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Prognostic grade for resecting hepatocellular carcinoma: multicentre retrospective study
T Takayama1, S Yamazaki1, Y Matsuyama2
1Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan.
The British Journal of Surgery
|April 1, 2021
Summary
A new prognostic grading system for hepatocellular carcinoma (HCC) resection improves survival prediction. This system classifies patients into four grades (A1-C) to guide treatment decisions for liver cancer patients.
Area of Science:
- Hepatobiliary surgery
- Surgical oncology
- Liver cancer research
Background:
- Hepatocellular carcinoma (HCC) surgical treatment is advancing.
- A robust prediction model for survival after HCC resection is lacking.
- This study aimed to develop a prognostic grading system for HCC resection.
Purpose of the Study:
- To propose and validate a prognostic grading system for hepatocellular carcinoma (HCC) resection.
- To improve survival prediction for patients undergoing liver cancer surgery.
Main Methods:
- Retrospective, multicentre study of 16,931 patients undergoing HCC resection (2000-2007).
- Patients divided into training (8465) and validation (8466) sets using cross-validation.
- Prognostic factors identified using Cox model; predictive model built using decision-tree analysis.
Main Results:
- Four surgical grades (A1-C) classified based on prognosis, tumor characteristics, and resection margins.
- Five-year survival rates decreased significantly across grades: A1 (73.9%) to C (34.8%).
- Grades demonstrated equivalent reproducibility for overall and recurrence-free survival in the validation set (P < 0.001).
Conclusions:
- A novel prognostic grading system for HCC resection was developed.
- This grade effectively predicts prognosis for patients undergoing liver cancer surgery.
- The system offers a valuable tool for guiding clinical decisions in HCC management.
