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Xie Z.-B.,Guangxi Medical University | Xie Z.-B.,Fudan University | Wang X.-B.,Guangxi Medical University | Fu D.-L.,Fudan University | And 5 more authors.
OncoTargets and Therapy

Background: Patients with hepatocellular carcinoma have the risk of postoperative hepatitis B virus (HBV) reactivation (PHR). Antiviral therapy was given to patients with detectable HBV DNA levels but not to patients with undetectable HBV DNA levels. Methods: In this retrospective study, 258 patients were enrolled (HBV DNA levels <00 copies/mL group, n=159, and HBV DNA levels <500 copies/mL group, n=99). Results: A total of 50 patients (19.4%) had PHR. The following significant factors related to PHR were found: without antiviral therapy (hazard ratio [HR] =0.17, 95% confidence interval [CI] 0.031-0.911), hepatitis B e antigen positivity (HR =5.20, 95% CI 1.931-14.007), hepatitis B core antigen S1 positivity (HR =2.54, 95% CI 1.116-5.762), preoperative HBV DNA levels ≥500 copies/mL (HR =1.28, 95% CI 1.085-2.884), hepatic inflow occlusion (HR =3.60, 95% CI 1.402-9.277), moderate liver cirrhosis or more (HR =2.26, 95% CI 1.001-5.121), and blood transfusion (HR =2.89, 95% CI 0.836-10.041). Recurrence-free survival time was significantly shorter in patients with PHR (23.06±2.46 months) than in patients without PHR (29.30±1.27 months). Conclusion: Antiviral therapy could efficiently decrease the incidence of PHR. Patients with HBV DNA levels <500 copies/mL still have the risk of PHR. PHR remained as a prognostic risk factor for hepatocellular carcinoma recurrence and recurrence-free survival. © 2016 Xie et al. Source

Pang Y.-B.,Guangxi Medical University | Zhong J.-H.,Guangxi Medical University | Zhong J.-H.,Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center | Luo X.-L.,Guangxi Medical University | And 8 more authors.
Tumor Biology

The aim of this study was to analyze the clinicopathological characteristics and expression of liver stem cell markers of hepatocellular carcinoma (HCC) involving bile duct tumor thrombi (BDTT). A total of 35 patients with HCC and BDTT in a consecutive series of HCC patients who underwent surgical treatment were studied retrospectively and compared with 916 patients without BDTT from the same series. Clinicopathological characteristics, overall survival (OS), and tumor expression of liver stem cell markers CD133, CD90, EpCAM, CK19, VEGF, and C-kit were compared between the two patient groups. Analysis was performed for the entire patient groups as well as for 35 pairs of patients with or without BDTT matched by propensity score. HCC patients with BDTT tended to have smaller tumors than those without BDTT, as well as a higher probability of having poorly differentiated tumor, Child-Pugh class B, liver cirrhosis, and microvascular invasion. Tumor tissue in patients with BDTT showed significantly higher expression rates of all liver stem cell markers examined. OS was significantly lower for patients with BDTT at 1 year (69 vs 84 %), 3 years (37 vs 64 %), and 5 years (20 vs 55 %) (P < 0.001). Patients with HCC and BDTT show lower OS than patients without BDTT. The higher frequency of liver stem cell marker expression in the presence of BDTT suggests that such stem cells may play a role in the pathogenesis of this form of HCC. © 2015 International Society of Oncology and BioMarkers (ISOBM) Source

Liu L.,Guangxi Medical University | Zhang Q.-S.,Guangxi Medical University | Pan L.-H.,Guangxi Medical University | Zhong J.-H.,Guangxi Medical University | And 12 more authors.
Tumor Biology

Official guidelines group together all cases of solitary hepatocellular carcinoma (HCC) without macroscopic vascular invasion, regardless of tumor size. Here, we examined whether this is justified based on overall survival (OS) after hepatic resection (HR). Patients with newly diagnosed solitary HCC treated by initial HR from January 2004 to October 2013 were classified into six groups based on tumor size (in 2-cm increments). Combining adjacent categories with similar OS led to three groups: ≤5 cm (n = 426), >5 and ≤8 cm (n = 229), and >8 cm (n = 202). Among all patients, median survival time was 62 months, and OS was 95 % at 1 year, 73 % at 3 years, and 54 % at 5 years. Patients in the ≤5 cm group showed significantly higher OS (P < 0.001) and lower tumor recurrence (P = 0.004) than those in the >5 and ≤8 cm group, who in turn showed significantly higher OS (P = 0.003) and lower tumor recurrence (P = 0.021) than those in the >8 cm group. Our results suggest that patients with solitary HCC should be subclassified based on tumor size for more accurate prognosis. We propose defining solitary HCC tumors >5 and ≤8 cm as “large” and tumors >8 cm as “huge”. © 2015 International Society of Oncology and BioMarkers (ISOBM) Source

