Introduction Introduction of new systemic therapies for hepatocellular carcinoma (HCC) has led to the development of new oncological criteria of resectability for the resectability of HCC. This study was aimed at validating the prognosticating ability and clinical utility of the resectability classification based on the novel criteria in real-world clinical practice. Methods This study was conducted in 1,822 patients who had undergone curative resection for HCC (population 1) and 107 patients with unresectable disease who had received lenvatinib therapy (population 2). Patients were classified into three groups according to the novel oncological criteria for resectability (R, resectable; BR1, borderline resectable 1; and BR2, borderline resectable 2), and the prognosticating ability and clinical utility of this classification based on the novel criteria were examined. Results Multivariate analysis confirmed that classification of the patients according to the oncological resectability criteria was significantly correlated with the overall survival (OS) (BR1: hazard ratio [HR], 1.88; 95% CI, 1.38-2.55; BR2: HR, 4.12; 95% CI, 3.01-5.65) and recurrence-free survival (BR1: HR, 1.86; 95% CI, 1.44-2.41; BR2: HR, 3.62; 95% CI, 2.71-4.82) in population 1. In population 2, the resectability classification was correlated with the rates of successful additional intervention (surgery, transarterial chemoembolization, or radiotherapy) (BR1 65.7% vs. BR2 42.3%, p = 0.023) and curative-intent conversion surgery (BR1 17.1% vs. BR2 4.2%, p = 0.056) after lenvatinib therapy, and was also predictive of the OS (HR, 1.96; 95% CI, 1.13-3.38 for BR2 [vs. BR1]) and time-to-treatment failure (HR, 1.81; 95% CI, 1.04-3.17 for BR2 [vs. BR1]). Conclusion The resectability classification based on the novel oncological criteria for resectability showed acceptable prognosticating ability in both surgically and medically treated populations with advanced HCC.

中文翻译：

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晚期肝细胞癌可切除性的新肿瘤学标准的临床应用。


引言 肝细胞癌 （HCC） 新的全身疗法的引入导致了 HCC 可切除性的新肿瘤学可切除性标准的制定。本研究旨在验证基于真实世界临床实践中新标准的可切除性分类的预后能力和临床效用。方法 本研究在 1,822 例接受根治性切除术的 HCC 患者 （人群 1） 和 107 例接受 lenvatinib 治疗的不可切除疾病患者 （人群 2） 中进行。根据可切除性的新肿瘤学标准 （R，可切除;BR1，临界可切除 1;和 BR2，临界可切除 2），并检查了基于新标准的该分类的预后能力和临床效用。结果 多因素分析证实，根据肿瘤可切除性标准对患者进行分类与总生存期 （OS） 显著相关 （BR1： 风险比 [HR]，1.88;95% CI，1.38-2.55;BR2： 心率，4.12;95% CI，3.01-5.65）和无复发生存期（BR1：HR，1.86;95% CI，1.44-2.41;BR2： 心率，3.62;95% CI，2.71-4.82）。在人群 2 中，可切除性分类与仑伐替尼治疗后额外干预（手术、经动脉化疗栓塞术或放疗）的成功率（BR1 65.7% vs. BR2 42.3%，p = 0.023）和根治性转诊手术（BR1 17.1% vs. BR2 4.2%，p = 0.056）相关，并且还预测 OS（HR，1.96;95% CI，BR2 为 1.13-3.38 [vs. BR1]）和治疗失败时间（HR， 1.81;95% CI，BR2 为 1.04-3.17 [vs. BR1]）。 结论 基于新的肿瘤学可切除性标准的可切除性分类在手术和药物治疗的晚期 HCC 人群中均显示出可接受的预后能力。