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Prognostication algorithm for non-cirrhotic non-B non-C hepatocellular carcinoma—a multicenter study under the aegis of the French Association of Hepato-Biliary Surgery and liver Transplantation

BACKGROUND: Liver resection and local ablation are the only curative treatment for non-cirrhotic hepatocellular carcinoma (HCC). Few data exist concerning the prognosis of patients resected for non-cirrhotic HCC. The objectives of this study were to determine the prognostic factors of recurrence-fre...

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Detalles Bibliográficos
Autores principales: Maulat, Charlotte, Truant, Stéphanie, Hobeika, Christian, Barbier, Louise, Herrero, Astrid, Doussot, Alexandre, Gagnière, Johan, Girard, Édouard, Tranchart, Hadrien, Regimbeau, Jean-Marc, Fuks, David, Cauchy, François, Prodeau, Mathieu, Notte, Antoine, Toubert, Cyprien, Salamé, Ephrem, El Amrani, Mehdi, Andrieu, Sandrine, Muscari, Fabrice, Shourick, Jason, Suc, Bertrand
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10129883/
https://www.ncbi.nlm.nih.gov/pubmed/37124677
http://dx.doi.org/10.21037/hbsn-22-33
Descripción
Sumario:BACKGROUND: Liver resection and local ablation are the only curative treatment for non-cirrhotic hepatocellular carcinoma (HCC). Few data exist concerning the prognosis of patients resected for non-cirrhotic HCC. The objectives of this study were to determine the prognostic factors of recurrence-free survival (RFS) and overall survival (OS) and to develop a prognostication algorithm for non-cirrhotic HCC. METHODS: French multicenter retrospective study including HCC patients with non-cirrhotic liver without underlying viral hepatitis: F0, F1 or F2 fibrosis. RESULTS: A total of 467 patients were included in 11 centers from 2010 to 2018. Non-cirrhotic liver had a fibrosis score of F0 (n=237, 50.7%), F1 (n=127, 27.2%) or F2 (n=103, 22.1%). OS and RFS at 5 years were 59.2% and 34.5%, respectively. In multivariate analysis, microvascular invasion and HCC differentiation were prognostic factors of OS and RFS and the number and size were prognostic factors of RFS (P<0.005). Stratification based on RFS provided an algorithm based on size (P=0.013) and number (P<0.001): 2 HCC with the largest nodule ≤10 cm (n=271, Group 1); 2 HCC with a nodule >10 cm (n=176, Group 2); >2 HCC regardless of size (n=20, Group 3). The 5-year RFS rates were 52.7% (Group 1), 30.1% (Group 2) and 5% (Group 3). CONCLUSIONS: We developed a prognostication algorithm based on the number (≤ or >2) and size (≤ or >10 cm), which could be used as a treatment decision support concerning the need for perioperative therapy. In case of bifocal HCC, surgery should not be a contraindication.