Sex Differences in Early and Late Recurrence after Liver Resection of Hepatocellular Carcinoma (A Multicenter Study from China)

( Jiong-jie Yu ),( Ju-dong Li ),( Xin-fei Xu ),( Zhen-li Li ),( Jun Han ),( Hao Xing ),( Han Wu ),( Jian-hong Zhong ),( Yi-sheng Huang ),( Ya- Hao Zhou ),( Ting-hao Chen ),( Hong Wang ),( Wei-min Gu ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: There is a striking sex difference in the incidence of hepatocellular carcinoma (HCC), with a strong predominance for males. However, the impact of sex on the incidence of recurrence after curative resection of HCC remains controversial. Herein, we assess sex differences in the risks of recurrence and mortality for patients undergone curative resection of HCC. Methods: Data from 1,435 HCC patients undergone curative resection (1,228 males and 207 females) between 2004 and 2014 at five institutions in China were retrospectively analyzed. Patients’ baseline characteristics, operative variables, and rates of early recurrence (≤ 2 years after resection), late recurrence (> 2 years) and cancer-specific mortality (CSM) were evaluated and compared. Multivariable competing-risks regression analyses were performed to identify predictors associated with CSM, early and late recurrence. Results: The early recurrence rates between males and females were similar (43.3% vs. 42.0%, P=0.728), but the late recurrence and CSM rates in males were higher when compared to females (17.2% vs. 11.2%, P=0.044; 42.8% vs. 34.3%, P=0.022). Multivariable competing-risks regression analyses revealed no sex difference in early recurrence; however, males had significantly higher late recurrence rate [hazard ratio (HR), 1.752; 95% CI, 1.145-2.682; P=0.010] and CSM rate (HR, 1.307; 95% CI, 1.015-1.683; P=0.038) than females. Conclusions: Males had significantly higher late recurrence and CSM rates after curative resection of HCC than females. This suggests postoperative surveillance for HCC recurrence be varied by sex, especially for patients without recurrence at 2 years after resection.

Study on modulation of near infrared radiation based on plasma photonic crystal

Hao Jiong-Ju,Xie Xun,Gu Ke-Da,Liu Yu-Jie,Xia Lei,Yang Hong-Wei 한국물리학회 2020 Current Applied Physics Vol.20 No.8

In this paper, a plasma photonic crystal (PPC) for infrared radiation modulation which is composed of indium tin oxide (ITO) and plasma is proposed. The performance of plasma photonic crystal in near infrared radiation modulation is researched by transfer matrix method (TMM). The simulation results show that the near infrared radiation pass band can be adjusted by the changing of plasma frequency of plasma. The reflection to near infrared radiation by plasma photonic crystal increases with plasma frequency and that of absorption decreases. In addition, the modulation performance of the plasma photonic crystal at different incidence wave angles is also studied. The results show that the incident wave angles have little effect on the transmission of plasma photonic crystal in near infrared band. The reflection of the plasma photonic crystal to near infrared radiation decreases with increasing of the incident wave angle, but that of the absorption increases with the incident wave angle. Therefore, the proposed plasma photonic crystal has a potential application in tunable near infrared filter devices.

Preoperative Prealbumin Level as an Independent Predictor of Long-Term Prognosis after Curative Liver Resection of Hepatocellular Carcinoma (a Multicenter Study of 1,483 Patients)

( Ju-dong Li ),( Xin-fei Xu ),( Jiong-jie Yu ),( Jia-he Wang ),( Li- Yang Sun ),( Wen-tao Yan ),( Bing Quan ),( Jian-hong Zhong ),( Yi-sheng Huang ),( Ya-hao Zhou ),( Ting-hao Chen ),( Hong Wang ),( W 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: Serum prealbumin is more sensitive to profile nutritional status and liver function than albumin, which could hardly be affected by infusion supplement. This study aims: to identify the relationship between preoperative prealbumin level and the long-term prognosis after curative resection of hepatocellular carcinoma (HCC). Methods: Patients undergone HCC curative resection between 2001 and 2014 at six institutions in China were enrolled. By using 170 mg/dl as cut-off value of serum prealbumin level, these patients were divided into the low and normal preoperative prealbumin groups. The overall survival (OS) and recurrence-free survival (RFS) were analyzed and compared. Univariable and multivariable Cox-regression analyses were performed to identify predictive factors of OS and RFS. Results: Among 1,483 patients, 437 (29.5%) had a low prealbumin level within a week before surgery. The 1-, 3-, and 5-year OS and RFS rates of patients in the low prealbumin group were 83.8, 57.0, and 31.1%, and 67.0, 39.8, and19.9%, respectively, which was significantly poorer than those in the normal group (93.0, 75.5, and 42.6%, and 77.0, 56.4, and 28.4%, both P<0.001). Multivariable analyses revealed that preoperative prealbumin level, but not albumin level, was an independent predictor of OS (HR, 1.789; 95% CI: 1.544 -2.072, P<0.001) and RFS (HR, 1.420; 95% CI: 232-1.636, P<0.001). Conclusions: Preoperative prealbumin level is useful for predicting long-term prognosis in patients undergoing liver resection for HCC. Prealbumin may be suitable to displace albumin, yielding to an updated Child-Pugh grade for accessing liver function.

