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Teh-ia Huo - One of the best experts on this subject based on the ideXlab platform.
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An Albumin-Bilirubin (ALBI) Grade-based Prognostic Model For Patients With Hepatocellular Carcinoma Within Milan Criteria.
American journal of clinical oncology, 2019Co-Authors: Po-hong Liu, Cheng-yuan Hsia, Chia-yang Hsu, Yi-hsiang Huang, Hao-jan Lei, Ming-chih Hou, Teh-ia HuoAbstract:OBJECTIVE The Milan Criteria are recommended as the major reference for liver transplantation in patients with small hepatocellular carcinoma (HCC). However, alternative anticancer treatments are often utilized due to severe donor organ shortage. This study aimed to develop and validate an albumin-bilirubin (ALBI) grade-based prognostic model to stratify survival in patients within Milan Criteria undergoing nontransplant therapy. PATIENTS AND METHODS A total of 1655 patients were assigned into the derivation and validation cohort according to treatment modalities. Multivariate analysis was used to identify independent predictors of survival in the derivation cohort. An ALBI-based model was evaluated in the validation cohort. RESULTS In the Cox multivariate model, age 65 years or older (hazard ratio [HR]=1.576, P 100 ng/mL (HR=1.671, P 100 ng/mL, presence of ascites, performance status 1 to 4, and ALBI grade 2, and 2 points for ALBI grade 3. This model can accurately predict long-term outcome in the validation cohort (P
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Surgical Resection Is Better than Transarterial Chemoembolization for Hepatocellular Carcinoma Beyond Milan Criteria Independent of Performance Status
Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2014Co-Authors: Po-hong Liu, Yun-hsuan Lee, Cheng-yuan Hsia, Chia-yang Hsu, Yi-hsiang Huang, Han-chieh Lin, Yi-you Chiou, Teh-ia HuoAbstract:Background and Aims Performance status is tightly linked with survival in patients with hepatocellular carcinoma (HCC). We investigated the impact of performance status on HCC patients beyond the Milan Criteria receiving surgical resection (SR) or transarterial chemoembolization (TACE).
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Total Tumor Volume Is a Better Marker of Tumor Burden in Hepatocellular Carcinoma Defined by the Milan Criteria
World journal of surgery, 2013Co-Authors: Yun-hsuan Lee, Cheng-yuan Hsia, Chia-yang Hsu, Yi-hsiang Huang, Han-chieh Lin, Teh-ia HuoAbstract:Background The Milan Criteria are used to define small hepatocellular carcinoma (HCC) and to select patients for curative treatments. Total tumor volume (TTV) is an alternative parameter for tumor burden. We aimed to evaluate whether TTV is a feasible prognostic marker in HCC patients with upper boundary TTV of 65.5 cm3, which is equivalent to a single 5 cm tumor nodule defined by the Milan Criteria.
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a prognostic model for patients with hepatocellular carcinoma within the Milan Criteria undergoing non transplant therapies based on 1106 patients
Alimentary Pharmacology & Therapeutics, 2012Co-Authors: Yun-hsuan Lee, Cheng-yuan Hsia, Chia-yang Hsu, Yi-hsiang Huang, Han-chieh Lin, Yi-you Chiou, Teh-ia HuoAbstract:Summary Background The Milan Criteria are used to select candidates with small hepatocellular carcinoma (HCC) for liver transplantation. Due to severe shortage of donors, majority of patients within the Milan Criteria need to seek alternative treatments. Aim To propose a prognostic model for these patients undergoing non-transplant therapies. Methods A total of 1106 HCC patients, who were within the Milan Criteria and received non-transplant therapies were retrospectively analysed. Patients were randomly assigned to the derivation and validation set according to treatments. A prognostic model was constructed from independent predictors of survival identified in the multivariate Cox model of the derivation set and was confirmed in the validation set. Results In the Cox model, serum bilirubin ≥1.5 mg/dL [risk ratio (RR): 1.525, P = 0.016], α-fetoprotein (AFP) ≥100 ng/mL (RR: 1.728, P < 0.001), mild ascites (RR: 1.705, P = 0.025) and moderate/severe ascites (RR: 4.163, P < 0.001) were independent predictors of poor survival in the derivation set (n = 553). A prognostic model with a total of 0–4 points was derived with the sum of three variables: 1 point each for bilirubin ≥1.5 mg/dL, AFP ≥100 ng/mL and mild ascites, and 2 points for moderate/severe ascites. This scoring system accurately predicted the survival in the validation set (n = 553; P < 0.001). The model consistently discriminated the survival in patients stratified by curative and noncurative treatments (both P values <0.001). Conclusion The newly proposed prognostic scoring model, based on serum bilirubin and AFP level, and severity of ascites, is informative to predict the survival in non-transplant HCC patients within the Milan Criteria.
