Impact of liver fibrosis on prognosis following liver resection for hepatitis B-associated hepatocellular carcinoma

Background: This study aims to evaluate the impact of liver fibrosis severity on prognosis following liver resection among HBV–HCC patients. Methods: Data were extracted from a prospective database of 189 HBV–HCC patients treated at Mount Sinai between 1995 and 2008. Fibrosis staging of each surgica...

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Published inBritish journal of cancer Vol. 109; no. 3; pp. 573 - 581
Main Authors Wang, Q, Fiel, M I, Blank, S, Luan, W, Kadri, H, Kim, K W, Manizate, F, Rosenblatt, A G, Labow, D M, Schwartz, M E, Hiotis, S P
Format Journal Article
LanguageEnglish
Published London Nature Publishing Group UK 06.08.2013
Nature Publishing Group
Subjects
692/699/1503/1607/1605
692/699/67/1504/1610
692/700/1750
692/700/565/545
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Biomedical and Life Sciences
Biomedicine
Cancer Research
Carcinoma, Hepatocellular - pathology
Carcinoma, Hepatocellular - surgery
Carcinoma, Hepatocellular - virology
Cirrhosis
Clinical Study
Drug Resistance
Epidemiology
Female
Gastroenterology. Liver. Pancreas. Abdomen
Hepatitis B
Hepatitis B, Chronic - pathology
Humans
Liver cancer
Liver cirrhosis
Liver Cirrhosis - pathology
Liver Cirrhosis - virology
Liver Neoplasms - pathology
Liver Neoplasms - surgery
Liver Neoplasms - virology
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Magnetic resonance imaging
Male
Medical prognosis
Medical research
Medical sciences
Middle Aged
Molecular Medicine
Multiple tumors. Solid tumors. Tumors in childhood (general aspects)
Neoplasm Recurrence, Local - pathology
Neoplasm Recurrence, Local - virology
Oncology
Other diseases. Semiology
Patients
Prognosis
Tumors
Young Adult
New York
United States > US
Ishak stage
hepatitis B
prognosis
resection
hepatocellular carcinoma
Hepatic fibrosis
Prognosis
Hepatic disease
Hepatocellular carcinoma
Surgical resection
Malignant tumor
Infection
Viral hepatitis B
Liver cancer
Clinical stage
Cancerology
Treatment
Surgery
Viral disease
Digestive diseases
Cancer
Online AccessGet full text
ISSN0007-0920
1532-1827
1532-1827
DOI10.1038/bjc.2013.352

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Abstract Background: This study aims to evaluate the impact of liver fibrosis severity on prognosis following liver resection among HBV–HCC patients. Methods: Data were extracted from a prospective database of 189 HBV–HCC patients treated at Mount Sinai between 1995 and 2008. Fibrosis staging of each surgical resection specimen using the modified Ishak method was performed by a single liver pathologist. Results: A wide range of Ishak fibrosis stage was observed among this patient population, with 29% having established cirrhosis (Ishak stage 6). Ishak stage 6 was independently associated with poor overall and recurrence-free survival. In patients with Ishak stage 1–5, Ishak stage did not affect survival; rather, tumour size was associated with poor overall survival, and tumour size, histologic activity index and serum AFP>20 ng ml −1 were associated with poor recurrence-free survival. In patients with Ishak stage 6, poorly differentiated histology and tumour size were associated with poor overall survival, and tumour size was associated with poor recurrence-free survival. Conclusion: HBV–HCC develops with varying degrees of underlying liver fibrosis; however, progressive liver fibrosis does not affect the outcomes following resection until cirrhosis is reached. Established cirrhosis, as defined histologically by Ishak stage 6, is an independent predictor of poor overall and recurrence-free survival among these patients.
AbstractList This study aims to evaluate the impact of liver fibrosis severity on prognosis following liver resection among HBV-HCC patients. Data were extracted from a prospective database of 189 HBV-HCC patients treated at Mount Sinai between 1995 and 2008. Fibrosis staging of each surgical resection specimen using the modified Ishak method was performed by a single liver pathologist. A wide range of Ishak fibrosis stage was observed among this patient population, with 29% having established cirrhosis (Ishak stage 6). Ishak stage 6 was independently associated with poor overall and recurrence-free survival. In patients with Ishak stage 1-5, Ishak stage did not affect survival; rather, tumour size was associated with poor overall survival, and tumour size, histologic activity index and serum AFP>20ngml(-1) were associated with poor recurrence-free survival. In patients with Ishak stage 6, poorly differentiated histology and tumour size were associated with poor overall survival, and tumour size was associated with poor recurrence-free survival. HBV-HCC develops with varying degrees of underlying liver fibrosis; however, progressive liver fibrosis does not affect the outcomes following resection until cirrhosis is reached. Established cirrhosis, as defined histologically by Ishak stage 6, is an independent predictor of poor overall and recurrence-free survival among these patients.
