Factors associated with recurrence and survival following hepatectomy for large hepatocellular carcinoma: A multicenter analysis

Schiffman, Suzanne; Woodall, Charles E.; Kooby, David A.; Martin, Robert C.G.; Staley, Charles A.; Egnatashvili, Vasili; McMasters, Kelly M.; Scoggins, Charles R.

doi:10.1002/jso.21461

Cited by 37 publications

(22 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5 Regarding HCCs > 50 mm in the present study, TACE + 3D-HDCRT led to 64% CR, 79% and 42% overall survival rates at one and 3-years (median, 30 months). Some published series reported that surgical resection of HCCs > 50 mm gives 69% and 37% overall survival rates at respectively 1 and 3-years (median, 20 months) 37,38 , thus at least comparable, although with a trends to inferiority, to our TACE + 3D-HDCRT data.…”

Section: Discussionsupporting

confidence: 82%

Efficacy and safety of transarterial chemoembolization combined to conformal radiotherapy for uninodular hepatocellular carcinoma

Merle

Rode

Benlaredj

et al. 2014

Int J Cancer Ther Oncol

View full text Add to dashboard Cite

Original ArticleAbstract Purpose: A proportion of patients with uninodular hepatocellular carcinoma (HCC) cannot benefit from potential curative therapies such as liver transplantation, surgical resection or radiofrequency ablation. Thus, they are prone to receive transarterial chemoembolization (TACE) that is a palliative option with low probability of both complete response and prolonged local control. Herein, we assessed the combination of TACE and 3D-high dose conformal radiotherapy (3D-HDCRT) for efficacy and safety in HCC. Methods: We retrospectively analyzed the outcome of 35 consecutive patients with uninodular HCC ≤ 100 mm, treated by one course of TACE combined to 3D-HDCRT. The follow-up consisted on clinics, biology, hepatic CT-scan or MRI at month-1 and -3, and thereafter every 3 months. Results: Complete response was obtained in 80% of patients following mRE-CIST criteria (95% in HCC ≤ 50 mm, and 60% in HCC > 50 mm) with uncommon local recurrence (11%), overall survival rates of 79%, 59% and 44% at respectively 1, 2 and 3 years (median, 37.3 months), and 11.4% grade-3/4 toxicities. Pre-therapeutic α-fetoprotein level ≥ 200 ng/mL was found as a strong predictor of poorer outcome. Conclusion: We showed that TACE combined to 3D-HDCRT can be highly efficient to reach local control and interesting overall survival rates for uninodular HCC, with limited severe toxicities for Child-Pugh A patients. Subsequent prospective controlled trials are warranted for comparison with therapeutic standards.

show abstract

Section: Discussionsupporting

confidence: 82%

Efficacy and safety of transarterial chemoembolization combined to conformal radiotherapy for uninodular hepatocellular carcinoma

Merle

Rode

Benlaredj

et al. 2014

Int J Cancer Ther Oncol

View full text Add to dashboard Cite

show abstract

“…This finding is in accordance with previous studies on other solid malignancies that have reported a more favorable prognosis among patients who undergo complete tumor resection. 23,35–39 …”

Section: Discussionmentioning

confidence: 99%

Adrenocortical Carcinoma: Impact of Surgical Margin Status on Long-Term Outcomes

et al. 2015

View full text Add to dashboard Cite

Background The influence of surgical margin status on long-term outcomes of patients undergoing adrenal resection for ACC remains not well defined. We studied the impact of surgical tumor margin status on recurrence-free survival (RFS) and overall survival (OS) of patients undergoing resection for ACC. Methods A total of 165 patients who underwent adrenal resection for ACC and met inclusion criteria were identified form a multi-institutional database. Clinicopathological data, pathologic margin status, and long-term outcomes were assessed. Patients were stratified into two groups based on margin status: R0 (margin >1 mm) versus R1. Results R0 resection was achieved in 126 patients (76.4 %), whereas 39 patients (23.6 %) had an R1 resection. Median and 5-year OS for patients undergoing R0 resection were 96.3 months and 64.8 % versus 25.1 months and 33.8 % for patients undergoing an R1 resection (both p < 0.001). On multivariable analysis, surgical margin status was an independent predictor of worse OS (hazard ratio [HR] 2.22, 95 % confidence interval [CI] 1.03–4.77; p = 0.04). The incidence of recurrence also differed between the two groups; 5-year RFS was 30.3 % among patients with an R0 resection versus 13.8 % among patients who had an R1 resection (p = 0.03). Lymph node metastasis (N1) was an independent predictor of RFS (HR 2.70, 95 % CI 1.04–6.99; p = 0.04). Conclusions A positive margin after ACC resection was associated with worse long-term survival. Patient selection and an emphasis on surgical technique to achieve R0 margins are pivotal to optimizing the best chance for long-term outcome among patients with ACC.

show abstract

“…The presence of vascular invasion, multifocality of tumors, and tumor size are considered to predict recurrence after hepatic resection for large HCCs (32). However, microvascular invasion and peritumoral satellite nodules o 1 cm in diameter, which are not detectable on preoperative CT or MR imaging, can be identified only by intraoperative ultrasonography or pathology; preoperative prediction of recurrence after hepatic resection, which facilitates the selection of optimal candidates for resection, is challenging (33).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Transarterial Chemoembolization and Hepatic Resection for Large Solitary Hepatocellular Carcinoma: A Propensity Score Analysis

Lee

Cho

et al. 2015

Journal of Vascular and Interventional Radiology

View full text Add to dashboard Cite

Factors associated with recurrence and survival following hepatectomy for large hepatocellular carcinoma: A multicenter analysis

Abstract: For patients with HCC larger than 5 cm, tumor-related factors predict outcomes and survival.

Cited by 37 publications

References 25 publications

Efficacy and safety of transarterial chemoembolization combined to conformal radiotherapy for uninodular hepatocellular carcinoma

Efficacy and safety of transarterial chemoembolization combined to conformal radiotherapy for uninodular hepatocellular carcinoma

Adrenocortical Carcinoma: Impact of Surgical Margin Status on Long-Term Outcomes

Comparison of Transarterial Chemoembolization and Hepatic Resection for Large Solitary Hepatocellular Carcinoma: A Propensity Score Analysis

Contact Info

Product

Resources

About