alexa Prediction of recurrence and prognosis in patients with hepatocellular carcinoma after resection by use of CLIP score.
Gastroenterology

Gastroenterology

Journal of Liver

Author(s): Zhao WH, Ma ZM, Zhou XR, Feng YZ, Fang BS, Zhao WH, Ma ZM, Zhou XR, Feng YZ, Fang BS

Abstract Share this page

Abstract AIM: The survival time of patients with hepatocellular carcinoma (HCC) after resection is hard to predict. Both residual liver function and tumor extension factors should be considered. A new scoring system has recently been proposed by the Cancer of the Liver Italian Program (CLIP). CLIP score was confirmed to be one of the best ways to stage patients with HCC. To our knowledge, however, the literature concerning the correlation between CLIP score and prognosis for patients with HCC after resection was not published. The aim of this study is to evaluate the recurrence and prognostic value of CLIP score for the patients with HCC after resection. METHODS: A retrospective survey was carried out in 174 patients undergoing resection of HCC from January 1986 to June 1998. Six patients who died in the hospital after operation and 11 patients with the recurrence of the disease were excluded at 1 month after hepatectomy. By the end of June 2001, 4 patients were lost and 153 patients with curative resection have been followed up for at least three years. Among 153 patients, 115 developed intrahepatic recurrence and 10 developed extrahepatic recurrence, whereas the other 28 remained free of recurrence. Recurrences were classified into early (< or =3 year) and late (>3 year) recurrence. The CLIP score included the parameters involved in the Child-Pugh stage (0-2), plus macroscopic tumor morphology (0-2), AFP levels (0-1), and the presence or absence of portal thrombosis (0-1). By contrast, portal vein thrombosis was defined as the presence of tumor emboli within vascular channel analyzed by microscopic examination in this study. Risk factors for recurrence and prognostic factors for survival in each group were analyzed by the chi-square test, the Kaplan-Meier estimation and the COX proportional hazards model respectively. RESULTS: The 1-, 3-, 5-, 7-,and 10-year disease-free survival rates after curative resection of HCC were 57.2\%, 28.3\%, 23.5\%, 18.8\%, and 17.8\%, respectively. Median survival time was 28, 10, 4, and 5 mo for CLIP score 0, 1, 2, 3, and 4 to 5, respectively. Early and late recurrence developed in 109 patients and 16 patients respectively. By the chi-square test, tumor size, microsatellite, venous invasion, tumor type (uninodular, multinodular, massive), tumor extension (< or = or >50\% of liver parenchyma replaced by tumor), TNM stage, CLIP score, and resection margin were the risk factors for early recurrence, whereas CLIP score and Child-Pugh stage were significant risk factors for late recurrence. In univariate survival analysis, Child-Pugh stages, resection margin, tumor size, microsatellite, venous invasion, tumor type, tumor extension, TNM stages, and CLIP score were associated with prognosis. The multivariate analysis by COX proportional hazards model showed that the independent predictive factors of survival were resection margins and TNM stages. CONCLUSION: CLIP score has displayed a unique superiority in predicting the tumor early and late recurrence and prognosis in the patients with HCC after resection.
This article was published in World J Gastroenterol and referenced in Journal of Liver

