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Prognostic value of preoperative protein-induced vitamin K absence or antagonist II after liver resection for hepatitis B-related hepatocellular carcinoma: a nationwide multicenter study.
Byun, Dahn; Lee, Seul Gi; Kim, Hyeyoung; You, Yunghun; Jung, Jaehag; Jang, Je Ho; Lee, Moon-Soo; Kim, Chang-Nam; Cho, Byung Sun; Kang, Yoon-Jung.
Afiliação
  • Byun D; Department of Surgery, Daejeon Eulji Medical Center, Eulji University College of Medicine, Daejeon, Korea.
  • Lee SG; Department of Surgery, Daejeon Eulji Medical Center, Eulji University College of Medicine, Daejeon, Korea.
  • Kim H; Department of Surgery, Daejeon Eulji Medical Center, Eulji University College of Medicine, Daejeon, Korea.
  • You Y; Department of Surgery, Daejeon Eulji Medical Center, Eulji University College of Medicine, Daejeon, Korea.
  • Jung J; Department of Surgery, Daejeon Eulji Medical Center, Eulji University College of Medicine, Daejeon, Korea.
  • Jang JH; Department of Surgery, Daejeon Eulji Medical Center, Eulji University College of Medicine, Daejeon, Korea.
  • Lee MS; Department of Surgery, Daejeon Eulji Medical Center, Eulji University College of Medicine, Daejeon, Korea.
  • Kim CN; Department of Surgery, Daejeon Eulji Medical Center, Eulji University College of Medicine, Daejeon, Korea.
  • Cho BS; Department of Surgery, Daejeon Eulji Medical Center, Eulji University College of Medicine, Daejeon, Korea.
  • Kang YJ; Department of Surgery, Daejeon Eulji Medical Center, Eulji University College of Medicine, Daejeon, Korea.
Ann Surg Treat Res ; 103(5): 271-279, 2022 Nov.
Article em En | MEDLINE | ID: mdl-36452307
ABSTRACT

Purpose:

Although protein-induced vitamin K absence or antagonist II (PIVKA-II) has been used as a diagnostic tool for hepatocellular carcinoma (HCC), its prognostic value remains unclear.

Methods:

This was a nationwide multicenter study using the database of the Korean Liver Cancer Association. Patients with hepatitis B-related HCC who underwent liver resection as the first treatment after initial diagnosis (2008-2014) were selected randomly. Propensity score matching (11) was performed for comparative analysis between those with low and high preoperative PIVKA-II. Univariable and multivariable Cox proportional-hazards regression were used to identify prognostic factors for HCC-specific survival.

Results:

Among 6,770 patients, 956 patients were included in this study. After propensity score matching, the 2 groups (n = 245, each) were well balanced. The HCC-specific 5-year survival rate was 80.9% in the low PIVKA-II group and 78.7% in the high PIVKA-II group (P = 0.605). In univariable analysis, high PIVKA-II (>106.0 mAU/mL) was not a significant predictor for worse HCC-specific survival (hazard ratio [HR], 1.183; 95% confidence interval [CI], 0.76-1.85; P = 0.461). In multivariable analysis, hyponatremia of <135 mEq/L (HR, 4.855; 95% CI, 1.67-14.12; P = 0.004), preoperative ascites (HR, 4.072; 95% CI, 1.59-10.43; P = 0.003), microvascular invasion (HR, 3.112; 95% CI, 1.69-5.74; P < 0.001), and largest tumor size of ≥5.0 cm (HR, 2.665; 95% CI, 1.65-4.31; P < 0.001), but not preoperative high PIVKA-II, were independent predictors for worse HCC-specific survival.

Conclusion:

Preoperative PIVKA-II is not an independent prognostic factor for HCC-specific survival after liver resection for hepatitis B-related HCC.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Clinical_trials / Prognostic_studies Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Clinical_trials / Prognostic_studies Idioma: En Ano de publicação: 2022 Tipo de documento: Article