Abstract
BackgroundUntil now, several classification staging system and treatment algorithm for hepatocelluar carcinoma (HCC) has been presented. However, anatomical location is not taken into account in these staging systems. The aim of this study is to investigate whether anatomical sites could predict the postoperative recurrence of HCC patients.Methods294 HCC patients were enrolled in this retrospective study. A novel score classification based on anatomical sites was established by a Cox regression model and validated in the internal validation cohort.ResultsHCC patients were stratified according to the novel score classification into three groups (score 0, score 1–3 and score 4–6). The predictive accuracy of the novel recurrence score for HCC patients as determined by the area under the receiver operating characteristic curves (AUCs) at 1, 3, and 5 years (AUCs 0.703, 0.706, and 0.605) was greater than that of the other representative classification systems. These findings were supported by the internal validation cohort. For patients with Barcelona Clinic Liver Cancer (BCLC) 0 and A stage, our data demonstrated that there was no significant difference in recurrence-free survival (RFS) between patients with score 0 and liver transplantation recipients. Additionally, we introduced this novel classification system to guide anatomical liver resection for centrally located liver tumors.ConclusionThe novel score classification may provide a reliable and objective model to predict the RFS of HCC after hepatic resection.
Highlights
Until now, several classification staging system and treatment algorithm for hepatocelluar carcinoma (HCC) has been presented
According to Takasaki’s segmentation, there were 64 patients with HCC located in the left segment (L-HCC), 28 patients with HCC located in the middle segment (M-HCC), 58 patients with HCC located in the right segment (R-HCC), 1 patient with HCC located in caudate area and 60 multiple-HCC patients in the training cohort Table 2
In the internal validation cohort, there were 4 L-HCC, 12 M-HCC, 10 R-HCC, 1 patient with HCC located in caudate area and 3 multiple-HCC patients
Summary
Several classification staging system and treatment algorithm for hepatocelluar carcinoma (HCC) has been presented. Qin et al BMC Surg (2021) 21:278 the Milan criteria, tumors located in the same hepatic section (Couinaud’s segmentation) may lead to better long-term survival and lower HCC recurrence rates than tumors in different sections after HR [9]. The liver can be separated into three segments (a left, a middle and a right), which is supplied directly from the primary branch, and the caudate [10]. This Glissonean pedicle approach has made different types of hepatectomy possible including hemihepatectomy and small anatomical hepatectomies, such as sectionectomy and Couinaud’s segmentectomy in a cirrhotic liver [11]
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