Clinicopathological determinants of survival after hepatic resection of hepatocellular carcinoma in 97 patients--experience from an Australian hepatobiliary unit.
BACKGROUND
Identification of clinicopathological determinants that predict for risk of recurrence and overall survival after undergoing potentially curative hepatic resection for hepatocellular carcinoma is a strategy towards personalizing therapy to improve outcome. Through evaluation of a center's experience with treatment of a disease, determinants unique to the treated patient cohort may be identified.


METHODS
Ninety-seven patients with hepatocellular carcinoma underwent liver resection. Clinical, treatment, and histopathological variables were collected and evaluated using univariate and multivariate analyses with disease-free survival (DFS) and overall survival (OS) as the endpoints.


RESULTS
The median follow-up period of 19 (range, 1 to 188) months from the time of hepatic resection. The median DFS and OS after resection of HCC were 17 and 41 months, respectively. Five-year overall survival rate was 45%. Eight independent factors associated with disease-free and overall survival were identified through a multivariate analysis. Three factors: Child-Pugh score (DFS p = 0.045, OS p = 0.001), histopathological grade (DFS p < 0.001, OS p < 0.001), and histological diagnosis of cirrhosis (DFS p < 0.001, OS p < 0.001) predicted for both disease-free and overall survival.


CONCLUSIONS
Integrating the knowledge of identified prognostic factors into clinical decision making may provide a clinicopathological signature that could identify patients at greatest risk of treatment failure such that novel interventions may be applied to improve the survival outcome.
Chua
Terence C
TC
University of New South Wales Department of Surgery, St George Hospital, Level 3 Pitney Building, Gray Street, Kogarah, Sydney, 2217, NSW, Australia.
Saxena
Akshat
A
Chu
Francis
F
Liauw
Winston
W
Zhao
Jing
J
Morris
David L
DL
D014408:Biomarkers, Tumor / Q000097:blood; D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000401:mortality; D009517:New South Wales / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D000509:alpha-Fetoproteins / Q000378:metabolism
D014408:Biomarkers, Tumor; D000509:alpha-Fetoproteins