PMID- 24100755
OWN - NLM
STAT- MEDLINE
DCOM- 20150511
LR  - 20220408
IS  - 1539-2031 (Electronic)
IS  - 0192-0790 (Linking)
VI  - 48
IP  - 8
DP  - 2014 Sep
TI  - Vascular invasion in hepatocellular carcinoma: prevalence, determinants and 
      prognostic impact.
PG  - 734-41
LID - 10.1097/MCG.0b013e3182a8a254 [doi]
AB  - GOALS/BACKGROUND: Macrovascular invasion (MaVI) is often detected by radiologic 
      imaging in hepatocellular carcinoma (HCC) patients and may affect their long-term 
      survival. We aimed to investigate the prevalence, determinants, and prognostic 
      impact of MaVI in patients with HCC receiving curative and noncurative therapies. 
      STUDY: A total of 2654 HCC patients in a single center were identified. The risk 
      factors and prognostic determinants of MaVI were determined. RESULTS: A total of 
      928 (35%) patients had MaVI. Old age, lower serum alpha-fetoprotein level, higher 
      serum sodium level, good performance status, smaller total tumor volume, and 
      better liver functional reserve were significantly associated with a lower risk 
      for VI. In the Cox proportional hazards model, patients with lower serum albumin 
      level, higher serum bilirubin and alpha-fetoprotein level, worse performance status, 
      the presence of ascites, and MaVI independently predicted a decreased long-term 
      survival in patients undergoing both curative and noncurative treatments. In 
      addition, lower sodium level and larger tumor size were independently associated 
      with a poor outcome in the noncurative treatment group. Of the patients with 
      MaVI, the 1-year survival rates for patients receiving surgical treatment, local 
      ablation, transarterial chemoembolization, and supportive care were 83%, 75%, 
      57%, and 24%, respectively (P<0.001). CONCLUSIONS: MaVI represents a distinct 
      tumor phenotype of HCC and is associated with younger age, aggressive tumor 
      behavior, poor liver functional reserve, and poor performance status. It 
      adversely affects the survival of HCC patients independent of treatment strategy. 
      Intensive anticancer therapy should be proposed to achieve a better long-term 
      survival for the at-risk patients.
FAU - Lee, Yun-Hsuan
AU  - Lee YH
AD  - *Faculty of Medicine  section signInstitute of Clinical Medicine #Institute of Pharmacology, 
      National Yang-Ming University School of Medicine, Taipei, Taiwan Departments of 
      daggerMedicine  parallelSurgery  paragraph signRadiology, Taipei Veterans General Hospital, Taipei, Taiwan 
      double daggerDepartment of Biostatistics, UCLA, Los Angeles, CA.
FAU - Hsu, Chia-Yang
AU  - Hsu CY
FAU - Huang, Yi-Hsiang
AU  - Huang YH
FAU - Hsia, Cheng-Yuan
AU  - Hsia CY
FAU - Chiou, Yi-You
AU  - Chiou YY
FAU - Su, Chien-Wei
AU  - Su CW
FAU - Lin, Han-Chieh
AU  - Lin HC
FAU - Huo, Teh-Ia
AU  - Huo TI
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Clin Gastroenterol
JT  - Journal of clinical gastroenterology
JID - 7910017
RN  - 0 (alpha-Fetoproteins)
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Carcinoma, Hepatocellular/*pathology/therapy
MH  - Female
MH  - Humans
MH  - Liver Neoplasms/*pathology/therapy
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Invasiveness
MH  - Prevalence
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Survival Rate
MH  - *Tumor Burden
MH  - alpha-Fetoproteins/metabolism
EDAT- 2013/10/09 06:00
MHDA- 2015/05/12 06:00
CRDT- 2013/10/09 06:00
PHST- 2013/10/09 06:00 [entrez]
PHST- 2013/10/09 06:00 [pubmed]
PHST- 2015/05/12 06:00 [medline]
AID - 10.1097/MCG.0b013e3182a8a254 [doi]
PST - ppublish
SO  - J Clin Gastroenterol. 2014 Sep;48(8):734-41. doi: 10.1097/MCG.0b013e3182a8a254.