ArticleHepatology international2022
A proposal for T1 subclassification in hepatocellular carcinoma: reappraisal of the AJCC 8th edition.
Article in Hepatology international, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06628661 (Ten-Year Outcomes of Operable Solitary Hepatocellular Carcinoma Patients), which is not on this map. Cited by 11 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Ten-Year Outcomes of Operable Solitary Hepatocellular Carcinoma Patients: Impact of Tumor Size Over 6.5 cm and Microvascular Invasion
Who cites it
11 citing papers in PubMed.
- Perioperative tislelizumab plus lenvatinib treatment for resectable hepatocellular carcinoma at high risk of recurrence: single-arm phase II trial.Nature communications · 2026Trial
- Comparative effectiveness of Chinese herbal medicine versus liraglutide for weight loss in adults with obesity: A 12-month real-world target trial emulation study.Integrative medicine research · 2026Article
- Tumor size larger than 6.5 cm and microvascular invasion are comparable prognosticators for hepatocellular carcinoma: a multi-institutional observational study.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Observational
- A Clinlabomics-Based Machine Learning Model Accurately Differentiates Atypical Hepatocellular Carcinoma from Atypical Benign Focal Hepatic Lesion.Journal of hepatocellular carcinoma · 2026Article
- Tumor Size Does Not Affect Survival Outcomes of Patients Undergoing Resection for a Single Hepatocellular Carcinoma Without Microscopic Vascular Invasion in the Modern Era of Antiviral Therapy.Digestive diseases and sciences · 2025Article
- Does autoimmune disease impair the survival of hepatocellular carcinoma patients undergoing liver resection? A multi-institutional observational study.Journal of cancer research and clinical oncology · 2024Observational
- Can Chinese herbal medicine offer feasible solutions for newly diagnosed esophageal cancer patients with malnutrition? a multi-institutional real-world study.Frontiers in pharmacology · 2024Article
- Survival impact of pre-transplant local treatments in liver transplant recipients with BCLC stage A hepatocellular carcinoma.American journal of cancer research · 2024Article
- The Index sAGP is Valuable for Distinguishing Atypical Hepatocellular Carcinoma from Atypical Benign Focal Hepatic Lesions.Journal of hepatocellular carcinoma · 2024Article
- The Extended Surgical Concepts for Hepatocellular Carcinoma in the Era of Immune Checkpoint Inhibitors.Journal of hepatocellular carcinoma · 2023Article
- Article
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10 authors.
Funding
Abstract
backgroundIn the 8th edition of American Joint Committee on Cancer (AJCC) staging system for hepatocellular carcinoma (HCC), tumor size is not considered in T1 stage. The present study aimed to find out the optimal cutoff for tumor size to further stratify patients with T1 HCC.
methodsOperated HCC patients were identified from the Chang Gung Research Database (CGRD), and the patients with T1bN0M0 tumors were further divided into two groups based on the tumor size. The resulting subgroups were denoted as T1b (≤ cutoff) and T1c (> cutoff). The survivals were compared between T1a/b and T1c as well as T1c and T2.
resultsFrom 2002 to 2018, a total of 2893 patients who underwent surgery for T1N0M0 HCC were identified from the CGRD. After excluding cases who died within 30 days of surgery, Kaplan-Meier survival analysis discovered that T1 tumors > 65 mm (T1c) had survivals similar to those of T2N0M0 tumors. Cox regression multivariate analysis further demonstrated that tumor size > 6.5 cm was an independent poor prognostic indicator for T1 HCC. Sensitivity tests also confirmed that tumors lager than 6.5 cm were significantly more likely to develop both tumor recurrence and liver-specific death after surgery.
conclusionsOur study demonstrated that tumor size would significantly impact the survival outcome of T1 HCC after surgery. Due to significantly worse survival, we proposed a subclassification within T1 HCC, T1c: solitary tumor > 6.5 cm without vascular invasion, to further stratify those patients at risk. Further studies are mandatory to validate our findings.
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