Effect of Diameter and Number of Hepatocellular Carcinomas on Survival After Resection, Transarterial Chemoembolization, and Ablation
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- Yoshikuni Kawaguchi
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan;
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- Kiyoshi Hasegawa
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan;
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- Yasuhiro Hagiwara
- Department of Biostatistics, School of Public Health, the University of Tokyo, Tokyo, Japan;
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- Mario De Bellis
- Department of Surgery, Division of General and Hepatobiliary Surgery, G.B. Rossi Hospital, University of Verona Medical School, Verona, Italy;
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- Simone Famularo
- School of Medicine and Surgery, University of Milano—Bicocca, Monza, Italy;
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- Elena Panettieri
- Hepatobiliary Surgery Unit, Foundation “Policlinico Universitario A. Gemelli” IRCCS, Catholic University of the Sacred Heart, Rome, Italy;
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- Yutaka Matsuyama
- Department of Biostatistics, School of Public Health, the University of Tokyo, Tokyo, Japan;
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- Ryosuke Tateishi
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;
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- Tomoaki Ichikawa
- Department of Diagnostic Radiology, Saitama Medical University International Medical Center, Saitama, Japan;
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- Takashi Kokudo
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan;
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- Namiki Izumi
- Department of Gastroenterology, Musashino Red Cross Hospital, Tokyo, Japan;
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- Shoji Kubo
- Departments of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan;
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- Michiie Sakamoto
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan;
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- Shuichiro Shiina
- Department of Gastroenterology, The Juntendo University, Tokyo, Japan;
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- Tadatoshi Takayama
- Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan;
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- Osamu Nakashima
- Department of Clinical Laboratory Medicine, Kurume University Hospital, Fukuoka, Japan;
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- Takamichi Murakami
- Department of Radiology, Kobe University Graduate School of Medicine, Hyogo, Japan;
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- Jean-Nicolas Vauthey
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA;
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- Felice Giuliante
- Hepatobiliary Surgery Unit, Foundation “Policlinico Universitario A. Gemelli” IRCCS, Catholic University of the Sacred Heart, Rome, Italy;
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- Luciano De Carlis
- School of Medicine and Surgery, University of Milano—Bicocca, Monza, Italy;
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- Fabrizio Romano
- School of Medicine and Surgery, University of Milano—Bicocca, Monza, Italy;
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- Andrea Ruzzenente
- Department of Surgery, Division of General and Hepatobiliary Surgery, G.B. Rossi Hospital, University of Verona Medical School, Verona, Italy;
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- Alfredo Guglielmi
- Department of Surgery, Division of General and Hepatobiliary Surgery, G.B. Rossi Hospital, University of Verona Medical School, Verona, Italy;
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- Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Kindai University School of Medicine, Osaka, Japan;
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- Norihiro Kokudo
- National Center for Global Health and Medicine, Tokyo, Japan.
抄録
<jats:sec> <jats:title>INTRODUCTION:</jats:title> <jats:p>Most studies predicting survival after resection, transarterial chemoembolization (TACE), and ablation analyzed diameter and number of hepatocellular carcinomas (HCCs) as dichotomous variables, resulting in an underestimation of risk variation. We aimed to develop and validate a new prognostic model for patients with HCC using largest diameter and number of HCCs as continuous variables.</jats:p> </jats:sec> <jats:sec> <jats:title>METHODS:</jats:title> <jats:p>The prognostic model was developed using data from patients undergoing resection, TACE, and ablation in 645 Japanese institutions. The model results were shown after balanced using the inverse probability of treatment-weighted analysis and were externally validated in an international multi-institution cohort.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS:</jats:title> <jats:p>Of 77,268 patients, 43,904 patients, including 15,313 (34.9%) undergoing liver resection, 13,375 (30.5%) undergoing TACE, and 15,216 (34.7%) undergoing ablation, met the inclusion criteria. Our model (http://www.u-tokyo-hbp-transplant-surgery.jp/about/calculation.html) showed that the 5-year overall survival (OS) in patients with HCC undergoing these procedures decreased with progressive incremental increases in diameter and number of HCCs. For patients undergoing resection, the inverse probability of treatment-weighted-adjusted 5-year OS probabilities were 10%–20% higher compared with patients undergoing TACE for 1–6 HCC lesions <10 cm and were also 10%–20% higher compared with patients undergoing ablation when the HCC diameter was 2–3 cm. For patients undergoing resection and TACE, the model performed well in the external cohort.</jats:p> </jats:sec> <jats:sec> <jats:title>DISCUSSION:</jats:title> <jats:p>Our novel prognostic model performed well in predicting OS after resection and TACE for HCC and demonstrated that resection may have a survival benefit over TACE and ablation based on the diameter and number of HCCs.</jats:p> </jats:sec>
収録刊行物
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- American Journal of Gastroenterology
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American Journal of Gastroenterology 116 (8), 1698-1708, 2021-04-21
Ovid Technologies (Wolters Kluwer Health)
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詳細情報 詳細情報について
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- CRID
- 1360013168807849472
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- ISSN
- 15720241
- 00029270
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- データソース種別
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- Crossref
- KAKEN