Prediction of long‑term survival rates in patients undergoing curative resection for solitary hepatocellular carcinoma

Cao,Yi; Jiang,Zhelong; Wang,Shaohu; Zhang,Haoyang; Jiang,Yi; Lv,Lizhi

doi:10.3892/ol.2017.7612

Prediction of long‑term survival rates in patients undergoing curative resection for solitary hepatocellular carcinoma

Authors:
- Yi Cao
- Zhelong Jiang
- Shaohu Wang
- Haoyang Zhang
- Yi Jiang
- Lizhi Lv
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Affiliations: Department of Hepatobiliary Surgery, Fuzhou General Hospital (Dongfang Hospital), Fuzhou, Fujian 350025, P.R. China, School of Public Health, Sun Yat‑sen University, Guangzhou, Guangdong 510000, P.R. China
Published online on: December 13, 2017 https://doi.org/10.3892/ol.2017.7612
Pages: 2574-2582

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Abstract

The present study developed a novel laboratory-based algorithm to predict long‑term survival rates in patients undergoing curative resection for solitary hepatitis B virus (HBV)‑related hepatocellular carcinoma (HCC). The present study included 426 patients with solitary HBV‑related HCC who underwent surgery for primary tumors at a single center between 2003 and 2012. Demographic characteristics, laboratory analysis, clinical pathology and immunohistochemistry of topoisomerase II‑a and Ki67 were analyzed. A simple prognostic risk calculator was developed using regression coefficients from multivariate models. A prognostic risk calculator incorporating tumor encapsulation, neutrophil-to-lymphocyte ratio, vascular invasion, α‑fetoprotein level, Edmondson‑Steiner classification, Topo II‑α, prognostic nutritional index and Child‑Pugh grade was constructed. The prognostic model demonstrated good discrimination with a C‑index prior to adjustment of 0.81 (95% confidence interval: 0.78‑0.84) and a bootstrap‑corrected C‑index of 0.81. Kaplan‑Meier curves demonstrated that the probabilities of overall survival rates in the low‑risk group were increased compared with those in the high‑risk group. The areas under the receiver operating characteristic curve using the method were greater compared with those under the 7th Tumor‑Node‑Metastasis system and Cancer of the Liver Italian Program scoring system [0.83 vs. 0.62 and 0.77 (P<0.001), respectively]. The simple prognostic model of the present study accurately predicted survival rates in patients. Such a prognostic risk calculator for staging patients undergoing curative resection for solitary HBV‑related HCC facilitates clinical surveillance and therapy.