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A prognostic model for patients with hepatocellular carcinoma within the Milan Criteria undergoing non-transplant therapies, based on 1106 patients.
Alimentary pharmacology & therapeutics, 2012Co-Authors: Yun-hsuan Lee, Cheng-yuan Hsia, Chia-yang Hsu, Yi-hsiang Huang, Han-chieh Lin, Yi-you Chiou, Teh-ia HuoAbstract:Summary Background The Milan Criteria are used to select candidates with small hepatocellular carcinoma (HCC) for liver transplantation. Due to severe shortage of donors, majority of patients within the Milan Criteria need to seek alternative treatments. Aim To propose a prognostic model for these patients undergoing non-transplant therapies. Methods A total of 1106 HCC patients, who were within the Milan Criteria and received non-transplant therapies were retrospectively analysed. Patients were randomly assigned to the derivation and validation set according to treatments. A prognostic model was constructed from independent predictors of survival identified in the multivariate Cox model of the derivation set and was confirmed in the validation set. Results In the Cox model, serum bilirubin ≥1.5 mg/dL [risk ratio (RR): 1.525, P = 0.016], α-fetoprotein (AFP) ≥100 ng/mL (RR: 1.728, P
Jia-yin Yang - One of the best experts on this subject based on the ideXlab platform.
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Hepatic resection vs. transarterial chemoembolization for hepatocellular carcinoma beyond the Milan Criteria with portal hypertension.
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 2018Co-Authors: Jian Yang, Tian-fu Wen, Lunan Yan, Jia-yin Yang, Wentao WangAbstract:Abstract Objective To assess the value of hepatic resection by comparing it with transarterial chemoembolization for hepatocellular carcinoma beyond the Milan Criteria with clinically relevant portal hypertension. Methods A total of 363 patients and 193 propensity score-matched patients who had hepatocellular carcinoma beyond the Milan Criteria with clinically relevant portal hypertension and underwent hepatic resection or transarterial chemoembolization were retrospectively analyzed. The short-term and long-term results were compared. Results Postoperative complications and 30-day mortality were similar between the two groups. The hepatic resection provided a survival benefit over TACE at 1, 2, 3, and 5 years. Similar results were observed in the propensity score analysis. Five variables were identified as independent prognostic factors: treatment, AFP, Child–Pugh classification, tumor number and extension of disease in a multivariate analysis of the whole study population. In addition, only the tumor number was identified as an independent risk factor after propensity matching. The subgroup analysis demonstrated that the survival benefit of the hepatic resection can only be derived in a subset of patients with a single tumor. Conclusions In a properly selected group of patients with hepatocellular carcinoma beyond the Milan Criteria with clinically relevant portal hypertension, hepatic resection appears to be as safe as TACE and provides a significant survival benefit.
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Transplantation versus hepatectomy for HCC beyond the Milan Criteria: A propensity score analysis.
International journal of surgery (London England), 2017Co-Authors: Junyi Shen, Wentao Wang, Tian-fu Wen, Lvnan Yan, Jia-yin Yang, Jun WenAbstract:Abstract Background Increasing studies have suggested that surgical resection (SR) or liver transplantation (LT) could bring survival benefits for patients with hepacelluar carcinoma (HCC) beyond Milan Criteria. This study compared the long-term survival of patients beyond the Milan Criteria who received SR or LT. Material and methods A total of 461 HCC patients were retrospectively collected. Analysis was performed using propensity score matching (PSM), the Kaplan-Meier method and the Cox proportional hazards model. Results Prognosis was significantly better for the LT group than the SR group before (P Conclusion Our propensity model suggested that LT provided significantly better long-term survival than SR for HCC beyond Milan Criteria before and after PSM.
