Comparison of 10-Year Survival Outcomes for Early Single Hepatocellular Carcinoma following Different Treatments

Meng, Fanyu; Zhang, Haoyun; Peng, Haiwen; Lu, Shichun

doi:10.1155/2021/6638117

Cited by 5 publications

(6 citation statements)

References 20 publications

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“…A recent Chinese study including 1,255 patients with HCC compared the 10-year survival outcomes from three different first-line treatments, namely, radiofrequency ablation, liver resection, and transplantation. LT was clearly superior in terms of 10-year survival, even after adjustment for confounders and balancing of the compared cohorts using inverse probability weighting ( 8 ). A meta-analysis comparing LT and resection as the treatment options in small HCC meeting the Milan criteria reported that the 5-year OS rates were similar, whereas the 10-year rates were significantly higher in patients who underwent LT than resection (50.0 vs. 29.8%; P < 0.001) ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

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Prognostic Factors for 10-Year Survival in Patients With Hepatocellular Cancer Receiving Liver Transplantation

et al. 2022

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BackgroundLong-term survival after liver transplantation (LT) for hepatocellular cancer (HCC) continues to increase along with the modification of inclusion criteria. This study aimed at identifying risk factors for 5- and 10-year overall and HCC-specific death after LT.MethodsA total of 1,854 HCC transplant recipients from 10 European centers during the period 1987–2015 were analyzed. The population was divided in three eras, defined by landmark changes in HCC transplantability indications. Multivariable logistic regression analyses were used to evaluate the significance of independent risk factors for survival.ResultsFive- and 10-year overall survival (OS) rates were 68.1% and 54.4%, respectively. Two-hundred forty-two patients (13.1%) had HCC recurrence. Five- and 10-year recurrence rates were 16.2% and 20.3%. HCC-related deaths peaked at 2 years after LT (51.1% of all HCC-related deaths) and decreased to a high 30.8% in the interval of 6 to 10 years after LT. The risk factors for 10-year OS were macrovascular invasion (OR = 2.71; P = 0.001), poor grading (OR = 1.56; P = 0.001), HCV status (OR = 1.39; P = 0.001), diameter of the target lesion (OR = 1.09; P = 0.001), AFP slope (OR = 1.63; P = 0.006), and patient age (OR = 0.99; P = 0.01). The risk factor for 10-year HCC-related death were AFP slope (OR = 4.95; P < 0.0001), microvascular (OR = 2.13; P < 0.0001) and macrovascular invasion (OR = 2.32; P = 0.01), poor tumor grading (OR = 1.95; P = 0.001), total number of neo-adjuvant therapies (OR = 1.11; P = 0.001), diameter of the target lesion (OR = 1.11; P = 0.002), and patient age (OR = 0.97; P = 0.001). When analyzing survival rates in function of LT era, a progressive improvement of the results was observed, with patients transplanted during the period 2007–2015 showing 5- and 10-year death rates of 26.8% and 38.9% (vs. 1987–1996, P < 0.0001; vs. 1997–2006, P = 0.005).ConclusionsLT generates long-term overall and disease-free survival rates superior to all other oncologic treatments of HCC. The role of LT in the modern treatment of HCC becomes even more valued when the follow-up period reaches at least 10 years. The results of LT continue to improve even when prudently widening the inclusion criteria for transplantation. Despite the incidence of HCC recurrence is highest during the first 5 years post-transplant, one-third of them occur later, indicating the importance of a life-long follow-up of these patients.

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Section: Discussionmentioning

confidence: 99%

“…Reporting of outcome is usually limited to 5-year survival rates. The impact of LT in the very long follow-up (i.e., ≥10 years) is still an unanswered question, especially when compared to other (curative) approaches such as liver resection ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

Prognostic Factors for 10-Year Survival in Patients With Hepatocellular Cancer Receiving Liver Transplantation

et al. 2022

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“…For early single HCC, LT is the best treatment. However, since donors are in short supply, both SR and RFA are considered effective treatments [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

The Efficacy of Surgical Resection versus Radiofrequency Ablation for the Treatment of Single Hepatocellular Carcinoma: A SEER-Based Study