Chen J.,Guangxi Medical University | Chen J.,Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center | Bai T.,Guangxi Medical University | Bai T.,Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center | And 10 more authors.
International Journal of Clinical and Experimental Medicine

Background: Compared with open hepatectomy (OH), laparoscopic hepatectomy (LH) had better shortterm outcomes in normal hepatocellular carcinoma (HCC) patients. Since liver cirrhosis is the major risk of HCC, serve postoperative complications can be observed after LH in HCC patients with cirrhosis. We conducted this systematic review to analysis the safety and the efficiency of LH in HCC patients with liver cirrhosis. Methods: MEDLINE, EMBASE, the Cochrane Library, the Chinese National Knowledge Infrastructure database, and clinical trial registries were searched through March 2015. Risk ratios (RRs), weigh mean difference (WMD) and 95% confidence intervals (CIs) were calculated. Results: The analysis included 7 retrospective trials, altogether involving 828 patients. Patients in LH group had wider tumor margin (WMD = 0.12, 95% CI 0.04 to 0.21, P = 0.003), less blood loss (WMD = -157.25, 95% CI -295.05 to -19.45, P = 0.03), less blood transfusion (RR = 0.41, 95% CI 0.22 to 0.74, P = 0.004), less postoperative mobility (RR = 0.48, 95% CI 0.35 to 0.66, P<0.001) and less hospital stay (WMD = -4.11, 95% CI -6.23 to -1.98, P<0.001). Overall survival (OS) and disease free survival (DFS) were similar between 2 groups, except LH had a better 5-year survival rate (RR = 1.28, 95% CI 1.01 to 1.62, P = 0.04). Conclusion: In HCC patients with liver cirrhosis, LH have short-term outcomes advantages of tumor margin, blood loss, blood transfusion, postoperative mobility, and hospital stay. OS and DFS were similar between LH and OH. LH is safe in HCC patients with liver cirrhosis. © 2015 E-Century Publishing Corporation. All rights reserved. Source

Wang Y.-Y.,Guangxi Medical University | Zhong J.-H.,Guangxi Medical University | Zhong J.-H.,Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center | Su Z.-Y.,Guangxi Medical University | And 11 more authors.
British Journal of Surgery

Background The Child-Pugh (CP) score is used widely to assess liver function and predict postoperative outcomes in patients with hepatocellular carcinoma (HCC). Recently, the albumin-bilirubin (ALBI) score has been validated as a predictor of overall survival in these patients. This study aimed to compare the ability of the ALBI and CP scores to predict outcomes in patients with HCC after liver resection with curative intent. Methods Consecutive patients who underwent liver resection with curative intent for HCC between January 2007 and July 2013 were included in this retrospective study. The performance of the ALBI score in predicting postoperative liver failure (PHLF) and long-term survival was compared with that of the CP score. Results A total of 1242 patients were enrolled. Of these, 166 (13·4 per cent) experienced PHLF. The area under the receiver operating characteristic (ROC) curve of the ALBI score for predicting PHLF was greater than that of the CP score (0·723 versus 0·607; P < 0·001). Similar to findings for CP grade, the incidence and severity of PHLF increased with increasing ALBI grade. The ALBI grade stratified patients into at least two distinct overall survival cohorts (P < 0·001), whereas the CP grade did not. The ALBI grade also classified patients with CP grade A disease into two distinct overall survival cohorts (P < 0·001), and overall survival rates in the group with poorer survival were similar to those in the majority of patients with CP grade B disease. Both CP and ALBI scores had low power in predicting disease-free survival. Conclusion The ALBI grade predicted PHLF and overall survival in patients with HCC undergoing liver resection with curative intent more accurately than the CP grade. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd. Source

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