Background
Methods
Patients
CTC analysis
Statistical analysis
Results
Patient characteristics
Clinical characteristics | No. of patients |
---|---|
Preoperative | |
Age, years | Mean: 49.9 ± 10.3; Median: 48.0 |
Sex | |
Male | 122 |
Female | 17 |
HBsAg | |
Negative | 21 |
Positive | 118 |
Liver cirrhosis | |
No | 36 |
Yes | 103 |
Child-Pugh score | |
A | 132 |
B | 7 |
Operative | |
Operation method | |
Open | 123 |
Laparoscopic | 16 |
Operation time (min) | Mean: 245.94 ± 83.22; Median: 236.00 |
Blood loss (ml) | Mean: 447.12 ± 636.25; Median: 200.00 |
Blood transfusion | |
Yes | 28 |
No | 111 |
Hepatic vascular occlusion | |
Yes | 83 |
No | 56 |
Tumor characteristics | |
Largest tumor size, cm | |
≤ 5 | 61 |
> 5 | 78 |
No. of tumors | |
Single | 106 |
Multiple | 33 |
Macroscopic tumor thrombus | |
No | 113 |
Yes | 26 |
Vascular invasion | |
No | 84 |
Yes | 55 |
BCLC stage | |
0 + A | 56 |
B + C | 83 |
AFP, ng/mL | |
Negative (≤ 7.0) | 39 |
Positive (> 7.0) | 100 |
Preoperative and postoperative CTC counts
Characteristics | Postoperative vs. Preoperative CTC counts | ||||
---|---|---|---|---|---|
Total (N = 139) | Decreased (N = 35) | No change (N = 46) | Increased (N = 58) |
P
| |
Age, years | 0.153 | ||||
≤ 50 | 80 | 25 | 25 | 30 | |
> 50 | 59 | 10 | 21 | 28 | |
Sex | 0.577 | ||||
Male | 122 | 32 | 41 | 49 | |
Female | 17 | 3 | 5 | 9 | |
HBsAg | 0.521 | ||||
Negative | 21 | 7 | 5 | 9 | |
Positive | 118 | 28 | 41 | 49 | |
Liver cirrhosis | 0.077 | ||||
No | 36 | 13 | 7 | 16 | |
Yes | 103 | 22 | 39 | 42 | |
Child-Pugh score | 0.562* | ||||
A | 132 | 32 | 44 | 56 | |
B | 7 | 3 | 2 | 2 | |
Operation method | 0.408 | ||||
Open | 123 | 33 | 39 | 51 | |
Laparoscopic | 16 | 2 | 7 | 7 | |
Operation time (min) | 0.247 | ||||
≥ 240 | 68 | 21 | 19 | 28 | |
< 240 | 71 | 14 | 27 | 30 | |
Blood loss (ml) | 0.313 | ||||
> 200 | 67 | 19 | 18 | 20 | |
≤ 200 | 72 | 16 | 28 | 28 | |
Blood transfusion | 0.318 | ||||
Yes | 28 | 10 | 7 | 11 | |
No | 111 | 25 | 39 | 47 | |
Hepatic vascular occlusion | 0.211 | ||||
Yes | 83 | 25 | 24 | 34 | |
No | 56 | 10 | 22 | 24 | |
AFP, ng/mL | 0.102 | ||||
Negative (≤ 7.0) | 39 | 5 | 16 | 18 | |
Positive (> 7.0) | 100 | 30 | 30 | 40 | |
Largest tumor size, cm | 0.067 | ||||
≤ 5 | 61 | 10 | 25 | 26 | |
> 5 | 78 | 25 | 21 | 32 | |
No. of tumors | 0.718 | ||||
Single | 106 | 26 | 37 | 43 | |
Multiple | 33 | 9 | 9 | 15 | |
Macroscopic tumor thrombus | 0.012 | ||||
No | 113 | 29 | 43 | 41 | |
Yes | 26 | 6 | 3 | 17 | |
Vascular invasion | 0.053 | ||||
No | 84 | 17 | 34 | 33 | |
Yes | 55 | 18 | 12 | 25 | |
BCLC stage | 0.089 | ||||
0 + A | 56 | 10 | 24 | 22 | |
B + C | 83 | 25 | 22 | 36 |
Prognostic significance of the surgery caused CTC count changes
Variables | Disease-free survival | Overall survival | ||||||
---|---|---|---|---|---|---|---|---|
Univariate analysis | Multivariate analysis | Univariate analysis | Multivariate analysis | |||||
HR (95% CI) |
P
| HR (95% CI) |
P
| HR (95% CI) |
P
| HR (95% CI) |
P
| |
Age, > 50 years vs. ≤ 50 years | 0.739(0.398–1.373) | 0.339 | 0.466 (0.207–1.054) | 0.067 | ||||
Sex, male vs. female | 0.505(0.156–1.637) | 0.255 | 0.574 (0.136–2.431) | 0.451 | ||||
HBsAg, positive vs. negative | 2.528(0.780–8.192) | 0.122 | 4.966 (0.673–36.617) | 0.116 | ||||
Liver cirrhosis, yes vs. no | 0.568(0.303–1.065) | 0.078 | 0.799 (0.362–1.765) | 0.580 | ||||
Child-Pugh score, B vs. A | 1.398(0.430–4.543) | 0.577 | 1.977 (0.590–6.624) | 0.269 | ||||
No. of tumors, multiple vs. single | 2.287(1.209–4.327) | 0.011 | 0.939(0.475–1.855) | 0.856 | 3.223(1.505–6.902) | 0.003 | 1.379 (0.618–3.078) | 0.432 |
Tumor size, ≤ 5 cm vs. > 5 cm | 10.403(3.710–29.173) | 0.000 | 4.840(1.518–15.428) | 0.008 | 27.058 (3.679–199.020) | 0.001 | 11.728 (1.448–94.962) | 0.021 |
Macroscopic tumor thrombus, yes vs. no | 6.836(3.567–13.100) | 0.000 | 2.588(1.174–5.706) | 0.018 | 8.194 (3.646–18.413) | 0.000 | 2.795 (1.084–7.206) | 0.033 |
Vascular invasion, yes vs. no | 6.145(3.124–12.085) | 0.000 | 1.816(0.766–4.307) | 0.176 | 5.933 (2.584–13.622) | 0.000 | 1.491 (0.510–4.357)) | 0.466 |
AFP, positive vs. negative | 2.349(1.043–5.288) | 0.039 | 1.172(0.474–2.899) | 0.731 | 2.781 (0.966–8.001) | 0.058 | 1.709 (0.548–5.332) | 0.356 |
BCLC stage, B + C vs. 0 + A | 8.695(3.103–24.370) | 0.000 | 11.212 (2.663–47.204) | 0.001 | ||||
Group | 0.529(0.414–0.676) | 0.000 | 0.620(0.479–0.803) | 0.000 | 0.484 (0.357–0.656) | 0.000 | 0.608 (0.443–0.834) | 0.002 |