUND: Identification of clinicopathological determinants that predict for risk of recurrence and overall survival after undergoing potentially curative hepatic resection for hepatocellular carcinoma is a strategy towards personalizing therapy to improve outcome. Through evaluation of a center’s experience with treatment of a disease, determinants unique to the treated patient cohort may be identified. METHODS: Ninety-seven patients with hepatocellular carcinoma underwent liver resection. Clinical, treatment, and histopathological variables were collected and evaluated using univariate and multivariate analyses with disease-free survival (DFS) and overall survival (OS) as the endpoints. RESULTS: The median follow-up period of 19 (range, 1 to 188) months from the time of hepatic resection. The median DFS and OS after resection of HCC were 17 and 41 months, respectively. Five-year overall survival rate was 45%. Eight independent factors associated with disease-free and overall survival were identified through a multivariate analysis. Three factors: Child-Pugh score (DFS p = 0.045, OS p = 0.001), histopathological grade (DFS p < 0.001, OS p < 0.001), and histological diagnosis of cirrhosis (DFS p < 0.001, OS p < 0.001) predicted for both disease-free and overall survival. CONCLUSION: Integrating the knowledge of identified prognostic factors into clinical decision making may provide a clinicopathological signature that could identify patients at greatest risk of treatment failure such that novel interventions may be applied to improve the survival outcome.
PMID: 20585991 [PubMed - as supplied by publisher]
