Tumor Biology

, Volume 37, Issue 7, pp 9301–9310 | Cite as

Total tumor volume predicts survival following liver resection in patients with hepatocellular carcinoma

  • Mu-xing Li
  • Hong Zhao
  • Xin-yu Bi
  • Zhi-yu Li
  • Zhen Huang
  • Yue Han
  • Jian-guo Zhou
  • Jian-jun Zhao
  • Ye-fan Zhang
  • Wen-qiang Wei
  • Dong-bin Zhao
  • Jian-qiang Cai
Original Article

Abstract

Assessing the prognosis of patients with hepatocellular carcinoma (HCC) by the number and size of tumors is sometimes difficult. The main purpose of the study was to evaluate the prognostic value of total tumor volume (TTV), which combines the two factors, in patients with HCC who underwent liver resection. We retrospectively reviewed 521 HCC patients from January 2001 to December 2008 in our center. Patients were categorized using the tertiles of TTV. The prognostic value of TTV was assessed. With a median follow-up of 116 months, the 1-, 3-, and 5-year overall survival (OS) rates of the patients were 93.1 , 69.9, and 46.3 %, respectively. OS was significantly differed by TTV tertile groups, and higher TTV was associated with shorter OS (P < 0.001). Multivariate analysis revealed that TTV was an independent prognostic factor for OS. Larger TTV was significantly associated with higher alpha-fetoprotein level, presence of macrovascular invasion, multiple tumor lesions, larger tumor size, and advanced tumor stages (all P < 0.05). Within the first and second tertiles of TTV (TTV ≤ 73.5 cm3), no significant differences in OS were detected in patients within and beyond Milan criteria (P = 0.183). TTV-based Cancer of the Liver Italian Program (CLIP) score gained the lowest Akaike information criterion value, the highest χ 2 value of likelihood ratio test, and the highest C-index among the tested staging systems. Our results suggested that TTV is a good indicator of tumor burden in patients with HCC. Further studies are warranted to validate the prognostic value of TTV.

Keywords

Total tumor volume Tumor burden Hepatocellular carcinoma Prognosis 

Abbreviations

HCC

Hepatocellular carcinoma

LR

Liver resection

TTV

Total tumor volume

HBV

Hepatitis B virus

HCV

Hepatitis C virus

AFP

Alpha-fetoprotein

TNM

Tumor-node-metastasis

BCLC

Barcelona Clinic Liver Cancer stage

CLIP

Cancer of the Liver Italian Program

AIC

Akaike information criterion

Notes

Acknowledgments

This study was funded by the National High-Tech R&D (863) Program of China (2015AA020408), the National Natural Science Foundation of China (81201967), the Beijing Natural Science Foundation (7144238), and Beijing Nova Program (No. 2009A69).

Compliance with ethical standards

Conflicts of interest

None

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Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2016

Authors and Affiliations

  • Mu-xing Li
    • 1
  • Hong Zhao
    • 1
  • Xin-yu Bi
    • 1
  • Zhi-yu Li
    • 1
  • Zhen Huang
    • 1
  • Yue Han
    • 2
  • Jian-guo Zhou
    • 1
  • Jian-jun Zhao
    • 1
  • Ye-fan Zhang
    • 1
  • Wen-qiang Wei
    • 3
  • Dong-bin Zhao
    • 1
  • Jian-qiang Cai
    • 1
  1. 1.Department of Abdominal Surgical Oncology, Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical College (CAMS and PUMC)BeijingPeople’s Republic of China
  2. 2.Department of Interventional Therapies, Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical College (CAMS and PUMC)BeijingPeople’s Republic of China
  3. 3.Department of Cancer EpidemiologyCancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS and PUMC)BeijingPeople’s Republic of China

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