ArticleAnnals of surgical oncology2021
Tumor Necrosis Impacts Prognosis of Patients Undergoing Curative-Intent Hepatocellular Carcinoma.
Article in Annals of surgical oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 51 citations in OpenAlex.
- Is tumor necrosis a clinical prognostic factor in hepato-biliary-pancreatic cancers? A systematic review and meta-analysis.Cancer medicine · 2023Pooled it
- Article
- Noninvasive prediction model for predicting spontaneous tumor necrosis in hepatocellular carcinoma and prognostic study.European journal of gastroenterology & hepatology · 2025Article
- MRI Imaging Biomarkers for Prognostication of Hepatocellular Carcinoma.Journal of the Korean Society of Radiology · 2025Review
- Article
- Deep learning for hepatocellular carcinoma recurrence before and after liver transplantation: a multicenter cohort study.Scientific reports · 2025Article
- Integrating CEUS Imaging Features and LI-RADS Classification for Postoperative Early Recurrence Prediction in Solitary Hepatocellular Carcinoma: A Machine Learning-Based Prognostic Approach.Journal of hepatocellular carcinoma · 2025Article
- Prognostic significance of MRI features in patients with solitary large hepatocellular carcinoma following surgical resection.European radiology · 2024Article
- Multiparametric MRI manifestations of the spontaneous intratumoral coagulative necrosis in HCC.Abdominal radiology (New York) · 2024Article
- Sopa: a technology-invariant pipeline for analyses of image-based spatial omics.Nature communications · 2024Article
- Article
- Portal Venous and Hepatic Arterial Coefficients Predict Post-Hepatectomy Overall and Recurrence-Free Survival in Patients with Hepatocellular Carcinoma: A Retrospective Study.Journal of hepatocellular carcinoma · 2024Article
- Pretreatment pulmonary tumor necrosis is a promising prognostic imaging biomarker for first-line anti-PD-1/PD-L1 therapy in advanced lung squamous cell carcinoma: a multi-institutional, propensity score-matching cohort analysis.Therapeutic advances in medical oncology · 2024Article
- Preoperative Noninvasive Prediction of Recurrence-Free Survival in Hepatocellular Carcinoma Using CT-Based Radiomics Model.Journal of hepatocellular carcinoma · 2024Article
- Prognostic value of tumor necrosis based on the evaluation of frequency in invasive breast cancer.BMC cancer · 2023Article
- Tumor micronecrosis predicts poor prognosis of patients with hepatocellular carcinoma after liver transplantation.BMC cancer · 2023Article
- Preoperative prediction model for macrotrabecular-massive hepatocellular carcinoma based on contrast-enhanced CT and clinical characteristics: a retrospective study.Frontiers in oncology · 2023Article
- Tumor necrosis as a predictor of early tumor recurrence after resection in patients with hepatoma.PloS one · 2023Article
- Early extrahepatic recurrence as a pivotal factor for survival after hepatocellular carcinoma resection: A 15-year observational study.World journal of gastroenterology · 2022Observational
- The SMART-ALPPS Protocol: Strategy to Minimize ALPPS Risks by Targeting Invasiveness.Annals of surgical oncology · 2021Article
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Authors and funding
19 authors at 12 institutions in 9 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe impact of tumor necrosis relative to prognosis among patients undergoing curative-intent resection for hepatocellular carcinoma (HCC) remains ill-defined.
methodsPatients who underwent curative-intent resection for HCC without any prior treatment between 2000 and 2017 were identified from an international multi-institutional database. Tumor necrosis was graded as absent, moderate (< 50% area), or extensive (≥ 50% area) on histological examination. The relationship between tumor necrosis, clinicopathologic characteristics, and long-term survival were analyzed.
resultsAmong 919 patients who underwent curative-intent resection for HCC, the median tumor size was 5.0 cm (IQR, 3.0-8.5). Tumor necrosis was present in 367 (39.9%) patients (no necrosis: n = 552, 60.1% vs < 50% necrosis: n = 256, 27.9% vs ≥ 50% necrosis: n = 111, 12.1%). Extent of tumor necrosis was also associated with more advanced tumor characteristics. HCC necrosis was associated with OS (median OS: no necrosis, 84.0 months vs < 50% necrosis, 73.6 months vs ≥ 50% necrosis: 59.3 months; p < 0.001) and RFS (median RFS: no necrosis, 49.6 months vs < 50% necrosis, 38.3 months vs ≥ 50% necrosis: 26.5 months; p < 0.05). Patients with T1 tumors with extensive ≥ 50% necrosis had an OS comparable to patients with T2 tumors (median OS, 62.9 vs 61.8 months; p = 0.645). In addition, patients with T2 disease with necrosis had long-term outcomes comparable to patients with T3 disease (median OS, 61.8 vs 62.4 months; p = 0.713).
conclusionTumor necrosis was associated with worse OS and RFS, as well as T-category upstaging of patients. A modified AJCC T classification that incorporates tumor necrosis should be considered in prognostic stratification of HCC patients.
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