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Prognostic Value of Preoperative Circulating Tumor Cells for Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis: A Propensity Score Analysis.

JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY(2023)

Hepatic Surgery Center

Cited 4|Views25
Abstract
The role of circulating tumor cells (CTCs) in hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is not fully understood. In this retrospective analysis, we included 316 HCC patients who underwent hepatectomy and preoperative CTC detection. We selected 41 pairs of matched HCC patients with and without PVTT using propensity score matching (PSM) analysis. We compared the preoperative CTC counts in patients from both the full cohort and the PSM model. We also analyzed their associations with disease-free survival (DFS) and overall survival (OS). Before and after PSM analysis, the preoperative CTC counts in the HCC with PVTT group were substantially higher than in the HCC without PVTT group. In both the full cohort of patients and the PSM model, patients with CTC ≥ 2 had significantly shorter OS and DFS than patients with CTC < 2. The outcomes of HCC patients with PVTT could be well differentiated by preoperative CTC levels. HCC patients with CTC ≥ 2 had noticeably shorter OS (9.9 months vs. 24.6 months, P = 0.0003) and DFS (6.0 months vs. 12.3 months, P = 0.0041) than those with CTC < 2. Moreover, preoperative CTC ≥ 2 remained an independent predictor in all groups’ multivariate analysis. We discovered a link between preoperative CTC counts and the occurrence of PVTT and confirmed the prognostic significance of preoperative CTC in HCC patients with PVTT. These findings suggest that preoperative CTC counts have the potential to assist in identifying patients with HCC and PVTT who may benefit from surgery.
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Circulating tumor cells,Hepatocellular carcinoma,Portal vein tumor thrombosis,Prognosis,Propensity score matching analysis
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要点】:本研究发现术前循环肿瘤细胞(CTCs)的数量对于预测伴有门静脉癌栓(PVTT)的肝细胞癌(HCC)患者的预后具有重要价值。

方法】:研究采用回顾性分析,通过倾向得分匹配(PSM)方法对316例接受肝切除术和术前CTC检测的HCC患者进行了分析。

实验】:在全体队列和PSM模型中,对比了HCC患者伴或不伴PVTT的术前CTC数量,并分析了这些数量与无病生存期(DFS)和总生存期(OS)的关联。结果表明,术前CTC≥2的患者比CTC<2的患者OS(9.9个月 vs. 24.6个月)和DFS(6.0个月 vs. 12.3个月)明显缩短,且在多变量分析中,术前CTC≥2是所有组的独立预后因素。数据集名称在文中未明确提及。