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Analysis of conditional survival in primary hepatocellular carcinoma after narrow-margin hepatectomy: a large-sample, dual-centre, retrospective study

  • Author Footnotes
    ∗ These authors contributed equally to this work.
    Jie Kong
    Footnotes
    ∗ These authors contributed equally to this work.
    Affiliations
    The First Clinical Medical College of Fujian Medical University, Fuzhou, 350025, China

    Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, 350025, China
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  • Author Footnotes
    ∗ These authors contributed equally to this work.
    Tingfeng Huang
    Footnotes
    ∗ These authors contributed equally to this work.
    Affiliations
    Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, 350025, China

    Southeast Big Data Institute of Hepatobiliary Health, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, 350025, China
    Search for articles by this author
  • Author Footnotes
    ∗ These authors contributed equally to this work.
    Jianxi Zhang
    Footnotes
    ∗ These authors contributed equally to this work.
    Affiliations
    Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, 350025, China

    Department of Hepatobiliary Surgery, Xiamen Hospital, Beijing University of Chinese Medicine, Xiamen, Fujian, 361000, China
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  • Shichuan Tang
    Affiliations
    Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, 350025, China

    Southeast Big Data Institute of Hepatobiliary Health, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, 350025, China
    Search for articles by this author
  • Hongzhi Liu
    Affiliations
    Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, 350025, China

    Southeast Big Data Institute of Hepatobiliary Health, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, 350025, China
    Search for articles by this author
  • Author Footnotes
    ∗ These authors contributed equally to this work.
    Jingfeng Liu
    Footnotes
    ∗ These authors contributed equally to this work.
    Affiliations
    Southeast Big Data Institute of Hepatobiliary Health, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, 350025, China

    Fujian Provincial Cancer Hospital, Fuzhou, 350025, China
    Search for articles by this author
  • Author Footnotes
    ∗ These authors contributed equally to this work.
    Yongyi Zeng
    Correspondence
    Correspondence: Yongyi Zeng, Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China.
    Footnotes
    ∗ These authors contributed equally to this work.
    Affiliations
    The First Clinical Medical College of Fujian Medical University, Fuzhou, 350025, China

    Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, 350025, China

    Southeast Big Data Institute of Hepatobiliary Health, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, 350025, China
    Search for articles by this author
  • Author Footnotes
    ∗ These authors contributed equally to this work.
Published:August 24, 2022DOI:https://doi.org/10.1016/j.hpb.2022.08.005

      Abstract

      Background

      Overall survival (OS) reflects the constant hazard and survival probabilities calculated from the initial follow-up. Conditional survival (CS) dynamically estimates prognosis based on survival time after treatment. This study aimed to estimate CS in patients who had undergone narrow-margin hepatectomy for primary hepatocellular carcinoma.

      Methods

      The clinical data of 1010 eligible patients between 2012 and 2017 were retrospectively analysed. The equation CS1=OS(x+1)/OS(x) was used to calculate the probability of an additional 1-year survival in patients who had survived for x years.

      Results

      Tumour differentiation, microvascular invasion, and tumour emboli were independent risk factors for OS. Actuarial survival decreased from 91.53% at 1 year after hepatectomy to 48.92% at 4 years, whereas CS1 increased from 69.45% at 1 year to 94.62% at 4 years. The difference was more obvious in the tumour-emboli subgroup, with an OS of 26.38% at 5 years versus a CS1 of 88.91% at 4 years following narrow-margin hepatectomy (Δ62.53%).

      Conclusion

      CS is potentially useful in providing a dynamic evaluation of survival, predicting prognosis more accurately than OS during follow-up, and formulating more appropriate treatment measures based on disease progression.
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