Association of Family History with Cancer Recurrence and Survival in Patients with Hepatitis B-Related Hepatocellular Carcinoma (A Propensity Score Matching Analysis)

( Ju-dong Li ),( Xin-fei Xu ),( Jiong-jie Yu ),( Zhen-li Li ),( Hao Xing ),( Han Wu ),( Han Zhang ),( Chao Li ),( Ming-da Wang ),( Meng-chao Wu ),( Wan-yee Lau ),( Tian Yang ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: A family history of liver cancer is regarded as a risk factor for hepatocellular carcinoma (HCC) development. We investigated the association between family history and cancer recurrence and survival in patients with hepatitis B virus (HBV)- related HCC. Methods: Patients who underwent curative resection of HBV-related HCC between 2003 and 2013 from a tertiary hepatobiliary center in China were enrolled in this study. A family history was defined as a self-reported history of primary liver cancer in the first-degree relatives. Propensity score matching (PSM) and multivariable Cox-regression analyses were performed to compare the overall survival (OS) and recurrence-free survival (RFS) between patients with and without a family history of liver cancer. Results: Of 1,112 patients, 183 patients (16.5%) had a family history of liver cancer. A family history was not associated with OS and RFS (P=0.994 and 0.428) in the entire cohort. Using PSM, 179 pairs of patients with and without a family history but with comparable baseline characteristics and operative variables were created. A family history was associated with decreased OS and RFS (P=0.042 and 0.006) in the PSM cohort. On multivariable Cox-regression analyses, a family history was significantly associated with decreased OS (HR: 1.574, 95% CI: 1.171-2.116, P=0.003) and RFS (HR: 1.534, 95% CI: 1.176-2.002, P=0.002) after adjusting for other prognostic factors. Conclusions: A family history of liver cancer was associated with decreased OS and RFS rates after curative resection in patients with HBV-related HCC.

Risk Factors, Patterns, and Outcomes of Late Recurrence after Liver Resection for Patients with Hepatocellular Carcinoma (Analysis of a Multicenter Cohort over 15 Years)

( Xin-fei Xu ),( Jiong-jie Yu ),( Ju-dong Li ),( Hao Xing ),( Jun Han ),( Zhen-li Li ),( Han Wu ),( Han Zhang ),( Jian-hong Zhong ),( Yi- Sheng Huang ),( Ya-hao Zhou ),( Ting-hao Chen ),( Hong Wang ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: Late recurrence (> 2 years) after liver resection of hepatocellular carcinoma (HCC) is usually considered as multi-centric tumors or de novo cancer formation. We aimed to investigate risk factors, patterns and outcomes of late recurrence after HCC resection. Methods: From a multicenter database from 2001 to 2015, 734 patients who were alive and recurrence-free at 2 years after curative resection of initial HCC were enrolled into this retrospective study. Univariate and multivariate Cox-regression analysis were used to identify independent risk factors of late recurrence. Patterns, treatments and outcomes of late recurrence were investigated and analyzed. Results: During a median follow-up of 78.0 months after surgery, 303 patients (41.3%) developed late recurrence. Multivariate analysis revealed that cirrhosis, macroscopic vascular invasion, satellites, and tumor size > 5cm were independent risk factors of late recurrence. Among them, 273 (90.1%) were sole intrahepatic recurrence, 30 (9.9%) were concurrent intrahepatic and extrahepatic recurrence, and none of them was sole extrahepatic recurrence; 165 (54.4%) patients received curative treatments for recurrent HCC, including re-resection, transplantation and local ablation. Multivariate analysis showed regular postoperative surveillance and receiving curative treatments were two independent protective factors of prolonging survival for those patients with late recurrence. Conclusions: Late recurrence is correlated with cirrhosis and certain tumor-related characteristics of initial HCC. The patterns of late recurrence suggest that postoperative surveillance after 2 years of surgery could be adjusted and more targeted. Regular postoperative surveillance improves the probability to receive curative treatments again, yielding to better outcomes for patients with late recurrence.

Is Surgical Resection Justified for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus? (A Systematic Review and Meta-Analysis)

( Liang Lei ),( Xin-fei Xu ),( Jiong-jie Yu ),( Ju-dong Li ),( Zhen-li Li ),( Jun Han ),( Han Zhang ),( Hao Xing ),( Han Wu ),( Ming-da Wang ),( Chao Li ),( Zheng Wang ),( Feng Shen ),( Meng-chao Wu ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: The prognosis of hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) is very poor. According to the BCLC treatment recommendations, sorafenib or other palliative treatment (PT) is recommended as the first-line therapy when it happens. In real world, however, a significant number of selected patients with HCC and PVTT suffered from surgical resection (SR). Methods: PubMed, Embase, Medline and Cochrane library were searched for studies comparing SR with PT (including TACE, sorafenib, etc.) for HCC with PVTT, which were published before September 2017. Results: 4,810 patients from 7 studies were enrolled in this meta-analysis, which divided into the SR group (n = 2,344) and the PT group (n = 2476). When compared with the PT group, the pooled hazard ratio (HR) for the 1, 3 and 5-year OS rates of the SR group were 0.56 (95% CI 0.52-0.60, P=0.03), 0.56 (95% CI 0.53-0.59, P<0.001) and 0.55 (95% CI 0.54-0.57, P<0.001). For subgroup analysis, when compared with the mere TACE group, the pooled HR for the 1, 3 and 5-year OS rates of the SR group were 0.54 (95% CI 0.43-0.67, P=0.81), 0.75 (95% CI 0.65-0.87, P=0.25) and 0.76 (95% CI 0.67-0.88, P=0.25). Conclusions: This meta-analysis demonstrated SR had better OS than TACE or other palliative therapy for HCC with PVTT. SR may be suitable as the first-line treatment for selected patients with resectable HCC and removable PVTT.