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postoperative prognostic nutritional index predicts survival of patients with hepatocellular carcinoma within Milan Criteria and hypersplenism
Journal of Gastrointestinal Surgery, 2017Co-Authors: Xiaoyun Zhang, Wei Peng, Chuan Li, Jia-yin YangAbstract:Background To investigate the predictable value of postprognostic nutritional index (PNI) for patients who are suffering hepatocellular carcinoma (HCC) within Milan Criteria and hypersplenism with well-preserved liver function after curative resection.
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Liver resection versus liver resection plus TACE for patients with hepatocellular carcinoma beyond Milan Criteria.
The Journal of surgical research, 2016Co-Authors: Tian-fu Wen, Wentao Wang, Lvnan Yan, Jia-yin YangAbstract:Abstract Background The recurrence of patients with hepatocellular carcinoma (HCC) beyond the Milan Criteria after liver resection (LR) is common. This study aimed to clarify whether LR plus postoperative adjuvant transcatheter arterial chemoembolization (TACE) could improve the outcomes of patients with HCC beyond the Milan Criteria after LR. Methods A total of 754 consecutive patients with HCC beyond the Milan Criteria who received LR alone ( n = 459) or LR + TACE ( n = 295) were included. A propensity scoring matched model (PSM) was used to adjust for the baseline differences between the groups. Results The 1, 3, and 5-y recurrence-free survival (76.7%, 40.4%, and 30.8%, respectively, for the LR-alone group versus 78.3%, 50.5%, and 46.2%, respectively, for the LR + TACE group; P = 0.004) and overall survival (94.1%, 58.3%, and 36.3%, respectively, for the LR-alone group versus 95.3%, 71.3%, and 54.9%, respectively, for the LR + TACE group; P Conclusions This study showed that LR + TACE may be beneficial for patients with HCC beyond the Milan Criteria. Postoperative adjuvant TACE should be considered to patients with HCC beyond the Milan Criteria.
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risk factors for early recurrence of hbv related hepatocellular carcinoma meeting Milan Criteria after curative resection
Asian Pacific Journal of Cancer Prevention, 2013Co-Authors: Wenjiang Zhu, Wentao Wang, Tian-fu Wen, Lvnan Yan, Jia-yin Yang, Chuying Huang, Wei Peng, Li JiangAbstract:Background: The prognosis of patients with hepatocellular carcinoma (HCC) after curative resection varies greatly. Few studies had investigated the risk factors for early recurrence (recurrence-free time ≤ 1 year) of hepatitis B virus (HBV)-related HCCs meeting Milan Criteria. Methods: A retrospective analysis was performed on the 224 patients with HCC meeting Milan Criteria who underwent curative liver resection in our center between February 2007 and March 2012. The overall survival (OS) rate, recurrence-free survival (RFS) rate and risk factors for early recurrence were analyzed. Results: After a median follow-up of 33.3 months, HCC reoccurred in 105 of 224 patients and 32 died during the period. The 1-, 3- and 5-year OS rates were 97.3%, 81.6% and 75.6% respectively, and the 1-, 3- and 5-year RFS rates were 73.2%, 53.7% and 41.6%. Cox regression showed alpha-fetoprotein (AFP) > 800 ng/ml (HR 2.538, 95% CI 1.464-4.401, P=0.001), multiple tumors (HR 2.286, 95% CI 1.123-4.246, P=0.009) and microvascular invasion (HR 2.518, 95% CI 1.475-4.298, P=0.001) to be associated with early recurrence (recurrence-free time ≤ 1-year) of HCC meeting Milan Criteria. Conclusions: AFP > 800 ng/ml, multiple tumors and microvascular invasion are independent risk factors affecting early postoperative recurrence of HCC. In addition resection appears capable of replacing liver transplantation in some situations with safety and a better outcome.
Tian-fu Wen - One of the best experts on this subject based on the ideXlab platform.
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Hepatic resection vs. transarterial chemoembolization for hepatocellular carcinoma beyond the Milan Criteria with portal hypertension.