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1	Stewart BW and Wild CP: World cancer report 2014International agency for research on cancer. World Health Organization; 2014, View Article : Google Scholar
2	Amarapurkar D, Han KH, Chan HL and Ueno Y: Asia-Pacific Working Party on Prevention of Hepatocellular Carcinoma: Application of surveillance programs for hepatocellular carcinoma in the Asia-Pacific region. J Gastroenterol Hepatol. 24:955–961. 2009. View Article : Google Scholar : PubMed/NCBI
3	Earl TM and Chapman WC: Hepatocellular carcinoma: Resection versus transplantation. Semin Liver Dis. 33:282–292. 2013. View Article : Google Scholar : PubMed/NCBI
4	Fan ST, Lo Mau C, Poon RT, Yeun C, Liu Leung C, Yuen WK, Lam Ming C, Ng KK and Chan Ching S: Continuous improvement of survival outcomes of resection of hepatocellular carcinoma: A 20-year experience. Ann Surg. 253:745–758. 2011. View Article : Google Scholar : PubMed/NCBI
5	Okamura Y, Sugiura T, Ito T, Yamamoto Y, Ashida R, Mori K and Uesaka K: Neutrophil to lymphocyte ratio as an indicator of the malignant behaviour of hepatocellular carcinoma. Br J Surg. 103:891–898. 2016. View Article : Google Scholar : PubMed/NCBI
6	Li X, Chen ZH, Xing YF, Wang TT, Wu DH, Wen JY, Chen J, Lin Q, Dong M, Wei L, et al: Platelet-to-lymphocyte ratio acts as a prognostic factor for patients with advanced hepatocellular carcinoma. Tumour Biol. 36:2263–2269. 2015. View Article : Google Scholar : PubMed/NCBI
7	Pinato D, North BV and Sharma R: A novel, externally validated inflammation-based prognostic algorithm in hepatocellular carcinoma: The prognostic nutritional index (PNI). Br J Cancer. 106:1439–1445. 2012. View Article : Google Scholar : PubMed/NCBI
8	Lee YL, Li WC, Tsai TH, Chiang HY and Ting CT: Body mass index and cholesterol level predict surgical outcome in patients with hepatocellular carcinoma in taiwan-a cohort study. Oncotarget. 7:22948–22959. 2016. View Article : Google Scholar : PubMed/NCBI
9	El Zawahry H, Nasar H, Mourad M, Zaky R and Samie AA: P-107Topoisomerase II Alpha (TopoIIα) As A Prognostic Biomarker In Hepatocellular Carcinoma. Ann Oncol. 26:iv302015. View Article : Google Scholar
10	Luo Y, Ren F, Liu Y, Shi Z, Tan Z, Xiong H, Dang Y and Chen G: Clinicopathological and prognostic significance of high Ki-67 labeling index in hepatocellular carcinoma patients: A meta-analysis. Int J Clin Exp Med. 8:10235–10247. 2015.PubMed/NCBI
11	Easson EC: TNM classification of malignant tumours. Br J Cancer. 30:101–102. 1974. View Article : Google Scholar
12	Llovet JM and Bruix J: Prospective validation of the cancer of the liver italian program (CLIP) score: A new prognostic system for patients with cirrhosis and hepatocellular carcinoma. Hepatology. 32:678–680. 2000. View Article : Google Scholar : PubMed/NCBI
13	Sobin LH: TNM: Evolution and relation to other prognostic factors. Semin Surg Oncol. 21:3–7. 2003. View Article : Google Scholar : PubMed/NCBI
14	Shim JH, Jun MJ, Han S, Lee YJ, Lee SG, Kim KM, Lim YS and Lee HC: Prognostic nomograms for prediction of recurrence and survival after curative liver resection for hepatocellular carcinoma. Ann Surg. 261:939–946. 2015. View Article : Google Scholar : PubMed/NCBI
15	Li Y, Xia Y, Li J, Wu D, Wan X, Wang K, Wu M, Liu J, Lau WY and Shen F: Prognostic nomograms for pre-and postoperative predictions of long-term survival for patients who underwent liver resection for huge hepatocellular carcinoma. J Am Coll Surg. 221:962–974.e4. 2015. View Article : Google Scholar : PubMed/NCBI
16	Yang P, Qiu J, Li J, Wu D, Wan X, Lau WY, Yuan Y and Shen F: Nomograms for pre-and postoperative prediction of long-term survival for patients who underwent hepatectomy for multiple hepatocellular carcinomas. Ann Surg. 263:778–786. 2016. View Article : Google Scholar : PubMed/NCBI
17	Repetto L, Fratino L, Audisio R A, Venturino A, Gianni W, Vercelli M, Parodi S, Lago Dal D, Gioia F, Monfardini S, et al: Comprehensive geriatric assessment adds information to Eastern cooperative oncology group performance status in elderly cancer patients: An Italian group for geriatric oncology study. J Clin Oncol. 20:494–502. 2002. View Article : Google Scholar : PubMed/NCBI
