ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2022
Tumor Burden Score and Serum Alpha-fetoprotein Subclassify Intermediate-Stage Hepatocellular Carcinoma.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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12 citing papers in PubMed, 24 citations in OpenAlex.
- AAT score based on pretreatment indicators predicts outcomes in unresectable HCC patients treated with TACE, Sintilimab, and Bevacizumab.Frontiers in oncology · 2026Article
- Construction and validation of a novel liver function-tumor burden-inflammation-nutrition (LTIN) score for HCC patients underwent hepatectomy.BMC cancer · 2025Article
- Nomogram for predicting early cancer-related death due to recurrence after liver resection in hepatocellular carcinoma patients with Barcelona Clinic Liver Cancer (BCLC) stage B/C: a multicenter study.BMC gastroenterology · 2025Article
- Development of a weighted Alpha-Fetoprotein tumor burden score-integrated nomogram for predicting overall survival in locally ablated hepatocellular carcinoma patients.Frontiers in oncology · 2025Article
- The TBS-PALB-NLR Triad: A Novel Preoperative Prognostic System Guiding Therapeutic Decision-Making in Unresectable HCC Treated with Transarterial Chemoembolization.Journal of hepatocellular carcinoma · 2025Article
- Nomogram based on tumor burden score for prediction of prognosis of patients with hepatocellular carcinoma before hepatectomy.Frontiers in oncology · 2025Article
- Article
- Survival Benefit of Lenvatinib Plus PD-1 Inhibitor with or Without HAIC in Advanced Hepatocellular Carcinoma Beyond Oligometastasis: a Multicenter Cohort Study.ImmunoTargets and therapy · 2024Article
- PIVKA-II combined with tumor burden score to predict long-term outcomes of AFP-negative hepatocellular carcinoma patients after liver resection.Cancer medicine · 2024Article
- Using the hazard function to evaluate hepatocellular carcinoma recurrence risk after curative resection.Updates in surgery · 2023Article
- Impact of Surgical Margin Width on Prognosis Following Resection of Hepatocellular Carcinoma Varies on the Basis of Preoperative Alpha-Feto Protein and Tumor Burden Score.Annals of surgical oncology · 2023Article
- Article
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20 authors at 13 institutions in 10 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundResection of Barcelona Clinic Liver Cancer (BCLC) intermediate-stage hepatocellular carcinoma (HCC) remains controversial. While not recommended by the BCLC algorithm, some patients may indeed benefit from hepatectomy. We sought to identify that subset of patients who might derive long-term survival benefit from resection.
methodsIntermediate-stage HCC patients who underwent curative-intent resection were identified from an international multi-institutional database. Factors associated with long-term prognosis were identified using multivariate analysis and a risk score was developed and assessed.
resultsAmong 194 patients, most individuals had two tumors (n = 123, 63.4%) with a median size of 6.0 cm (IQR, 4.0-8.4) for a median tumor burden score (TBS) of 6.5 (IQR, 5.0-9.1); median alpha-fetoprotein (AFP) was 23.9 ng/mL (IQR, 5.0-503.2), and median overall survival (OS) was 69 months (IAR, 60.7-77.3). Factors associated with OS included AFP (referent ≤ 20 ng/mL, > 20 ng/mL: HR 1.78 95%CI, 1.09-2.89) and TBS (referent TBS ≤ 8.0, TBS > 8.0: HR 1.72 95%CI, 1.07-2.75). While 71 (36.6%) patients had neither risk factor, 79 (40.7%) and 44 (22.7%) had 1 or 2, respectively. A simplified score stratified patients relative to recurrence-free survival (RFS) (0: 33.6% vs. 1: 18.0% vs. 2: 14.7%) (AUC 0.60) and recurrence time (i.e., < 6 months after surgery) (0: 21.3% vs. 1: 43.1% vs. 2: 68.6%) (AUC 0.69) (both p < 0.001). Of note, a higher score was also associated with incrementally worse 5-year OS (0: 68.1% vs. 1: 61.0% vs. 2: 29.9%) (AUC 0.62) (p < 0.001).
conclusionLong-term OS and RFS outcomes varied considerably. Using a simple risk score, patients with low AFP and low TBS were identified as the subset of individuals most likely to benefit from resection.
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