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 2018Co-Authors: Jian Yang, Tian-fu Wen, Lunan Yan, Jia-yin Yang, Wentao WangAbstract:Abstract Objective To assess the value of hepatic resection by comparing it with transarterial chemoembolization for hepatocellular carcinoma beyond the Milan Criteria with clinically relevant portal hypertension. Methods A total of 363 patients and 193 propensity score-matched patients who had hepatocellular carcinoma beyond the Milan Criteria with clinically relevant portal hypertension and underwent hepatic resection or transarterial chemoembolization were retrospectively analyzed. The short-term and long-term results were compared. Results Postoperative complications and 30-day mortality were similar between the two groups. The hepatic resection provided a survival benefit over TACE at 1, 2, 3, and 5 years. Similar results were observed in the propensity score analysis. Five variables were identified as independent prognostic factors: treatment, AFP, Child–Pugh classification, tumor number and extension of disease in a multivariate analysis of the whole study population. In addition, only the tumor number was identified as an independent risk factor after propensity matching. The subgroup analysis demonstrated that the survival benefit of the hepatic resection can only be derived in a subset of patients with a single tumor. Conclusions In a properly selected group of patients with hepatocellular carcinoma beyond the Milan Criteria with clinically relevant portal hypertension, hepatic resection appears to be as safe as TACE and provides a significant survival benefit.
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Transplantation versus hepatectomy for HCC beyond the Milan Criteria: A propensity score analysis.
International journal of surgery (London England), 2017Co-Authors: Junyi Shen, Wentao Wang, Tian-fu Wen, Lvnan Yan, Jia-yin Yang, Jun WenAbstract:Abstract Background Increasing studies have suggested that surgical resection (SR) or liver transplantation (LT) could bring survival benefits for patients with hepacelluar carcinoma (HCC) beyond Milan Criteria. This study compared the long-term survival of patients beyond the Milan Criteria who received SR or LT. Material and methods A total of 461 HCC patients were retrospectively collected. Analysis was performed using propensity score matching (PSM), the Kaplan-Meier method and the Cox proportional hazards model. Results Prognosis was significantly better for the LT group than the SR group before (P Conclusion Our propensity model suggested that LT provided significantly better long-term survival than SR for HCC beyond Milan Criteria before and after PSM.
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Liver resection versus liver resection plus TACE for patients with hepatocellular carcinoma beyond Milan Criteria.
The Journal of surgical research, 2016Co-Authors: Tian-fu Wen, Wentao Wang, Lvnan Yan, Jia-yin YangAbstract:Abstract Background The recurrence of patients with hepatocellular carcinoma (HCC) beyond the Milan Criteria after liver resection (LR) is common. This study aimed to clarify whether LR plus postoperative adjuvant transcatheter arterial chemoembolization (TACE) could improve the outcomes of patients with HCC beyond the Milan Criteria after LR. Methods A total of 754 consecutive patients with HCC beyond the Milan Criteria who received LR alone ( n = 459) or LR + TACE ( n = 295) were included. A propensity scoring matched model (PSM) was used to adjust for the baseline differences between the groups. Results The 1, 3, and 5-y recurrence-free survival (76.7%, 40.4%, and 30.8%, respectively, for the LR-alone group versus 78.3%, 50.5%, and 46.2%, respectively, for the LR + TACE group; P = 0.004) and overall survival (94.1%, 58.3%, and 36.3%, respectively, for the LR-alone group versus 95.3%, 71.3%, and 54.9%, respectively, for the LR + TACE group; P Conclusions This study showed that LR + TACE may be beneficial for patients with HCC beyond the Milan Criteria. Postoperative adjuvant TACE should be considered to patients with HCC beyond the Milan Criteria.
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Second Hepatectomy Improves Survival in Patients With Microvascular Invasive Hepatocellular Carcinoma Meeting the Milan Criteria.
