Total Tumor Volume Is a Better Marker of Tumor Burden in Hepatocellular Carcinoma Defined by the Milan Criteria.

16:59 EDT 1st September 2014 | BioPortfolio

Summary of "Total Tumor Volume Is a Better Marker of Tumor Burden in Hepatocellular Carcinoma Defined by the Milan Criteria."


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.
METHODS:
A total of 774 HCC patients with TTV <65.5 cm3 receiving surgical resection, liver transplantation, or radiofrequency ablation (RFA) as the primary treatment were retrospectively analyzed.
RESULTS:
Of these patients, 50 (6.5 %) did not fulfill the Milan criteria. Patients beyond the Milan criteria more often had larger tumor size and TTV, as well as more tumor nodules (p values all <0.01). There was no significant survival difference between patients within and beyond the Milan criteria (p = 0.205). Patients with TTV >15 cm3 had a significantly poorer survival than patients with TTV <15 cm3 (p = 0.007). There was no survival difference between patients receiving surgical treatments versus RFA (p = 0.932). In the Cox proportional hazards model, TTV >15 cm3 [risk ratio (RR): 1.474, p = 0.005], serum bilirubin ≥1.5 mg/dL (
RR:
1.663, p = 0.003), serum sodium <135 mmol/L (
RR:
2.016, p = 0.01), and α-fetoprotein (AFP) ≥100 ng/mL (
RR:
1.37, p = 0.033) were independent predictors of poor prognosis.
CONCLUSIONS:
Total tumor volume, is an independent and better prognostic marker than the Milan criteria to indicate tumor burden in HCC patients who had tumor volume defined by the Milan criteria and underwent curative therapies.

Affiliation

Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.

Journal Details

This article was published in the following journal.

Name: World journal of surgery
ISSN: 1432-2323
Pages:

Links

PubMed Articles [21106 Associated PubMed Articles listed on BioPortfolio]

Prognostic value of metabolic tumor burden in lung cancer.

Accurate prognosis in patients with lung cancer is important for clinical decision making and treatment selection. The TNM staging system is currently the main method for establishing prognosis. Using...

A Case of Hepatocellular Carcinoma with Vp4 Tumor Thrombus Treated by Radiation Therapy before Hepatectomy.

A 61-year-old man who complained of right hypochondralgia was diagnosed as hepatocellular carcinoma (HCC) associated with hepatitis B virus (HBV) infection. The tumor was located in the right lobe and...

Relationship between whole-body tumor burden, clinical phenotype, and quality of life in patients with neurofibromatosis.

Patients with neurofibromatosis 1 (NF1), NF2, and schwannomatosis share a predisposition to develop multiple nerve sheath tumors. Previous studies have demonstrated that patients with NF1 and NF2 have...

New approaches for precise response evaluation in hepatocellular carcinoma.

With the increasing clinical use of cytostatic and novel biologic targeted agents, conventional morphologic tumor burden assessments, including World Health Organization criteria and Response Evaluati...

A case of surgical resection of lesions caused by extrahepatic seeding of hepatocellular carcinoma after percutaneous radiofrequency ablation.

We report a rare case of laparoscopic resection of lesions caused by extrahepatic seeding of hepatocellular carcinoma following percutaneous radiofrequency ablation (RFA). A 52-year-old man had underg...

Clinical Trials [7952 Associated Clinical Trials listed on BioPortfolio]

Immunotherapy of Hepatocellular Carcinoma by Induction of Anti-alpha Fetoprotein Response

The secretion by tumor cells of alpha fetoprotein (AFP) was observed in 50 to 60% of hepatocellular carcinoma. The AFP can be used as a marker for tumor recurrence after treatment and may ...

Tumor Growth Factors in Hepatocellular Carcinoma

Malignant cells frequently produce many tumor growth factors to autocidal or endocrinal proliferate growth, metastasis,or angiogenesis about tumor cells. By studying tumor growth factors i...

Melanoma Inhibitory Activity (MIA): A Serological Marker for Metastatic Uveal Melanoma

Uveal Melanoma is the most common primary intraocular tumor in adults. Most tumors metastasize to the liver. So far no sensitive or specific serological tumor marker is routinely used. The...

Comprehensive Treatment for Different Types of Tumor Thrombi in the Portal Vein for Hepatocellular Carcinoma Patients

This study is working to evaluate the surgical comprehensive treatment for different types of tumor thrombi in the portal vein for hepatocellular carcinoma patients, to establish a standar...

Transarterial Chemoembolisation Plus Bevacizumab for Treatment of Hepatocellular Carcinoma

Patients with liver cirrhosis and hepatocellular carcinoma will undergo transarterial chemoembolisation (TACE) as clinically indicated and will be randomized to receive bevacizumab or plac...

Medical and Biotech [MESH] Definitions

The total amount (cell number, weight, size or volume) of tumor cells or tissue in the body.

A proto-oncogene protein and member of the Wnt family of proteins. It is frequently up-regulated in human GASTRIC CANCER and is a tumor marker (TUMOR MARKERS, BIOLOGICAL) of gastric and COLORECTAL CANCER.

An unusual and aggressive tumor of germ-cell origin that reproduces the extraembryonic structures of the early embryo. It is the most common malignant germ cell tumor found in children. It is characterized by a labyrinthine glandular pattern of flat epithelial cells and rounded papillary processes with a central capillary (Schiller-Duval body). The tumor is rarely bilateral. Before the use of combination chemotherapy, the tumor was almost invariably fatal. (From DeVita Jr et al., Cancer: Principles & Practice of Oncology, 3d ed, p1189)

A tumor, basically a carcinoma with a single sarcoma such as leiomyosarcoma or angiosarcoma or multiple sarcomas of uterine origin. The role of estrogen has been postulated as a possible etiological factor in this tumor. (Holland et al., Cancer Medicine, 3d ed, p1703)

A member of the tumor necrosis factor receptor superfamily that may play a role in the regulation of NF-KAPPA B and APOPTOSIS. They are found on activated T-LYMPHOCYTES; B-LYMPHOCYTES; NEUTROPHILS; EOSINOPHILS; MAST CELLS and NK CELLS. Overexpression of CD30 antigen in hematopoietic malignancies make the antigen clinically useful as a biological tumor marker. Signaling of the receptor occurs through its association with TNF RECEPTOR-ASSOCIATED FACTORS.

Search BioPortfolio:
Advertisement
Advertisement