A new staging system for hepatocellular carcinoma associated with portal vein tumor thrombus  

作　　者：Wan Yee Lau Kang Wang Xiu-Ping Zhang Le-Qun Li Tian-Fu Wen Min-Shan Chen Wei-Dong Jia Li Xu Jie Shi Wei-Xing Guo Ju-Xian Sun Zhen-Hua Chen Lei Guo Xu-Biao Wei Chong-De Lu Jie Xue Li-Ping Zhou Ya-Xing Zheng Meng Wang Meng-Chao Wu Shu-Qun Cheng 

机构地区：[1]Department of Hepatic Surgery VI,Eastern Hepatobiliary Surgery Hospital,The Second Military Medical University,Shanghai,China [2]Faculty of Medicine,The Chinese University of Hong Kong,Hong Kong,China [3]Faculty of Hepato-Pancreato-Biliary Surgery,The First Medical Center of Chinese People’s Liberation Army(PLA)General Hospital,Beijing,China [4]Department of Hepatobiliary Surgery,Affiliated Tumor Hospital of Guangxi Medical University,Nanning,China [5]Department of Liver Surgery&Transplantation Center,West China Hospital of Sichuan University,Chengdu,China [6]Department of Hepatobiliary Surgery,Sun Yat-sen University Cancer Center,Guangzhou,China [7]Department of General Surgery,Affiliated Provincial Hospital,Anhui Medical University,Hefei,China [8]Anhui Province Key Laboratory of Hepatopancreatobiliary Surgery,Hefei,China

出　　处：《Hepatobiliary Surgery and Nutrition》2021年第6期782-795,I0003-I0005,共17页肝胆外科与营养（英文）

摘　　要：Background:A new staging system for patients with hepatocellular carcinoma(HCC)associated with portal vein tumor thrombus(PVTT)was developed by incorporating the good points of the BCLC classification of HCC,and by improving on the currently existing classifications of HCC associated with PVTT.Methods:Univariate and multivariate analysis with Waldχ2 test were used to determinate the clinical prognostic factors for overall survival(OS)in patients with HCC and PVTT in the training cohort.Then the conditional inference trees analysis was applied to establish a new staging system.Results:A training cohort of 2,179 patients from the Eastern Hepatobiliary Surgery Hospital and a validation cohort of 1,550 patients from four major liver centers in China were enrolled into establishing and validating a new staging system.The system was established by incorporating liver function,general health status,tumor resectability,extrahepatic metastasis and extent of PVTT.This staging system had a good discriminatory ability to separate patients into different stages and substages.The median OS for the two cohorts were 57.1(37.2-76.9),12.1(11.0-13.2),5.7(5.1-6.2),4.0(3.3-4.6)and 2.5(1.7-3.3)months for the stages 0 to IV,respectively(P<0.001)in the training cohort.The corresponding figures for the validation cohort were 6.4(4.9-7.9),2.8(1.3-4.4),10.8(9.3-12.4),and 1.5(1.3-1.7)months for the stages II to IV,respectively(P<0.001).The mean survival for stage 0 to 1 were 37.6(35.9-39.2)and 30.4(27.4-33.4),respectively(P<0.001).Conclusions:A new staging system was established which provided a good discriminatory ability to separate patients into different stages and substages after treatment.It can be used to supplement the other HCC staging systems.

关 键 词：Hepatocellular carcinoma(HCC) portal vein tumor thrombus(PVTT) staging system overall survival(OS) 

分 类 号：R73[医药卫生—肿瘤]