Medicine, 2015Co-Authors: Yi-fu Hou, Tian-fu Wen, Yong Gang Wei, Jia-ying Yang, Ke-fei ChenAbstract:Microvascular invasion (MVI) is a strong risk factor for patients with hepatocellular carcinoma (HCC) meeting the Milan Criteria and who have received curative hepatectomy. The relevance of a second hepatectomy in patients with MVI-positive recurrent HCC remains controversial. We had 329 cases of HCC hepatectomy meeting the Milan Criteria and compared data on patient demographics, liver function, and tumor pathology between MVI-positive and MVI-negative group. We analyzed potential risk factors of overall survival (OS) and disease-free survival (DFS). Furthermore, newly developed pathological features following the second hepatectomy were also analyzed.The median OS and DFS were significantly superior in the MVI-negative group than in the MVI-positive group, 61 (10-81) versus 49 (11-82) months (P 3 cm were independent risk factors associated with both OS and DFS. Overall survival was significantly improved by a second hepatectomy in the MVI-positive group compared with the original MVI-positive group, 60 (26-82) versus 49 (11-82) months, respectively. This was now comparable to the MVI-negative group, 60 (26-82) versus 61 (10-81) months (P = 0.72). A second hepatectomy was consistently associated with better survival in the MVI-negative group as compared to the MVI-positive group. A second hepatectomy improves survival in patients with MVI HCC meeting the Milan Criteria. The biology of MVI may change following a second hepatectomy. The absence of MVI is a good prognostic sign for patients undergoing second hepatectomy.
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Short-term and long-term outcomes of surgical treatment for HCC within Milan Criteria with cirrhotic portal hypertension.
Hepato-gastroenterology, 2014Co-Authors: Wang Chuan, Tian-fu Wen, Lvnan Yan, Guan-lin LiangAbstract:BACKGROUND/AIMS To compare and assess the outcomes of liver resection, radiofrequency ablation and liver transplantation for patients with hepatocellular carcinoma (HCC) within Milan Criteria and cirrhotic portal hypertension. METHODOLOGY 248 patients with HCC within Milan Criteria and cirrhotic portal hypertension who underwent surgical treatments (liver resection, radiofrequency ablation and liver transplantation were reviewed in this study. Patients were divided into three groups according to different surgical strategies: RST Group, RFA Group and LT Group. Pre- and intra-operative parameters were statistically analyzed. Postoperative outcomes including Hematological data and tumor data, complications, long-term survival rates and recurrence-free survival rates were compared. RESULTS The incidence of postoperative complications that were classified according to Clavien-Dido Classification were 16.22% for RST Group, 9.09% for RFA Group and 53.85% for LT Group. The 1-, 2- and 3-year recurrence-free survival rate of three groups were 88%, 74%, 68% for RST Group, 60%, 39%, 35% for RFA Group and 97%, 89%, 87% for LT Group, respectively. CONCLUSION Although the postoperative recurrence rate following RFA was higher than that of RST and LT, the long-term survival rates of three managements for patients with HCC within Milan Criteria and portal hypertension were similar.
Cheng-yuan Hsia - One of the best experts on this subject based on the ideXlab platform.
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An Albumin-Bilirubin (ALBI) Grade-based Prognostic Model For Patients With Hepatocellular Carcinoma Within Milan Criteria.
American journal of clinical oncology, 2019Co-Authors: Po-hong Liu, Cheng-yuan Hsia, Chia-yang Hsu, Yi-hsiang Huang, Hao-jan Lei, Ming-chih Hou, Teh-ia HuoAbstract:OBJECTIVE The Milan Criteria are recommended as the major reference for liver transplantation in patients with small hepatocellular carcinoma (HCC). However, alternative anticancer treatments are often utilized due to severe donor organ shortage. This study aimed to develop and validate an albumin-bilirubin (ALBI) grade-based prognostic model to stratify survival in patients within Milan Criteria undergoing nontransplant therapy. PATIENTS AND METHODS A total of 1655 patients were assigned into the derivation and validation cohort according to treatment modalities. Multivariate analysis was used to identify independent predictors of survival in the derivation cohort. An ALBI-based model was evaluated in the validation cohort. RESULTS In the Cox multivariate model, age 65 years or older (hazard ratio [HR]=1.576, P 100 ng/mL (HR=1.671, P 100 ng/mL, presence of ascites, performance status 1 to 4, and ALBI grade 2, and 2 points for ALBI grade 3. This model can accurately predict long-term outcome in the validation cohort (P
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Surgical Resection Is Better than Transarterial Chemoembolization for Hepatocellular Carcinoma Beyond Milan Criteria Independent of Performance Status
Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2014Co-Authors: Po-hong Liu, Yun-hsuan Lee, Cheng-yuan Hsia, Chia-yang Hsu, Yi-hsiang Huang, Han-chieh Lin, Yi-you Chiou, Teh-ia HuoAbstract:Background and Aims Performance status is tightly linked with survival in patients with hepatocellular carcinoma (HCC). We investigated the impact of performance status on HCC patients beyond the Milan Criteria receiving surgical resection (SR) or transarterial chemoembolization (TACE).
