Importance of tumor size as a prognostic factor after partial liver resection for solitary hepatocellular carcinoma: Implications on the current AJCC staging system

作者：Goh Brian K P^*; Teo Jin Yao; Chan Chung Yip; Lee Ser Yee; Jeyaraj Premaraj; Cheow Peng Chung; Chow Pierce K H; Ooi London L P J; Chung Alexander Y F

来源：Journal of Surgical Oncology, 2016, 113(1): 89-93.

DOI：10.1002/jso.24099

• hepatocellular carcinoma
• solitary
• prognosis
• survival
• staging
• American Joint Committee for Cancer
• TNM
• resection

BackgroundPresently, the impact of tumors size as a prognostic factor after curative liver resection (LR) for solitary hepatocellular carcinoma (HCC) remains controversial. This study was performed to determine the prognostic factors of patients undergoing LR for solitary HCC with special emphasis on the importance of tumor size.
MethodsBetween 2000 and 2013, 560 patients underwent curative LR for solitary primary HCC which met the study criteria.
ResultsOne-hundred and seventy-eight patients underwent major hepatectomies and the overall in-hospital mortality was 2.0%. There were 282 patients (50.4%) with liver cirrhosis. The 5-year overall survival (OS) was 64% and recurrence free survival (RFS) was 50%, respectively. Multivariate analyses demonstrated that cirrhosis, microvascular invasion and size were independent predictors of RFS and cirrhosis, microvascular invasion and age were independent prognostic factors of OS. Subset analysis demonstrated that tumor size was a prognostic factor for solitary HCC with microvascular invasion (AJCC T2) but not solitary HCC without microvascular invasion (AJCC T1).
ConclusionsSize, microvascular invasion, and cirrhosis are independent prognostic factors of RFS for solitary HCC after LR. Tumor size is an important prognostic factor in T2 but not T1 solitary tumors. These findings suggest that the current AJCC TNM staging system may need to be revised. J. Surg. Oncol. 2016;113:89-93.

• 出版日期2016-1-1