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Prognostic Role of Time to Surgery in Hepatocellular Carcinoma at Barcelona Clinic Liver Cancer Stage 0-A

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Postsurgical recurrence is common in early-stage hepatocellular carcinoma (HCC). Prolonged time to surgery (TTS) may lead to tumor progression. However, the impact of TTS on HCC prognosis is controversial in Western studies and unknown in China. We aim to investigate the impact of TTS on the prognosis of Chinese HCC patients at Barcelona Clinic Liver Cancer (BCLC) stage 0-A who underwent surgery.

Patients and Methods

We retrospectively enrolled 967 BCLC 0-A HCC patients who underwent surgery at three tertiary centers in China. Primary outcomes were recurrence-free survival (RFS) and overall survival (OS). Restricted cubic spline (RCS) was used to select the cutoff value of TTS. Propensity score matching (PSM) was performed to reduce confounding bias, and a time-dependent Cox model was utilized to investigate factors influencing TTS.

Results

The median TTS of BCLC 0-A HCC patients was 13 days (interquartile range: 10–21 days). For patients with TTS ≤ 70 days, the cutoff value of TTS was 13 days according to RCS. After PSM, corresponding 1-, 3-, and 5-year RFS of the TTS > 13 days and TTS ≤ 13 days groups were 75.6%, 55.3%, 46.4% and 71.2%, 52.3%, 38.8%, respectively (P = 0.103). Corresponding 1-, 3-, and 5-year OS of TTS > 13 days and TTS ≤ 13 days groups were 93.7%, 82.8%, 69.6% and 92.4%, 78.5%, 68.4%, respectively (P = 0.580). Time-dependent Cox analysis revealed that age and tumor size were factors influencing TTS.

Conclusions

Our study suggests that, for patients with TTS ≤ 70 days, prolonged TTS had no impact on BCLC 0-A Chinese HCC patients receiving surgery.

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Acknowledgment

This work was supported by the National Natural Science Foundation of China (grant nos. 81801703, 81770608), the National Science Fund for Distinguished Young Scholars (grant no. 81825013), the Natural Science Foundation of Guangdong Province (grant no. 2018A030310282), Science and Technology Program of Guangzhou, China (grant no. 201704020215), and the National high level talents special support plan— “Ten thousand plan”—Young top-notch talent support program (grant no. not available).

Author information

Author notes

  1. Mengchao Wei, Shuling Chen, and Jiali Li have contributed equally to this paper.

Authors and Affiliations

  1. Department of Liver Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

    Mengchao Wei MD, Shaoqiang Li MD, Dongming Li MD, Baogang Peng MD & Ming Kuang MD

  2. Division of Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

    Shuling Chen MD & Ming Kuang MD

  3. Department of General Surgery, Dongguan People’s Hospital, Dongguan, China

    Jiali Li MD

  4. Clinical Trials Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

    Bin Li MSc, Zhenwei Peng MD, Qian Zhou MSc & Sui Peng MD

  5. Department of Medical Imaging, Cancer Center of Sun Yat-sen University, Guangzhou, China

    Jingxian Shen MD

  6. Department of Radiation Oncology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

    Zhenwei Peng MD & Xiaofang He MD

  7. Department of Medical Oncology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

    Ying Zou MM

  8. Department of Pancreatobiliary Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

    Jiaming Lai MD

  9. Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

    Sui Peng MD

  10. Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China

    Beijiao Qin MB

  11. Cancer Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

    Ming Kuang MD

  12. Institute of Precision Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

    Ming Kuang MD

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  1. Mengchao Wei MD
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  2. Shuling Chen MD
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Corresponding author

Correspondence to Ming Kuang MD.

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Electronic supplementary material

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Supplementary material 1 The distribution of TTS of 1018 eligible patients (TIFF 86 kb)

10434_2020_8499_MOESM2_ESM.tiff

Supplementary material 2 The comparison of RFS (Supplementary figure 2a) and OS (Supplementary figure 2b) between TTS > 13 days and TTS ≤ 13 days groups before PSM (TIFF 104 kb)

Supplementary material 3 (DOCX 16 kb)

Supplementary material 4 (DOCX 43 kb)

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Wei, M., Chen, S., Li, J. et al. Prognostic Role of Time to Surgery in Hepatocellular Carcinoma at Barcelona Clinic Liver Cancer Stage 0-A. Ann Surg Oncol 27, 3740–3753 (2020). https://doi.org/10.1245/s10434-020-08499-2

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  • DOI: https://doi.org/10.1245/s10434-020-08499-2

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