Prognostic factors affecting postoperative survival of patients with solitary small hepatocellular carcinoma.

Mu-Yan Cai,Jie-Wei Chen,Feng-Wei Wang,Jing-Ping Yun,Li-Xu Yan,Rong-Zhen Luo,Chang-Peng Li,Dan Xie,Yi-Xin Zeng

doi:10.1186/s40880-016-0143-x

Mu-Yan Cai, Jie-Wei Chen + Show 7 more

Open Access

https://doi.org/10.1186/s40880-016-0143-x

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Abstract

BackgroundSmall hepatocellular carcinoma (sHCC) is a unique variant of HCC that is characterized by small tumor size (maximum tumor diameter ≤3 cm) and favorable long-term outcomes. The present study aimed to define clinicopathologic factors that predict survival in patients with sHCC.MethodsThe study population consisted of 335 patients who underwent hepatectomy for solitary sHCC between December 1998 and 2010. Prognostic factors were evaluated using Kaplan–Meier curves and Cox proportional hazard models.ResultsThe 5-year overall survival (OS) and recurrence-free survival (RFS) rates were 77.7% and 59.9%, respectively. Kaplan–Meier curves showed that tumor size and vascular invasion had prognostic significance within this relatively selected cohort (P < 0.05). Multivariate analysis confirmed that increased tumor size and vascular invasion were independent prognostic factors for short OS (hazard ratio [HR] = 2.367, 95% confidence interval [CI] 1.406–3.985; HR = 2.954, 95% CI 1.781–4.900) and RFS (HR = 1.779, 95% CI 1.259–2.514; HR = 1.699, 95% CI 1.165–2.477) in sHCC patients (P < 0.05). Importantly, a proposed prognostic scoring model was derived according to the two variables; tumor size and extent of vascular invasion were significantly associated with OS and RFS in patients with sHCC (P < 0.001).ConclusionsTumor size and vascular invasion are feasible and useful prognostic factors for sHCC. The proposed prognostic model, based on tumor size and vascular invasion, is informative in predicting survival in sHCC patients undergoing hepatectomy.

Highlights

Small hepatocellular carcinoma is a unique variant of Hepatocellular carcinoma (HCC) that is characterized by small tumor size and favorable long-term outcomes
Patient characteristics Using the criteria described above, 335 cases of Small hepatocellular carcinoma (sHCC) were included in this study
New prognostic model of tumor size and vascular invasion in sHCC Based on the results of our univariate and multivariate analyses, we proposed a new clinicopathologic prognostic model with two prognostic factors: tumor size and vascular invasion

Summary

Introduction

Small hepatocellular carcinoma (sHCC) is a unique variant of HCC that is characterized by small tumor size (maximum tumor diameter ≤3 cm) and favorable long-term outcomes. The present study aimed to define clin‐ icopathologic factors that predict survival in patients with sHCC. Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide [1]. It is imperative to identify patients at high risk for optimal follow-up or postoperative adjuvant therapies in these patients [11, 12]. The known risk factors for sHCC enable the identification and screening of patients at high risk for HCC; prognosis-related factors are yet to know, which would enable stratification of sHCC patients into treatment groups following hepatectomy [13,14,15]. Clinicopathologic features are the main factors affecting postoperative survival of patients with sHCC. The current study was to identify clinicopathologic factors that predict survival of sHCC patients who underwent hepatectomy

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