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      • 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.

      • 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.

      • 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.

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        Fatty Acid Binding Protein 5 (FABP5) Promotes Aggressiveness of Gastric Cancer Through Modulation of Tumor Immunity

        Shu Zhang,Mei-qing Qiu,Hui-jun Wang,Ya-fei Ju,Zhen Liu,Tao Wang,Shi-feng Kan,Zhen Yang,Ya-yun Cui,You-qiang Ke,Hong-min He,Li Sun 대한위암학회 2023 Journal of gastric cancer Vol.23 No.2

        Purpose: Gastric cancer (GC) is the second most lethal cancer globally and is associated with poor prognosis. Fatty acid-binding proteins (FABPs) can regulate biological properties of carcinoma cells. FABP5 is overexpressed in many types of cancers; however, the role and mechanisms of action of FABP5 in GC remain unclear. In this study, we aimed to evaluate the clinical and biological functions of FABP5 in GC. Materials and Methods: We assessed FABP5 expression using immunohistochemical analysis in 79 patients with GC and evaluated its biological functions following in vitro and in vivo ectopic expression. FABP5 targets relevant to GC progression were determined using RNA sequencing (RNA-seq). Results: Elevated FABP5 expression was closely associated with poor outcomes, and ectopic expression of FABP5 promoted proliferation, invasion, migration, and carcinogenicity of GC cells, thus suggesting its potential tumor-promoting role in GC. Additionally, RNA-seq analysis indicated that FABP5 activates immune-related pathways, including cytokine-cytokine receptor interaction pathways, interleukin-17 signaling, and tumor necrosis factor signaling, suggesting an important rationale for the possible development of therapies that combine FABP5-targeted drugs with immunotherapeutics. Conclusions: These findings highlight the biological mechanisms and clinical implications of FABP5 in GC and suggest its potential as an adverse prognostic factor and/or therapeutic target.

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