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Original Article
Prediction of Post-resection Prognosis Using the ADV Score for Huge Hepatocellular Carcinomas ≥13 cm
Shin Hwang, Ki-Hun Kim, Deok-Bog Moon, Chul-Soo Ahn, Tae-Yong Ha, Gi-Won Song, Dong-Hwan Jung, Gil-Chun Park
J Liver Cancer. 2021;21(1):45-57.   Published online March 31, 2021
DOI: https://doi.org/10.17998/jlc.21.1.45
  • 5,271 Views
  • 86 Downloads
  • 3 Citations
AbstractAbstract PDF
Background/Aims
Multiplication of α-fetoprotein, des-γ-carboxy prothrombin, and tumor volume (ADV score) is a surrogate marker for post-resection prognosis of hepatocellular carcinoma (HCC). This study aimed to validate the predictive power of the ADV score-based prognostic prediction model for patients with solitary huge HCC.
Methods
Of 3,018 patients, 100 patients who underwent hepatic resection for solitary HCC ≥13 cm between 2008 and 2012 were selected.
Results
The median tumor diameter and tumor volume were 15.0 cm and 886 mL, respectively. Tumor recurrence and overall survival (OS) rates were 70.7% and 66.0% at one year and 84.9% and 34.0% at five years, respectively. Microvascular invasion (MVI) was the only independent risk factor for disease-free survival (DFS) and OS. DFS and OS, stratified by ADV score with 1-log intervals, showed significant prognostic contrasts (P=0.007 and P=0.017, respectively). DFS and OS, stratified by ADV score with a cut-off of 8-log, showed significant prognostic contrasts (P=0.014 and P=0.042, respectively). The combination of MVI and ADV score with a cut-off of 8-log also showed significant prognostic contrasts in DFS (P<0.001) and OS (P=0.001) considering the number of risk factors. Prognostic contrast was enhanced after combining the MVI and ADV score.
Conclusions
The prognostic prediction model with the ADV score could reliably predict the risk of tumor recurrence and long-term patient survival outcomes in patients with solitary huge HCCs ≥13 cm. The results of this study suggest that our prognostic prediction models can be used to guide surgical treatment and post-resection follow-up for patients with huge HCCs.

Citations

Citations to this article as recorded by  
  • Five-year complete remission of super-giant hepatocellular carcinoma with hepatectomy followed by sorafenib plus camrelizumab: A case report
    Xiao-Qin Zheng, Li-Bo Sun, Wen-Jie Jin, Hui Liu, Wen-Yan Song, Hui Xu, Ju-Shan Wu, Xiao-Jun Wang, Chun-Yan Gou, Hui-Guo Ding
    World Journal of Gastrointestinal Surgery.2025;[Epub]     CrossRef
  • Early identification of hepatocellular carcinoma patients at high-risk of recurrence using the ADV score: a multicenter retrospective study
    Shuya Cao, Zheyu Zhou, Chaobo Chen, Wenwen Li, Jinsong Liu, Jiawei Xu, Chunlong Zhao, Yihang Yuan, Zhenggang Xu, Huaiyu Wu, Guwei Ji, Xiaoliang Xu, Ke Wang
    World Journal of Surgical Oncology.2024;[Epub]     CrossRef
  • ADV score is a reliable surrogate biomarker of hepatocellular carcinoma in liver resection and transplantation
    Shin Hwang, Dong-Hwan Jung, Gi-Won Song
    Annals of Liver Transplantation.2023; 3(2): 86.     CrossRef
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Review Articles
Strategies for the Curative Therapy of Early Stage HCC: First or SalvageTransplantation?
Nam-Joon Yi
Journal of the Korean Liver Cancer Study Group. 2012;12(2):102-108.   Published online September 30, 2012
  • 694 Views
  • 4 Downloads
AbstractAbstract PDF
Hepatocellular carcinoma (HCC) is a major cause of cancer mortality worldwide, especially in Asian countriesas well as Korea, and liver transplantation (LT) has potentials to improve survival for patients with HCC. However, major hamper to LT for HCC has been graft shortage. To solve this problem, liver resection (LR) has to be rejuvenated in the general algorithm of HCC treatment in the light of salvage transplantation (ST) strategies. The LR followed by ST in case of HCC recurrence is an attractive concept in early stage HCC and cirrhosis with acceptable liver function. These challenges in technique, indications, pre-LT observation and treatments for recurred HCC, and prioritization policies of patients on the waiting list have to be precise through prospective investigations that have to include individualization of prognosis, biological variables and pathology surrogates as stratification criteria. Accepting this challenges have been part of the history of LT and will endure for the future. This article will focus on the ST after LR in terms of intention-to-analysis
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Prediction of Tumor Biology in Hepatocellular Carcinoma
Won Kim
Journal of the Korean Liver Cancer Study Group. 2009;9(1):1-6.   Published online June 30, 2009
  • 715 Views
  • 4 Downloads
AbstractAbstract PDF
Hepatocellular carcinoma (HCC) surveillance programs have led to an increase in the adoption of radical therapies. Nevertheless, HCCs often present at an advanced stage and the prognosis remains dismal even after resection due to the high rate of recurrence. The study of tumor biology is important to predict clinical outcome enabling more appropriate therapeutic decisions for HCC patients. Understanding molecular mechanisms of hepatocarcinogenesis may also lead to effective strategies in chemoprevention. However, current staging systems based on clinicopathologic factors are limited in prognostic prediction. Recently, there has been great interest in the study of gene expression profile in relation to prognosis of HCC. Global gene expression profiling may be the most appropriate technology to unravel the pathogenesis of HCC and explore its heterogeneous origin. The elucidation of tumor biology of HCC is of paramount clinical importance in the new era of molecular target therapy.
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