Typing of biliary tumor thrombus influences the prognoses of patients with hepatocellular carcinoma
Objective: To establish a new classification of biliary tumor thrombus (BTT). Methods: Overall survival of patients with BTT was first used to determine whether it correlated with current hepatocellular carcinoma staging systems. Univariate and multivariate analyses were used to determine factors af...
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doaj-8766ecafca844e0e91f59edee6ff2edb2021-08-10T05:03:48ZengChina Anti-Cancer AssociationCancer Biology & Medicine2095-39412021-08-0118380881510.20892/j.issn.2095-3941.2020.0202Typing of biliary tumor thrombus influences the prognoses of patients with hepatocellular carcinomaJuxian Sun0Jiayi Wu1Chang Liu2Jie Shi3Yonggang Wei4Jianyin Zhou5Zhibo Zhang6Wan Yee Lau7Maolin Yan8Shuqun Cheng9Department of Hepatic Surgery VI, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200433, ChinaShengli Clinical Medical College, Fujian Medical University, Fuzhou 350001, ChinaDepartment of Hepatic Surgery VI, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200433, ChinaDepartment of Hepatic Surgery VI, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200433, ChinaDepartment of Hepatobiliary Surgery, West China Hospital, Sichuan University, Chengdu 610041, ChinaDepartment of Hepatobiliary Surgery, Zhongshan Hospital, Xiamen University, Xiamen 361004, ChinaDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350002, ChinaDepartment of Hepatic Surgery VI, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200433, ChinaShengli Clinical Medical College, Fujian Medical University, Fuzhou 350001, ChinaDepartment of Hepatic Surgery VI, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200433, ChinaObjective: To establish a new classification of biliary tumor thrombus (BTT). Methods: Overall survival of patients with BTT was first used to determine whether it correlated with current hepatocellular carcinoma staging systems. Univariate and multivariate analyses were used to determine factors affecting the overall survival (OS) to form the basis of our new classification for BTT. Results: All 6 international staging systems showed overlapping survival curves. Univariate followed by multivariate analyses showed that total bilirubin and intrahepatic/extrahepatic BTT were significant risk factors of OS. Based on these data, a new BTT classification was defined as: Type I: intrahepatic BTT; and Type II: extrahepatic BTT involving a common bile duct or common hepatic duct. Type I was further subdivided into type Ia: BTT involving a second-order intrahepatic duct or above, and type Ib: BTT involving a first-order intrahepatic duct. Type II was further subdivided into type IIa and type IIb using a cut-off total bilirubin (TB) > 300 μmol/L. The numbers (percentages) of patients with types I and II BTT were 69 (34.2%) and 133 (65.8%), respectively. The median OS of type I patients was significantly higher than that of type II patients (37.5 months vs. 23.2 months; P = 0.002). Using subgroup analyses, OS outcomes were significantly different between the subgroups of type IIb and type IIa, although there was no significant difference between the type Ia and type Ib subgroups (P = 0.07). Conclusions: A new BTT classification was established to predict prognoses of HCC patients with BTT who underwent liver resection.http://www.cancerbiomed.org/index.php/cocr/article/view/1859hepatocellular carcinomabiliary tumor thrombusstaging systemsurgeryprognosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Juxian Sun Jiayi Wu Chang Liu Jie Shi Yonggang Wei Jianyin Zhou Zhibo Zhang Wan Yee Lau Maolin Yan Shuqun Cheng |
spellingShingle |
Juxian Sun Jiayi Wu Chang Liu Jie Shi Yonggang Wei Jianyin Zhou Zhibo Zhang Wan Yee Lau Maolin Yan Shuqun Cheng Typing of biliary tumor thrombus influences the prognoses of patients with hepatocellular carcinoma Cancer Biology & Medicine hepatocellular carcinoma biliary tumor thrombus staging system surgery prognosis |
author_facet |
Juxian Sun Jiayi Wu Chang Liu Jie Shi Yonggang Wei Jianyin Zhou Zhibo Zhang Wan Yee Lau Maolin Yan Shuqun Cheng |
author_sort |
Juxian Sun |
title |
Typing of biliary tumor thrombus influences the prognoses of patients with hepatocellular carcinoma |
title_short |
Typing of biliary tumor thrombus influences the prognoses of patients with hepatocellular carcinoma |
title_full |
Typing of biliary tumor thrombus influences the prognoses of patients with hepatocellular carcinoma |
title_fullStr |
Typing of biliary tumor thrombus influences the prognoses of patients with hepatocellular carcinoma |
title_full_unstemmed |
Typing of biliary tumor thrombus influences the prognoses of patients with hepatocellular carcinoma |
title_sort |
typing of biliary tumor thrombus influences the prognoses of patients with hepatocellular carcinoma |
publisher |
China Anti-Cancer Association |
series |
Cancer Biology & Medicine |
issn |
2095-3941 |
publishDate |
2021-08-01 |
description |
Objective: To establish a new classification of biliary tumor thrombus (BTT). Methods: Overall survival of patients with BTT was first used to determine whether it correlated with current hepatocellular carcinoma staging systems. Univariate and multivariate analyses were used to determine factors affecting the overall survival (OS) to form the basis of our new classification for BTT. Results: All 6 international staging systems showed overlapping survival curves. Univariate followed by multivariate analyses showed that total bilirubin and intrahepatic/extrahepatic BTT were significant risk factors of OS. Based on these data, a new BTT classification was defined as: Type I: intrahepatic BTT; and Type II: extrahepatic BTT involving a common bile duct or common hepatic duct. Type I was further subdivided into type Ia: BTT involving a second-order intrahepatic duct or above, and type Ib: BTT involving a first-order intrahepatic duct. Type II was further subdivided into type IIa and type IIb using a cut-off total bilirubin (TB) > 300 μmol/L. The numbers (percentages) of patients with types I and II BTT were 69 (34.2%) and 133 (65.8%), respectively. The median OS of type I patients was significantly higher than that of type II patients (37.5 months vs. 23.2 months; P = 0.002). Using subgroup analyses, OS outcomes were significantly different between the subgroups of type IIb and type IIa, although there was no significant difference between the type Ia and type Ib subgroups (P = 0.07). Conclusions: A new BTT classification was established to predict prognoses of HCC patients with BTT who underwent liver resection. |
topic |
hepatocellular carcinoma biliary tumor thrombus staging system surgery prognosis |
url |
http://www.cancerbiomed.org/index.php/cocr/article/view/1859 |
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