Relevant Expert PPTs

Relevant Speaker PPTs

  • Li Yu-Jung
    Intra-maxillary Drug delivery and Bio-sensing via Dental Implant and its considerations
    PPT Version | PDF Version
  • Nicolae Bacalbasa
    The benefits of surgery for breast cancer liver metastases – a single center experience
    PPT Version | PDF Version
  • Sitanshu Sekhar Lahiri
    A novel oral formulation for cancer therapy, loaded in a slow release matrix for targeted delivery
    PPT Version | PDF Version
  • Li-Chun Tsou
    Drug delivery device strategy for patient centric therapies
    PDF Version
  • Dipesh Shah
    Compatibility assessment of a model monoclonal antibody formulation in glass and in blow-fi ll-seal (BFS) plastic vial delivery formats
    PPT Version | PDF Version
  • Stephanie Ramos
    Enhanced Delivery of Dna-Based Vaccines and Immunotherapeutics through Next-Generation Electroporation Devices
    PPT Version | PDF Version
  • Nirmala Chauhan
    Modification of dietary fiber psyllium for use in oral insulin delivery
    PPT Version | PDF Version
  • Youngmi Jung
    TSG-6 induces liver regeneration by enhancing autophagy in mice with chronic liver damage
    PPT Version | PDF Version
  • Yosef Yarden
    Classically, the 3’untranslated region (3’UTR) is that region in eukaryotic protein-coding genes from the translation termination codon to the polyA signal. It is transcribed as an integral part of the mRNA encoded by the gene. However, there exists another kind of RNA, which consists of the 3’UTR alone, without all other elements in mRNA such as 5’UTR and coding region. The importance of independent 3’UTR RNA (referred as I3’UTR) was prompted by results of artificially introducing such RNA species into malignant mammalian cells. Since 1991, we found that the middle part of the 3’UTR of the human nuclear factor for interleukin-6 (NF-IL6) or C/EBP gene exerted tumor suppression effect in vivo. Our subsequent studies showed that transfection of C/EBP 3’UTR led to down-regulation of several genes favorable for malignancy and to up-regulation of some genes favorable for phenotypic reversion. Also, it was shown that the sequences near the termini of the C/EBP 3’UTR were important for its tumor suppression activity. Then, the C/EBP 3’UTR was found to directly inhibit the phosphorylation activity of protein kinase CPKC in SMMC-7721, a hepatocarcinoma cell line. Recently, an AU-rich region in the C/EBP 3’UTR was found also to be responsible for its tumor suppression. Recently we have also found evidence that the independent C/EBP 3’UTR RNA is actually exists in human tissues, such as fetal liver and heart, pregnant uterus, senescent fibroblasts etc. Through 1990’s to 2000’s, world scientists found several 3’UTR RNAs that functioned as artificial independent RNAs in cancer cells and resulted in tumor suppression. Interestingly, majority of genes for these RNAs have promoter-like structures in their 3’UTR regions, although the existence of their transcribed products as independent 3’UTR RNAs is still to be confirmed. Our studies indicate that the independent 3’UTR RNA is a novel non-coding RNA species whose function should be the regulation not of the expression of their original mRNA, but of some essential life activities of the cell as a whole.
    PPT Version | PDF Version
  • Suoqin Tang
    Survivin siRNA nano particles are capable of inhibiting liver cancer cell growth both in vitro and in vivo
    PPT Version | PDF Version
  • Arshad mahmood
    TRANSPORT OF SELF-NANOEMULSIFYING DRUG DELIVERY SYSTEM (SNEDDS) ACROSS MUCUS AND CELLULAR INTERNALIZATION
    PPT Version | PDF Version
  • Wei Duan
    Cancer stem cells targeted delivery of siRNA to overcome induced chemoresistance
    PPT Version | PDF Version
  • Yung-Chih Kuo
    “Yung-Chih Kuo-National-Chung-Cheng-University-Republic-of-China-Targeting-delivery-of-etoposide-to-inhibit-the-growth-of-human-glioblastoma-multiforme-using-lactoferrin-and-folic-acid-grafted-poly(lactide-co-glycolide)-nanoparticles”
    PPT Version | PDF Version
  • Biplab Mishra
    Compression of hepatoduodenal ligament by sponges during perihepatic packing for liver trauma leading to difficult maneuvering of angiography catheter through common hepatic artery: ‘Mishra Phenomenon’
    PPT Version | PDF Version
  • Mukesh Kumar
    Membrane fusion mediated cytosolic drug delivery through scFv targeted Sendai viral envelopes
    PPT Version | PDF Version

Recommended Conferences

Relevant Topics

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords