Expanded use of aggressive therapies improves survival in early and intermediate hepatocellular carcinoma. Issue 8 (28th January 2014)

• Record Type: Journal Article
• Authors: Ho, Edith Y.; Cozen, Myrna L.; Shen, Hui; Lerrigo, Robert; Trimble, Erica; Ryan, James C.; Corvera, Carlos U.; Monto, Alexander; HOVAS Group (Hepatocellular Carcinoma Treatment Outcome at VA San Francisco)
• Is Part Of: HPB. Volume 16:Issue 8(2014:Aug.)
• Page Start: 758
• Page End: 767
• Publication Date: 2014-01-28
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1111/hpb.12214
• Languages: English
• ISSNs: 1365-182X

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="hpb12214-sec-0001" sec-type="section"> <title>Background</title> <p>Despite the increasing annual incidence of hepatocellular carcinoma (HCC) in the USA, now estimated at 2.7 cases per 100 000 population, only a small proportion of patients receive treatment and 5‐year survival rates range from 9% to 17%.</p> </sec> <sec id="hpb12214-sec-0002" sec-type="section"> <title>Objectives</title> <p>The present study examines the effects of multimodal treatment on survival in a mixed‐stage HCC cohort, focusing on the impact of radical therapy in patients with Barcelona Clinic Liver Cancer (BCLC) stage B disease.</p> </sec> <sec id="hpb12214-sec-0003" sec-type="section"> <title>Methods</title> <p>A retrospective review of the medical records of 254 patients considered for HCC treatment between 2003 and 2011 at a large tertiary referral centre was conducted.</p> </sec> <sec id="hpb12214-sec-0004" sec-type="section"> <title>Results</title> <p>A total of 195 (76.8%) patients were treated with a median of two liver‐directed interventions. Median survival time was 16 months. In proportional hazards analysis, radiofrequency ablation (RFA) and resection were associated with significantly improved 1‐ and 5‐year survival among patients with BCLC stage 0–A disease. In patients with BCLC stage B disease, RFA conferred a survival benefit at 1 year and resection was associated with significantly improved survival at 5 years.</p> </sec> <sec id="hpb12214-sec-0005" sec-type="section"> <title>Conclusions</title> <p>As one of few studies to track the complete course of sequential HCC therapies, the findings of the present study suggest that HCC patients with intermediate‐stage (BCLC stage B) disease may benefit from aggressive interventions not currently included in societal guidelines.</p> </sec> </abstract>