Wei

Zhang

et al. 2023

Gastroenterology Research and Practice

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Background. There is controversy regarding whether patients with single hepatocellular carcinoma (HCC) should be offered radiofrequency ablation (RFA) as a first-line treatment option. Thus, this study compared overall survival after surgical resection (SR) and RFA for single HCC. Methods. The Surveillance, Epidemiology, and End Results (SEER) database was used for this retrospective study. The study included 30- to 84-year-old patients diagnosed with HCC from 2000 to 2018. Selection bias was reduced via propensity score matching (PSM). The study compared the overall survival (OS) and cancer-specific survival (CSS) of patients with single HCC who were treated with SR and RFA. Results. Before and after PSM, the median OS and median CSS were significantly longer in the SR group than in the RFA group ( p < 0.05 ). In the subgroup analysis, the median OS and median CSS for male and female patients with male and female patients with tumor sizes <3, 3–5, and>5 cm, age at diagnosis between 60 and 84 years, and grades I–IV tumors were longer than in the SR group than in the RFA group ( p < 0.05 ). Similar results were reported for patients who received chemotherapy ( p < 0.05 ). Univariate and multivariate analyses revealed that compared with RFA, SR was an independent favorable factor for OS and CSS ( p < 0.05 ) before and after PSM. Conclusion. Patients with SR who had a single HCC showed higher OS and CSS compared with patients who received RFA. Hence, SR should be used as a first-line treatment in cases of single HCC.

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“…Nevertheless, over the last two decades, percutaneous ablation with thermal techniques such as radiofrequency ablation (RFA) and microwave ablation (MWA) has emerged as a suitable alternative treatment modality to surgical resection in those with limited dis-ease, particularly those with borderline liver function. Indeed, multiple studies [8][9][10][11][12] have failed to show a significant difference in overall survival between resection and ablation, and results of published meta-analyses comparing the two treatments in BCLC 0, 0/A and A disease have similarly had mixed results, potentially due to poor trial design in many of the primary studies [13][14][15][16][17][18][19][20][21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

Improved Survival Outcomes with Surgical Resection Compared to Ablative Therapy in Early-Stage HCC: A Large, Real-World, Propensity-Matched, Multi-Centre, Australian Cohort Study

Abdelmalak,

Strasser,

Ngu

et al. 2023

Cancers

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The optimal treatment approach in very-early and early-stage hepatocellular carcinoma (HCC) is not precisely defined, and there is ambiguity in the literature around the comparative efficacy of surgical resection versus ablation as curative therapies for limited disease. We performed this real-world propensity-matched, multi-centre cohort study to assess for differences in survival outcomes between those undergoing resection and those receiving ablation. Patients with Barcelona Clinic Liver Cancer (BCLC) 0/A HCC first diagnosed between 1 January 2016 and 31 December 2020 who received ablation or resection as initial treatment were included in the study. A total of 450 patients were included in the study from 10 major liver centres including two transplant centres. Following propensity score matching using key covariates, 156 patients were available for analysis with 78 in each group. Patients who underwent resection had significantly improved overall survival (log-rank test p = 0.023) and local recurrence-free survival (log rank test p = 0.027) compared to those who received ablation. Based on real-world data, our study supports the use of surgical resection in preference to ablation as first-line curative therapy in appropriately selected BCLC 0/A HCC patients.

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Comparison of 10-Year Survival Outcomes for Early Single Hepatocellular Carcinoma following Different Treatments

Cited by 5 publications

References 20 publications

Prognostic Factors for 10-Year Survival in Patients With Hepatocellular Cancer Receiving Liver Transplantation

Prognostic Factors for 10-Year Survival in Patients With Hepatocellular Cancer Receiving Liver Transplantation

The Efficacy of Surgical Resection versus Radiofrequency Ablation for the Treatment of Single Hepatocellular Carcinoma: A SEER-Based Study

Improved Survival Outcomes with Surgical Resection Compared to Ablative Therapy in Early-Stage HCC: A Large, Real-World, Propensity-Matched, Multi-Centre, Australian Cohort Study

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