Multimodal treatment of unresectable hepatocellular carcinoma to achieve complete response results in improved survival. Issue 5 (12th January 2015)

• Record Type: Journal Article
• Authors: Newell, Pippa H.; Wu, YingXing; Hoen, Helena; Uppal, Richa; Thiesing, John Tyler; Sasadeusz, Kevin; Cassera, Maria A.; Wolf, Ronald F.; Hansen, Paul; Hammill, Chet W
• Is Part Of: HPB. Volume 17:Issue 5(2015:May)
• Page Start: 454
• Page End: 460
• Publication Date: 2015-01-12
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1111/hpb.12377
• Languages: English
• ISSNs: 1365-182X

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="hpb12377-sec-0001" sec-type="section"> <title>Introduction</title> <p>With technological advances, questions arise regarding how to best fit newer treatment modalities, such as transarterial therapies, into the treatment algorithm for patients with hepatocellular carcinoma (HCC).</p> </sec> <sec id="hpb12377-sec-0002" sec-type="section"> <title>Methods</title> <p>Between 2005 and 2011, 128 patients initially treated with transarterial radioembolization or chemoembolization using drug‐eluting beads were identified. The response was graded retrospectively. Toxicity was measured 1, 3, and 6 months after the first and last treatments.</p> </sec> <sec id="hpb12377-sec-0003" sec-type="section"> <title>Results</title> <p>Sixty‐five patients (53%) were advanced stage. Twenty patients (16%) had an initial complete response, but with additional treatments, this was increased to 46 (36%). Patients with a complete response as their best response to treatment had a median survival [95% confidence interval (CI)] of 5.77 (2.58, upper limit not yet reached) years, significantly longer than those whose best response was a partial response, 1.22 (0.84, 2.06) years and those with stable disease as their best response, 0.34 (0.29, 0.67) years. Repeated treatments did not increase toxicity.</p> </sec> <sec id="hpb12377-sec-0004" sec-type="section"> <title>Discussion</title> <p>This retrospective review of patients treated for intermediate and advanced stage HCC revealed a significant survival advantage in patients who achieved a complete response. These data support use of a multi‐modality approach to intermediate and advanced stage HCC, combining liver‐directed treatments as necessary to achieve a complete response.</p> </sec> </abstract>