Background: This study aims to evaluate the impact of liver fibrosis severity on prognosis following liver resection among HBV-HCC patients. Methods: Data were extracted from a prospective database of 189 HBV-HCC patients treated at Mount Sinai between 1995 and 2008. Fibrosis staging of each surgical resection specimen using the modified Ishak method was performed by a single liver pathologist. Results: A wide range of Ishak fibrosis stage was observed among this patient population, with 29% having established cirrhosis (Ishak stage 6). Ishak stage 6 was independently associated with poor overall and recurrence-free survival. In patients with Ishak stage 1-5, Ishak stage did not affect survival; rather, tumour size was associated with poor overall survival, and tumour size, histologic activity index and serum AFP>20 ng ml super(-1) were associated with poor recurrence-free survival. In patients with Ishak stage 6, poorly differentiated histology and tumour size were associated with poor overall survival, and tumour size was associated with poor recurrence-free survival. Conclusion: HBV-HCC develops with varying degrees of underlying liver fibrosis; however, progressive liver fibrosis does not affect the outcomes following resection until cirrhosis is reached. Established cirrhosis, as defined histologically by Ishak stage 6, is an independent predictor of poor overall and recurrence-free survival among these patients.
Background: This study aims to evaluate the impact of liver fibrosis severity on prognosis following liver resection among HBV–HCC patients. Methods: Data were extracted from a prospective database of 189 HBV–HCC patients treated at Mount Sinai between 1995 and 2008. Fibrosis staging of each surgical resection specimen using the modified Ishak method was performed by a single liver pathologist. Results: A wide range of Ishak fibrosis stage was observed among this patient population, with 29% having established cirrhosis (Ishak stage 6). Ishak stage 6 was independently associated with poor overall and recurrence-free survival. In patients with Ishak stage 1–5, Ishak stage did not affect survival; rather, tumour size was associated with poor overall survival, and tumour size, histologic activity index and serum AFP>20 ng ml −1 were associated with poor recurrence-free survival. In patients with Ishak stage 6, poorly differentiated histology and tumour size were associated with poor overall survival, and tumour size was associated with poor recurrence-free survival. Conclusion: HBV–HCC develops with varying degrees of underlying liver fibrosis; however, progressive liver fibrosis does not affect the outcomes following resection until cirrhosis is reached. Established cirrhosis, as defined histologically by Ishak stage 6, is an independent predictor of poor overall and recurrence-free survival among these patients.
This study aims to evaluate the impact of liver fibrosis severity on prognosis following liver resection among HBV-HCC patients. Data were extracted from a prospective database of 189 HBV-HCC patients treated at Mount Sinai between 1995 and 2008. Fibrosis staging of each surgical resection specimen using the modified Ishak method was performed by a single liver pathologist. A wide range of Ishak fibrosis stage was observed among this patient population, with 29% having established cirrhosis (Ishak stage 6). Ishak stage 6 was independently associated with poor overall and recurrence-free survival. In patients with Ishak stage 1-5, Ishak stage did not affect survival; rather, tumour size was associated with poor overall survival, and tumour size, histologic activity index and serum AFP>20 ng ml(-1) were associated with poor recurrence-free survival. In patients with Ishak stage 6, poorly differentiated histology and tumour size were associated with poor overall survival, and tumour size was associated with poor recurrence-free survival. HBV-HCC develops with varying degrees of underlying liver fibrosis; however, progressive liver fibrosis does not affect the outcomes following resection until cirrhosis is reached. Established cirrhosis, as defined histologically by Ishak stage 6, is an independent predictor of poor overall and recurrence-free survival among these patients.
