Both the 5th and 6th editions of TNM staging system fail to independently predict long-term prognosis after radical hepatectomy in hepatocellular carcinoma sized > or = 5 cm.
- Author:
Li ZHOU
1
;
Jing-an RUI
;
Da-xiong YE
;
Shao-bin WANG
;
Shu-guang CHEN
;
Qiang QU
Author Information
- Publication Type:Journal Article
- MeSH: Adolescent; Adult; Aged; Carcinoma, Hepatocellular; mortality; pathology; surgery; Female; Hepatectomy; Humans; Liver Neoplasms; mortality; pathology; surgery; Male; Middle Aged; Neoplasm Staging; Prognosis
- From: Chinese Medical Sciences Journal 2009;24(4):220-226
- CountryChina
- Language:English
-
Abstract:
OBJECTIVETo validate the predictive power of the 5th and 6th editions of TNM staging system (TNM-5, TNM-6) in a Chinese patient cohort with hepatocellular carcinoma (HCC) sized > or = 5 cm after radical hepatectomy.
METHODSConsecutive 121 patients with HCC sized > or = 5 cm undergoing radical hepatectomy between January 1995 and December 2002 were included. The impact of clinicopathological variables on prognosis was determined by univariate and multivariate analyses, after excluding 2 perioperative deaths.
RESULTSIn univariate analysis, TNM-5 stage did not show prognostic significance for overall or disease-free survival, as opposed to TNM-6 stage, Edmondson-Steiner grade, portal vein tumor thrombosis (PVTT), vascular invasion, satellite nodule, Child-Pugh grade, and hepatitis B surface antigen (HBsAg) positivity. When these significant variables were entered in multivariate analysis, Edmondson-Steiner grade was the sole independent prognosticator for both overall and disease-free survival, whereas Child-Pugh grade independently influenced disease-free survival. However, TNM-6 stage lost its predictive potential in multivariate analysis.
CONCLUSIONSNeither TNM-5 nor TNM-6 staging system is revealed to be independently prognostic in patients with HCC sized > or = 5 cm after radical hepatectomy. Therefore, TNM-6 calls for more support in many subsets of HCC patients.