18	Zhou L, Rui JA, Zhou WX, Wang SB, Chen SG and Qu Q: Edmondson-Steiner grade: A crucial predictor of recurrence and survival in hepatocellular carcinoma without microvascular invasio. Pathol Res Pract. 213:824–830. 2017. View Article : Google Scholar : PubMed/NCBI
19	Schmilovitz-Weiss H, Tobar A, Halpern M, Levy I, Shabtai E and Ben-Ari Z: Tissue expression of squamous cellular carcinoma antigen and Ki67 in hepatocellular carcinoma-correlation with prognosis: A historical prospective study. Diagn Pathol. 6:1212011. View Article : Google Scholar : PubMed/NCBI
20	Kinoshita A, Onoda H, Imai N, Iwaku A, Oishi M, Fushiya N, Koike K, Nishino H and Tajiri H: Comparison of the prognostic value of inflammation-based prognostic scores in patients with hepatocellular carcinoma. Br J Cancer. 107:988–993. 2012. View Article : Google Scholar : PubMed/NCBI
21	Cillo U, Vitale A, Grigoletto F, Farinati F, Brolese A, Zanus G, Neri D, Boccagni P, Srsen N, D'Amico F, et al: Prospective validation of the Barcelona clinic liver cancer staging system. J Hepatol. 44:723–731. 2006. View Article : Google Scholar : PubMed/NCBI
22	Thuluvath PJ: Vascular invasion is the most important predictor of survival in HCC, but how do we find it? J Clin Gastroenterol. 43:101–102. 2009. View Article : Google Scholar : PubMed/NCBI
23	Yang L, Xu J, Ou D, Wu W and Zeng Z: Hepatectomy for huge hepatocellular carcinoma: Single institute's experience. World J Surg. 37:2189–2196. 2013. View Article : Google Scholar : PubMed/NCBI
24	Lim KC, Chow PK, Allen JC, Chia GS, Lim M, Cheow PC, Chung AY, Ooi LL and Tan SB: Microvascular invasion is a better predictor of tumor recurrence and overall survival following surgical resection for hepatocellular carcinoma compared to the Milan criteria. Ann Surg. 254:108–113. 2011. View Article : Google Scholar : PubMed/NCBI
25	Oishi K, Itamoto T, Amano H, Fukuda S, Ohdan H, Tashiro H, Shimamoto F and Asahara T: Clinicopathologic features of poorly differentiated hepatocellular carcinoma. J Surg Oncol. 95:311–316. 2007. View Article : Google Scholar : PubMed/NCBI
26	Hanahan D and Weinberg RA: Hallmarks of cancer: The next generation. Cell. 144:646–674. 2011. View Article : Google Scholar : PubMed/NCBI
27	Fu YP, Ni XC, Yi Y, Cai XY, He HW, Wang JX, Lu ZF, Han X, Cao Y, Zhou J, et al: A novel and validated inflammation-based score (IBS) predicts survival in patients with hepatocellular carcinoma following curative surgical resection: A STROBE-compliant article. Medicine (Baltimore). 95:e27842016. View Article : Google Scholar : PubMed/NCBI
28	Proctor MJ, Morrison DS, Talwar D, Balmer SM, Fletcher CD, O'Reilly DS, Foulis AK, Horgan PG and McMillan DC: A comparison of inflammation-based prognostic scores in patients with cancer. A Glasgow Inflammation Outcome Study. Eur J Cancer. 47:2633–2641. 2011. View Article : Google Scholar : PubMed/NCBI
29	Kinoshita A, Onoda H, Imai N, Nishino H and Tajiri H: C-reactive protein as a prognostic marker in patients with hepatocellular carcinoma. Hepatogastroenterology. 62:966–970. 2015.PubMed/NCBI
30	Watt PM and Hickson ID: Structure and function of type II DNA topoisomerases. Biochem J. 303:681–695. 1994. View Article : Google Scholar : PubMed/NCBI
31	Wendorff TJ, Schmidt BH, Heslop P, Austin CA and Berger JM: The structure of DNA-bound human topoisomerase II alpha: Conformational mechanisms for coordinating inter-subunit interactions with DNA cleavage. J Mol Biol. 424:109–124. 2012. View Article : Google Scholar : PubMed/NCBI
32	Ali Y and Hamid Abd S: Human topoisomerase II alpha as a prognostic biomarker in cancer chemotherapy. Tumour Biol. 37:47–55. 2016. View Article : Google Scholar : PubMed/NCBI
33	Panvichian R, Tantiwetrueangdet A, Angkathunyakul N and Leelaudomlipi S: TOP2A amplification and overexpression in hepatocellular carcinoma tissues. Biomed Res Int. 2015:3816022015. View Article : Google Scholar : PubMed/NCBI
34	Watanuki A, Ohwada S, Fukusato T, Makita F, Yamada T, Kikuchi A and Morishita Y: Prognostic significance of DNA topoisomerase IIalpha expression in human hepatocellular carcinoma. Anticancer Res. 22:1113–1119. 2001.
35	Scholzen T and Gerdes J: The Ki-67 protein: From the known and the unknown. J Cell Physiol. 182:311–322. 2000. View Article : Google Scholar : PubMed/NCBI