This study aims to evaluate the impact of liver fibrosis severity on prognosis following liver resection among HBV-HCC patients.BACKGROUNDThis study aims to evaluate the impact of liver fibrosis severity on prognosis following liver resection among HBV-HCC patients.Data were extracted from a prospective database of 189 HBV-HCC patients treated at Mount Sinai between 1995 and 2008. Fibrosis staging of each surgical resection specimen using the modified Ishak method was performed by a single liver pathologist.METHODSData were extracted from a prospective database of 189 HBV-HCC patients treated at Mount Sinai between 1995 and 2008. Fibrosis staging of each surgical resection specimen using the modified Ishak method was performed by a single liver pathologist.A wide range of Ishak fibrosis stage was observed among this patient population, with 29% having established cirrhosis (Ishak stage 6). Ishak stage 6 was independently associated with poor overall and recurrence-free survival. In patients with Ishak stage 1-5, Ishak stage did not affect survival; rather, tumour size was associated with poor overall survival, and tumour size, histologic activity index and serum AFP>20 ng ml(-1) were associated with poor recurrence-free survival. In patients with Ishak stage 6, poorly differentiated histology and tumour size were associated with poor overall survival, and tumour size was associated with poor recurrence-free survival.RESULTSA wide range of Ishak fibrosis stage was observed among this patient population, with 29% having established cirrhosis (Ishak stage 6). Ishak stage 6 was independently associated with poor overall and recurrence-free survival. In patients with Ishak stage 1-5, Ishak stage did not affect survival; rather, tumour size was associated with poor overall survival, and tumour size, histologic activity index and serum AFP>20 ng ml(-1) were associated with poor recurrence-free survival. In patients with Ishak stage 6, poorly differentiated histology and tumour size were associated with poor overall survival, and tumour size was associated with poor recurrence-free survival.HBV-HCC develops with varying degrees of underlying liver fibrosis; however, progressive liver fibrosis does not affect the outcomes following resection until cirrhosis is reached. Established cirrhosis, as defined histologically by Ishak stage 6, is an independent predictor of poor overall and recurrence-free survival among these patients.CONCLUSIONHBV-HCC develops with varying degrees of underlying liver fibrosis; however, progressive liver fibrosis does not affect the outcomes following resection until cirrhosis is reached. Established cirrhosis, as defined histologically by Ishak stage 6, is an independent predictor of poor overall and recurrence-free survival among these patients.
Author Hiotis, S P
Rosenblatt, A G
Schwartz, M E
Fiel, M I
Labow, D M
Luan, W
Wang, Q
Manizate, F
Kim, K W
Blank, S
Kadri, H
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  organization: Department of Surgery, Mount Sinai School of Medicine
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  organization: Department of Surgery, Mount Sinai School of Medicine
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  organization: Department of Surgery, Mount Sinai School of Medicine
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Issue 3
Keywords Ishak stage
hepatitis B
prognosis
resection
hepatocellular carcinoma
Hepatic fibrosis
Prognosis
Hepatic disease
Hepatocellular carcinoma
Surgical resection
Malignant tumor
Infection
Viral hepatitis B
Liver cancer
Clinical stage
Cancerology
Treatment
Surgery
Viral disease
Digestive diseases
Cancer
Language English
License http://www.springer.com/tdm
CC BY 4.0
From twelve months after its original publication, this work is licensed under the Creative Commons Attribution-NonCommercial-Share Alike 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/3.0
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OpenAccessLink https://www.nature.com/articles/bjc.2013.352
PMID 23846171
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PublicationTitle British journal of cancer
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Nature Publishing Group
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Snippet Background: This study aims to evaluate the impact of liver fibrosis severity on prognosis following liver resection among HBV–HCC patients. Methods: Data were...
This study aims to evaluate the impact of liver fibrosis severity on prognosis following liver resection among HBV-HCC patients. Data were extracted from a...
This study aims to evaluate the impact of liver fibrosis severity on prognosis following liver resection among HBV-HCC patients. Data were extracted from a...
This study aims to evaluate the impact of liver fibrosis severity on prognosis following liver resection among HBV-HCC patients.BACKGROUNDThis study aims to...
Background: This study aims to evaluate the impact of liver fibrosis severity on prognosis following liver resection among HBV-HCC patients. Methods: Data were...
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Liver Cirrhosis - virology
Liver Neoplasms - pathology
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Liver Neoplasms - virology
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Magnetic resonance imaging
Male
Medical prognosis
Medical research
Medical sciences
Middle Aged
Molecular Medicine
Multiple tumors. Solid tumors. Tumors in childhood (general aspects)
Neoplasm Recurrence, Local - pathology
Neoplasm Recurrence, Local - virology
Oncology
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Patients
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Title Impact of liver fibrosis on prognosis following liver resection for hepatitis B-associated hepatocellular carcinoma
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