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Classification of Intrahepatic Cholangiocarcinoma into Perihilar Versus Periphe...

Wei, T; Lu, J; Xiao, XL; Weiss, M; Popescu, I; Pinto Marques, H; Aldrighetti, L; Maithel, SK; Pulitano, C; Bauer, TW; Shen, F; Poultsides, GA

Background: Intrahepatic cholangiocarcinoma (ICC) constitutes a group of heterogeneous malignancies within the liver. We sought to subtype ICC based on anatomical origin of tumors, as well as propose modifications of the current classification system. Methods: Patients undergoing curative-intent resection for ICC, hilar cholangiocarcinoma (CCA), or hepatocellular carcinoma (HCC) were identified from three inter...


Application of Hazard Functions to Investigate Recurrence After Curative-Intent...

Lima, H; Alaimo, L; Brown, Z; Endo, Y; Moazzam, Z; Tsilimigras, D; Shaikh, C; Resende, V; Guglielmi, A; Ratti, F; Aldrighetti, L; Pinto Marques, H

Background: Defining patterns and risk of recurrence can help inform surveillance strategies and patient counselling. We sought to characterize peak hazard rates (pHR) and peak time of recurrence among patients who underwent resection of hepatocellular carcinoma (HCC). Methods: 1434 patients who underwent curative-intent resection of HCC were identified from a multi-institutional database. Hazard, patterns, and...


TAC Score Better Predicts Survival Than the BCLC Following Resection of Hepatoc...

Lima, H; Endo, Y; Moazzam, Z; Alaimo, L; Shaikh, C; Munir, M; Resende, V; Guglielmi, A; Pinto Marques, H; Cauchy, F; Lam, V; Poultsides, G; Popescu, I

Background: Heterogeneity in hepatocellular carcinoma (HCC) still exists within the Barcelona clinic liver cancer (BCLC) subcategories. We developed a simple model to better discriminate and predict prognosis following resection. Methods: Patients who underwent curative-intent resection for HCC were identified from a multi-institutional database. Predictive factors of survival were identified to develop TAC (tu...


An Attempt to Establish and Apply Global Benchmarks for Liver Resection of Mali...

Alaimo, L; Moazzam, Z; Lima, H; Endo, Y; Ruzzenente, A; Guglielmi, A; Ratti, F; Aldrighetti, L; Weiss, M; Bauer, T; Alexandrescu, S; Popescu, I

Background: Benchmarking is a process of continuous self-evaluation and comparison with best-in-class hospitals to guide quality improvement initiatives. We sought to define global benchmarks relative to liver resection for malignancy and to assess their achievement in hospitals in the United States. Methods: Patients who underwent curative-intent liver resection for hepatocellular carcinoma, intrahepatic chola...


A Novel Online Calculator to Predict Risk of Microvascular Invasion in the Preo...

Endo, Y; Alaimo, L; Lima, H; Moazzam, Z; Ratti, F; Pinto Marques, H; Soubrane, O; Lam, V; Kitago, M; Poultsides, G; Popescu, I; Alexandrescu, S

Background: The presence of microvascular invasion (MVI) has been highlighted as an important determinant of hepatocellular carcinoma (HCC) prognosis. We sought to build and validate a novel model to predict MVI in the preoperative setting. Methods: Patients who underwent curative-intent surgery for HCC between 2000 and 2020 were identified using a multi-institutional database. Preoperative predictive models fo...


Dynamic Prediction of Survival After Curative Resection of Intrahepatic Cholang...

Spolverato, G; Capelli, G; Lorenzoni, G; Gregori, D; He, J; Popescu, I; Pinto Marques, H; Aldrighetti, L; Maithel, S; Pulitano, C; Bauer, T; Shen, F

Background: The current study aimed to develop a dynamic prognostic model for patients undergoing curative-intent resection for intrahepatic cholangiocarcinoma (ICC) using landmark analysis. Methods: Patients who underwent curative-intent surgery for ICC from 1999 to 2017 were selected from a multi-institutional international database. A landmark analysis to undertake dynamic overall survival (OS) prediction wa...


Tumor Burden Score and Serum Alpha-fetoprotein Subclassify Intermediate-Stage H...

Lima, H; Endo, Y; Alaimo, L; Moazzam, Z; Munir, M; Shaikh, C; Resende, V; Guglielmi, A; Pinto Marques, H; Cauchy, F; Lam, V; Poultsides, G; Popescu, I

Background: Resection of Barcelona Clinic Liver Cancer (BCLC) intermediate-stage hepatocellular carcinoma (HCC) remains controversial. While not recommended by the BCLC algorithm, some patients may indeed benefit from hepatectomy. We sought to identify that subset of patients who might derive long-term survival benefit from resection. Methods: Intermediate-stage HCC patients who underwent curative-intent resect...


Non-transplantable Recurrence After Resection for Transplantable Hepatocellular...

Zhang, XF; Xue, F; Bagante, F; Ratti, F; Marques, HP; Silva, S; Soubrane, O; Lam, V; Poultsides, GA; Popescu, I; Grigorie, R; Alexandrescu, S; Martel, G

Objectives: To identify the preoperative risk factors for prediction of non-transplantable recurrence (NTR) after tumor resection for early-stage hepatocellular carcinoma (HCC) to assist in patient selection relative to upfront liver resection (LR) versus liver transplantation (LT). Methods: Patients who underwent curative resection for transplantable HCC and chronic liver disease were identified from an intern...


Impact of Time‐to‐Surgery on Outcomes of Patients Undergoing Curative‐Intent Li...

Tsilimigras, DI; Hyer, JM; Diaz, A; Moris, D; Bagante, F; Ratti, F; Pinto Marques, H; Soubrane, O; Lam, V; Poultsides, GA; Popescu, I; Alexandrescu, S

Background: The impact of a prolonged time-to-surgery (TTS) among patients with resectable hepatocellular carcinoma (HCC) is not well defined. Methods: Patients who underwent curative-intent hepatectomy for BCLC-0, A and B HCC between 2000 and 2017 were identified using a multi-institutional database. The impact of prolonged TTS on overall survival (OS) and disease-free survival (DFS) was examined. Results: Amo...


Impact of Tumor Burden Score on Conditional Survival after Curative-Intent Rese...

Elfadaly, AN; Tsilimigras, DI; Hyer, JM; Paro, A; Bagante, F; Ratti, F; Marques, HP; Soubrane, O; Lam, V; Poultsides, GA; Popescu, I; Alexandrescu, S

Background: The impact of tumor burden score (TBS) on conditional survival (CS) among patients undergoing curative-intent resection of hepatocellular carcinoma (HCC) has not been examined to date. Methods: Patients who underwent liver resection of HCC between 2000 and 2017 were identified from a multi-institutional database. The impact of TBS and other clinicopathologic factors on 3-year conditional survival (C...


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