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Total Tumor Volume Is a Better Marker of Tumor Burden in Hepatocellular Carcinoma Defined by the Milan Criteria
World journal of surgery, 2013Co-Authors: Yun-hsuan Lee, Cheng-yuan Hsia, Chia-yang Hsu, Yi-hsiang Huang, Han-chieh Lin, Teh-ia HuoAbstract:Background The Milan Criteria are used to define small hepatocellular carcinoma (HCC) and to select patients for curative treatments. Total tumor volume (TTV) is an alternative parameter for tumor burden. We aimed to evaluate whether TTV is a feasible prognostic marker in HCC patients with upper boundary TTV of 65.5 cm3, which is equivalent to a single 5 cm tumor nodule defined by the Milan Criteria.
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Milan Criteria, multi-nodularity, and microvascular invasion predict the recurrence patterns of hepatocellular carcinoma after resection.
Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2012Co-Authors: Hung-hsu Hung, Cheng-yuan Hsia, Hao-jan Lei, Gar-yang Chau, Wei-yu Kao, Wing-yiu Lui, Han-chieh LinAbstract:Aims This study aims to evaluate the risk factors for tumor recurrence beyond the Milan Criteria (MC) for patients with hepatocellular carcinoma (HCC) after surgical resection (SR) in which salvage liver transplantation is relatively contraindicated.
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a prognostic model for patients with hepatocellular carcinoma within the Milan Criteria undergoing non transplant therapies based on 1106 patients
Alimentary Pharmacology & Therapeutics, 2012Co-Authors: Yun-hsuan Lee, Cheng-yuan Hsia, Chia-yang Hsu, Yi-hsiang Huang, Han-chieh Lin, Yi-you Chiou, Teh-ia HuoAbstract:Summary Background The Milan Criteria are used to select candidates with small hepatocellular carcinoma (HCC) for liver transplantation. Due to severe shortage of donors, majority of patients within the Milan Criteria need to seek alternative treatments. Aim To propose a prognostic model for these patients undergoing non-transplant therapies. Methods A total of 1106 HCC patients, who were within the Milan Criteria and received non-transplant therapies were retrospectively analysed. Patients were randomly assigned to the derivation and validation set according to treatments. A prognostic model was constructed from independent predictors of survival identified in the multivariate Cox model of the derivation set and was confirmed in the validation set. Results In the Cox model, serum bilirubin ≥1.5 mg/dL [risk ratio (RR): 1.525, P = 0.016], α-fetoprotein (AFP) ≥100 ng/mL (RR: 1.728, P < 0.001), mild ascites (RR: 1.705, P = 0.025) and moderate/severe ascites (RR: 4.163, P < 0.001) were independent predictors of poor survival in the derivation set (n = 553). A prognostic model with a total of 0–4 points was derived with the sum of three variables: 1 point each for bilirubin ≥1.5 mg/dL, AFP ≥100 ng/mL and mild ascites, and 2 points for moderate/severe ascites. This scoring system accurately predicted the survival in the validation set (n = 553; P < 0.001). The model consistently discriminated the survival in patients stratified by curative and noncurative treatments (both P values <0.001). Conclusion The newly proposed prognostic scoring model, based on serum bilirubin and AFP level, and severity of ascites, is informative to predict the survival in non-transplant HCC patients within the Milan Criteria.
Yun-hsuan Lee - One of the best experts on this subject based on the ideXlab platform.
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Surgical Resection Is Better than Transarterial Chemoembolization for Hepatocellular Carcinoma Beyond Milan Criteria Independent of Performance Status
Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2014Co-Authors: Po-hong Liu, Yun-hsuan Lee, Cheng-yuan Hsia, Chia-yang Hsu, Yi-hsiang Huang, Han-chieh Lin, Yi-you Chiou, Teh-ia HuoAbstract:Background and Aims Performance status is tightly linked with survival in patients with hepatocellular carcinoma (HCC). We investigated the impact of performance status on HCC patients beyond the Milan Criteria receiving surgical resection (SR) or transarterial chemoembolization (TACE).
