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Identification of Actual 10-Year Survival After Hepatectomy of HBV-Related Hepatocellular Carcinoma: a Multicenter Study

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Hepatitis B virus (HBV) infection is the leading cause of hepatocellular carcinoma (HCC) worldwide. The aim of the study was to identify the incidence and predictive factors of actual 10-year survival following liver resection of HBV-related HCC.

Methods

A Chinese multicenter database of patients undergoing curative hepatectomy of HBV-related HCC was reviewed. Patients who survived ≥ 10 years and patients who died < 10 years after surgery were compared and analyzed. Univariable and multivariable regression analyses were performed to identify predictive factors associated with 10-year survival.

Results

Among all enrolled 1016 patients, the actuarial 10-year survival rate was 24.1%, while the actual 10-year survival rate was 16.6%. There were 169 patients who survived at least 10 years after surgery and 688 who died within 10 years from surgery. These patients constituted the study population of this study. Multivariable regression analysis revealed that cirrhosis, preoperative HBV viral load > 104 copies/mL, maximum tumor size > 5 cm, multiple tumors, macroscopic and microscopic vascular invasion, postoperative HBV reactivation, and early recurrence (< 2 years after surgery) were independent risk factors associated with actual 10-year survival, while postoperative antiviral therapy, regular recurrence surveillance, and curative treatments for initial recurrence were independent protective factors.

Conclusions

The actual 10-year survival after curative resection of HBV-related HCC was calculated to be 16.6%. Postoperative antiviral therapy and regular recurrence surveillance were independent protective factors associated with actual 10-year survival after liver resection of HBV-related HCC.

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Abbreviations

HCC:

Hepatocellular carcinoma

HBV:

Hepatitis B virus

HCV:

Hepatitis C virus

BMI:

Body mass index

ASA:

American Society of Anesthesiologists

AST:

Aspartate transaminase

ALT:

Alanine aminotransferase

AFP:

Alpha-fetoprotein

CT:

Computed tomography

MRI:

Magnetic resonance imaging

TACE:

Transcatheter arterial chemoembolization

SD:

Standard deviation

OR:

Odds ratios

95% CI:

95% confidence interval

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Financial Support

This work was supported in part by the National Natural Science Foundation of China (No. 81472284 and 81672699) and Shanghai Pujiang Program (No. 16PJD004).

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Author notes

  1. Zhen-Li Li, Wen-Tao Yan, Jin Zhang and Yi-Jun Zhao contributed equally to this work.

Authors and Affiliations

  1. Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, No. 225, Changhai Road, Shanghai, 200438, China

    Zhen-Li Li, Wen-Tao Yan, Jin Zhang, Yi-Jun Zhao, Wan Yee Lau, Jun Han, Hao Xing, Han Wu, Chao Li, Ming-Da Wang, Meng-Chao Wu, Feng Shen & Tian Yang

  2. Department of Clinical Medicine, Second Military Medical University, Shanghai, China

    Wen-Tao Yan

  3. Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong SAR

    Wan Yee Lau

  4. Department of Hepatobiliary Surgery, The People’s Hospital of Hunan Province, Changsha, Hunan, China

    Xian-Hai Mao

  5. Department of Hepatobiliary Surgery, Mengchao Hepatobiliary Hospital, Fujian Medical University, Fuzhou, Fujian, China

    Yong-Yi Zeng

  6. Department of Hepatobiliary Surgery, Pu’er People’s Hospital, Pu’er, Yunnan, China

    Ya-Hao Zhou

  7. The First Department of General Surgery, The Fourth Hospital of Harbin, Harbin, Heilongjiang, China

    Wei-Min Gu

  8. Department of General Surgery, Liuyang People’s Hospital, Liuyang, Hunan, China

    Hong Wang

  9. Department of General Surgery, Ziyang First People’s Hospital, Ziyang, Sichuan, China

    Ting-Hao Chen

Authors
  1. Zhen-Li Li
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  2. Wen-Tao Yan
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  3. Jin Zhang
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  4. Yi-Jun Zhao
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  7. Yong-Yi Zeng
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  8. Ya-Hao Zhou
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  9. Wei-Min Gu
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  10. Hong Wang
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  12. Jun Han
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  13. Hao Xing
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  14. Han Wu
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  15. Chao Li
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  16. Ming-Da Wang
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  17. Meng-Chao Wu
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  18. Feng Shen
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  19. Tian Yang
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Contributions

Conception: Tian Yang, Feng Shen; study design: Tian Yang, Zhen-Li Li, Wen-Tao Yan, Jin Zhang, Xian-Hai Mao, Hao Xing, Jun Han; administrative support: Meng-Chao Wu, Feng Shen; data collection and acquisition: Chao Li, Ming-Da Wang, Ya-Hao Zhou, Ting-Hao Chen, Wei-Min Gu, Hong Wang, Yong-Yi Zeng; data analysis: Zhen-Li Li, Yi-Jun Zhao, Jun Han, Han Wu, Tian Yang; manuscript preparation: Zhen-Li Li, Wen-Tao Yan, Jin Zhang, Yi-Jun Zhao, Xian-Hai Mao, Tian Yang; critical revision: Feng Shen, Tian Yang, Wan Yee Lau; final approval of manuscript: all authors.

Corresponding authors

Correspondence to Feng Shen or Tian Yang.

Ethics declarations

Informed consent for the data to be used for clinical researches was obtained from all enrolled patients. This study was performed in accordance with the Declaration of Helsinki and the Ethical Guidelines for Clinical Studies of all the seven enrolled hospitals.

Conflict of Interest

The authors declare that they have no conflicts of interest.

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Li, ZL., Yan, WT., Zhang, J. et al. Identification of Actual 10-Year Survival After Hepatectomy of HBV-Related Hepatocellular Carcinoma: a Multicenter Study. J Gastrointest Surg 23, 288–296 (2019). https://doi.org/10.1007/s11605-018-4006-4

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