Detailed Abstract
[Plenary Session - Liver (Liver Disease/Surgery)]
[PL 2] Liver resection for a solitary huge hepatocellular carcinoma (≥ 10cm): A large-scale multicenter observational study
Xin-Fei XU1 , Han WU1 , Ju-Dong LI2 , Lan-Qing YAO1 , Timothy M. PAWLIK3 , Wan Yee LAU1 , Feng SHEN1 , Tian YANG*1
1 Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), CHINA
2 Hepatobiliary Surgery, Changzheng Hospital, Naval Medical University (Second Military Medical University), CHINA
3 Surgery, Ohio State University, Wexner Medical Center, UNITED STATES OF AMERICA
Background : To investigate the association of tumor morphology with long-term survival outcomes after liver resection for a solitary huge hepatocellular carcinoma (HCC) of ≥ 10cm.
Methods : Patients undergoing curative liver resection for a solitary huge HCC were identified from a multicenter database. Preoperative imaging findings were used to define spherical- or ellipsoidal-shaped lesions with smooth edges as balloon-shaped HCCs (BS-HCCs); out-of-shape lesions or lesions of any shape with matt edges were defined as non-balloon-shaped HCCs (NBS-HCCs). The two groups of patients with BS-HCCs and NBS-HCCs were matched in a 1:1 ratio using propensity score matching (PSM). Clinicopathologic characteristics, long-term overall survival (OS) and recurrence-free survival (RFS) were assessed.
Results : Among patients with a solitary huge HCC, 74 pairs of patients with BS-HCC and NBS-HCC were matched. Tumor pathological features including proportions of microvascular invasion, satellite nodules, and incomplete tumor encapsulation in the BS-HCC group were lower than the NBS-HCC group. At a median follow-up of 50.7 months, median OS and RFS of all patients with a solitary huge HCC after PSM were 27.8 and 10.1 months, respectively. The BS-HCC group had better median OS and RFS than the NBS-HCC group (31.9 vs. 21.0 months, P=0.01; and 19.7vs.6.4 months, P=0.015). Multivariate analyses identified BS-HCC as independently associated with better OS (HR 0.637, P=0.026) and RFS (HR 0.657, P=0.025).
Conclusions : For a solitary huge HCC, preoperative imaging on tumor morphology was associated with prognosis following resection. In particular, patients with BS-HCCs had better long-term survival following liver resection versus patients with NBS-HCCs.
Methods : Patients undergoing curative liver resection for a solitary huge HCC were identified from a multicenter database. Preoperative imaging findings were used to define spherical- or ellipsoidal-shaped lesions with smooth edges as balloon-shaped HCCs (BS-HCCs); out-of-shape lesions or lesions of any shape with matt edges were defined as non-balloon-shaped HCCs (NBS-HCCs). The two groups of patients with BS-HCCs and NBS-HCCs were matched in a 1:1 ratio using propensity score matching (PSM). Clinicopathologic characteristics, long-term overall survival (OS) and recurrence-free survival (RFS) were assessed.
Results : Among patients with a solitary huge HCC, 74 pairs of patients with BS-HCC and NBS-HCC were matched. Tumor pathological features including proportions of microvascular invasion, satellite nodules, and incomplete tumor encapsulation in the BS-HCC group were lower than the NBS-HCC group. At a median follow-up of 50.7 months, median OS and RFS of all patients with a solitary huge HCC after PSM were 27.8 and 10.1 months, respectively. The BS-HCC group had better median OS and RFS than the NBS-HCC group (31.9 vs. 21.0 months, P=0.01; and 19.7vs.6.4 months, P=0.015). Multivariate analyses identified BS-HCC as independently associated with better OS (HR 0.637, P=0.026) and RFS (HR 0.657, P=0.025).
Conclusions : For a solitary huge HCC, preoperative imaging on tumor morphology was associated with prognosis following resection. In particular, patients with BS-HCCs had better long-term survival following liver resection versus patients with NBS-HCCs.
SESSION
Plenary Session
Room A 3/5/2022 3:10 PM - 4:10 PM