TY - JOUR
T1 - Time to surgery is not an oncological risk factor in HCC patients undergoing liver resection
AU - Otto, Carlos Constantin
AU - Wang, Guanwu
AU - Mantas, Anna
AU - Heise, Daniel
AU - Bruners, Philipp
AU - Lang, Sven Arke
AU - Ulmer, Tom Florian
AU - Neumann, Ulf Peter
AU - Heij, Lara Rosaline
AU - Bednarsch, Jan
PY - 2023/5/10
Y1 - 2023/5/10
N2 - PurposeGiven limitations of the health care systems in case of unforeseeable events, e.g., the COVID pandemic as well as trends in prehabilitation, time from diagnosis to surgery (time to surgery, (TTS)) has become a research issue in malignancies. Thus, we investigated whether TTS is associated with oncological outcome in HCC patients undergoing surgery.MethodsA monocentric cohort of 217 patients undergoing liver resection for HCC between 2009 and 2021 was analyzed. Individuals were grouped according to TTS and compared regarding clinical characteristics. Overall survival (OS) and recurrence-free survival (RFS) was compared using Kaplan-Meier analysis and investigated by univariate and multivariable Cox regressions.ResultsTTS was not associated with OS (p=0.126) or RFS (p=0.761) of the study cohort in univariate analysis. In multivariable analysis age (p=0.028), ASA (p=0.027), INR (0.016), number of HCC nodules (p=0.026), microvascular invasion (MVI; p<0.001), and postoperative complications (p<0.001) were associated with OS and INR (p=0.005), and number of HCC nodules (p<0.001) and MVI (p<0.001) were associated with RFS. A comparative analysis of TTS subgroups was conducted (group 1, <= 30 days, n=55; group 2, 31-60 days, n=79; group 3, 61-90 days, n=45; group 4, >90 days, n=38). Here, the median OS were 62, 41, 38, and 40 months (p=0.602 log rank) and median RFS were 21, 26, 26, and 25 months (p=0.994 log rank). No statistical difference regarding oncological risk factors were observed between these groups.ConclusionTTS is not associated with earlier tumor recurrence or reduced overall survival in surgically treated HCC patients.
AB - PurposeGiven limitations of the health care systems in case of unforeseeable events, e.g., the COVID pandemic as well as trends in prehabilitation, time from diagnosis to surgery (time to surgery, (TTS)) has become a research issue in malignancies. Thus, we investigated whether TTS is associated with oncological outcome in HCC patients undergoing surgery.MethodsA monocentric cohort of 217 patients undergoing liver resection for HCC between 2009 and 2021 was analyzed. Individuals were grouped according to TTS and compared regarding clinical characteristics. Overall survival (OS) and recurrence-free survival (RFS) was compared using Kaplan-Meier analysis and investigated by univariate and multivariable Cox regressions.ResultsTTS was not associated with OS (p=0.126) or RFS (p=0.761) of the study cohort in univariate analysis. In multivariable analysis age (p=0.028), ASA (p=0.027), INR (0.016), number of HCC nodules (p=0.026), microvascular invasion (MVI; p<0.001), and postoperative complications (p<0.001) were associated with OS and INR (p=0.005), and number of HCC nodules (p<0.001) and MVI (p<0.001) were associated with RFS. A comparative analysis of TTS subgroups was conducted (group 1, <= 30 days, n=55; group 2, 31-60 days, n=79; group 3, 61-90 days, n=45; group 4, >90 days, n=38). Here, the median OS were 62, 41, 38, and 40 months (p=0.602 log rank) and median RFS were 21, 26, 26, and 25 months (p=0.994 log rank). No statistical difference regarding oncological risk factors were observed between these groups.ConclusionTTS is not associated with earlier tumor recurrence or reduced overall survival in surgically treated HCC patients.
KW - HCC
KW - Time-to-surgery
KW - Surgery
KW - Recurrence
KW - Overall survival
KW - HEPATOCELLULAR-CARCINOMA
KW - MODEL
KW - DIAGNOSIS
KW - MORTALITY
KW - SURVIVAL
KW - DISEASE
KW - NUMBER
U2 - 10.1007/s00423-023-02922-4
DO - 10.1007/s00423-023-02922-4
M3 - Article
C2 - 37160788
SN - 1435-2443
VL - 408
JO - Langenbeck's Archives of Surgery
JF - Langenbeck's Archives of Surgery
IS - 1
M1 - 187
ER -