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Total Tumor Volume Is a Better Marker of Tumor Burden in Hepatocellular Carcinoma Defined by the Milan Criteria
World journal of surgery, 2013Co-Authors: Yun-hsuan Lee, Cheng-yuan Hsia, Chia-yang Hsu, Yi-hsiang Huang, Han-chieh Lin, Teh-ia HuoAbstract:Background The Milan Criteria are used to define small hepatocellular carcinoma (HCC) and to select patients for curative treatments. Total tumor volume (TTV) is an alternative parameter for tumor burden. We aimed to evaluate whether TTV is a feasible prognostic marker in HCC patients with upper boundary TTV of 65.5 cm3, which is equivalent to a single 5 cm tumor nodule defined by the Milan Criteria.
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a prognostic model for patients with hepatocellular carcinoma within the Milan Criteria undergoing non transplant therapies based on 1106 patients
Alimentary Pharmacology & Therapeutics, 2012Co-Authors: Yun-hsuan Lee, Cheng-yuan Hsia, Chia-yang Hsu, Yi-hsiang Huang, Han-chieh Lin, Yi-you Chiou, Teh-ia HuoAbstract:Summary Background The Milan Criteria are used to select candidates with small hepatocellular carcinoma (HCC) for liver transplantation. Due to severe shortage of donors, majority of patients within the Milan Criteria need to seek alternative treatments. Aim To propose a prognostic model for these patients undergoing non-transplant therapies. Methods A total of 1106 HCC patients, who were within the Milan Criteria and received non-transplant therapies were retrospectively analysed. Patients were randomly assigned to the derivation and validation set according to treatments. A prognostic model was constructed from independent predictors of survival identified in the multivariate Cox model of the derivation set and was confirmed in the validation set. Results In the Cox model, serum bilirubin ≥1.5 mg/dL [risk ratio (RR): 1.525, P = 0.016], α-fetoprotein (AFP) ≥100 ng/mL (RR: 1.728, P < 0.001), mild ascites (RR: 1.705, P = 0.025) and moderate/severe ascites (RR: 4.163, P < 0.001) were independent predictors of poor survival in the derivation set (n = 553). A prognostic model with a total of 0–4 points was derived with the sum of three variables: 1 point each for bilirubin ≥1.5 mg/dL, AFP ≥100 ng/mL and mild ascites, and 2 points for moderate/severe ascites. This scoring system accurately predicted the survival in the validation set (n = 553; P < 0.001). The model consistently discriminated the survival in patients stratified by curative and noncurative treatments (both P values <0.001). Conclusion The newly proposed prognostic scoring model, based on serum bilirubin and AFP level, and severity of ascites, is informative to predict the survival in non-transplant HCC patients within the Milan Criteria.
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A prognostic model for patients with hepatocellular carcinoma within the Milan Criteria undergoing non-transplant therapies, based on 1106 patients.
Alimentary pharmacology & therapeutics, 2012Co-Authors: Yun-hsuan Lee, Cheng-yuan Hsia, Chia-yang Hsu, Yi-hsiang Huang, Han-chieh Lin, Yi-you Chiou, Teh-ia HuoAbstract:Summary Background The Milan Criteria are used to select candidates with small hepatocellular carcinoma (HCC) for liver transplantation. Due to severe shortage of donors, majority of patients within the Milan Criteria need to seek alternative treatments. Aim To propose a prognostic model for these patients undergoing non-transplant therapies. Methods A total of 1106 HCC patients, who were within the Milan Criteria and received non-transplant therapies were retrospectively analysed. Patients were randomly assigned to the derivation and validation set according to treatments. A prognostic model was constructed from independent predictors of survival identified in the multivariate Cox model of the derivation set and was confirmed in the validation set. Results In the Cox model, serum bilirubin ≥1.5 mg/dL [risk ratio (RR): 1.525, P = 0.016], α-fetoprotein (AFP) ≥100 ng/mL (RR: 1.728, P