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

被引：7

作者：

Abdelmalak, Jonathan ^{[1
,2
]}

Strasser, Simone I. ^{[3
]}

Ngu, Natalie ^{[3
]}

Dennis, Claude ^{[3
]}

Sinclair, Marie ^{[4
]}

Majumdar, Avik ^{[4
]}

Collins, Kate ^{[4
]}

Bateman, Katherine ^{[4
]}

Dev, Anouk ^{[5
]}

Abasszade, Joshua H. ^{[5
]}

Valaydon, Zina ^{[6
]}

Saitta, Daniel ^{[6
]}

Gazelakis, Kathryn ^{[6
]}

Byers, Susan ^{[6
]}

Holmes, Jacinta ^{[7
,8
]}

Thompson, Alexander J. ^{[7
,8
]}

Pandiaraja, Dhivya ^{[7
]}

Bollipo, Steven ^{[9
]}

Sharma, Suresh ^{[9
]}

Joseph, Merlyn ^{[9
]}

Nicoll, Amanda ^{[10
,11
]}

Batt, Nicholas ^{[10
]}

Sawhney, Rohit ^{[10
,11
]}

Tang, Myo J. ^{[1
]}

Lubel, John ^{[1
]}

Riordan, Stephen ^{[12
]}

Hannah, Nicholas ^{[13
]}

Haridy, James ^{[13
]}

Sood, Siddharth ^{[13
]}

Lam, Eileen ^{[2
,14
]}

Greenhill, Elysia ^{[2
,14
]}

Majeed, Ammar ^{[1
,2
]}

Kemp, William ^{[1
,2
]}

Zalcberg, John ^{[14
,15
]}

Roberts, Stuart K. ^{[1
,2
]}

机构：

[1] Alfred Hlth, Dept Gastroenterol, Melbourne, Vic 3004, Australia

[2] Monash Univ, Cent Clin Sch, Dept Med, Melbourne, Vic 3004, Australia

[3] Royal Prince Alfred Hosp, Dept Gastroenterol, Sydney, NSW 2050, Australia

[4] Austin Hosp, Dept Gastroenterol, Heidelberg, Vic 3084, Australia

[5] Monash Hlth, Dept Gastroenterol, Clayton, Vic 3168, Australia

[6] Western Hlth, Dept Gastroenterol, Footscray, Vic 3011, Australia

[7] St Vincents Hosp Melbourne, Dept Gastroenterol, Fitzroy, Vic 3065, Australia

[8] Univ Melbourne, St Vincents Hosp, Dept Med, Parkville, Vic 3052, Australia

[9] John Hunter Hosp, Dept Gastroenterol, New Lambton Hts, NSW 2305, Australia

[10] Eastern Hlth, Dept Gastroenterol, Box Hill, Vic 3128, Australia

[11] Eastern Hlth Clin Sch, Dept Med, Box Hill, Vic 3128, Australia

[12] Prince Wales Hosp, Dept Gastroenterol, Randwick, NSW 2031, Australia

[13] Royal Melbourne Hosp, Dept Gastroenterol, Parkville, Vic 3052, Australia

[14] Monash Univ, Sch Publ Hlth & Prevent Med, Melbourne, Vic 3004, Australia

[15] Alfred Hlth, Dept Med Oncol, Melbourne, Vic 3004, Australia

来源：

CANCERS | 2023年 / 15卷 / 24期

关键词：

hepatocellular carcinoma; early; resection; ablation; PERCUTANEOUS RADIOFREQUENCY ABLATION; EARLY HEPATOCELLULAR-CARCINOMA; HEPATIC RESECTION; LIVER RESECTION; METAANALYSIS;

D O I：

10.3390/cancers15245741

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Simple Summary Cure is the goal of treatment in early primary liver cancer with surgical resection and ablation therapy being the two most common modalities used. This real-world multi-centre Australian study demonstrates that surgical treatment results in superior outcomes. We observed a significantly reduced risk of death from any cause and of recurrent liver cancer after controlling for factors such as initial tumour burden, liver disease severity and other medical comorbidities. Our study provides compelling evidence to recommend surgery for suitable patients to achieve the best possible outcomes.Abstract 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.

引用

页数：27

共 2 条

[1] Different Patterns of Care and Survival Outcomes in Transplant-Centre Managed Patients with Early-Stage HCC: Real-World Data from an Australian Multi-Centre Cohort Study
Abdelmalak, Jonathan
Strasser, Simone I.
Ngu, Natalie L.
Dennis, Claude
Sinclair, Marie
Majumdar, Avik
Collins, Kate
Bateman, Katherine
Dev, Anouk
Abasszade, Joshua H.
Valaydon, Zina
Saitta, Daniel
Gazelakis, Kathryn
Byers, Susan
Holmes, Jacinta
Thompson, Alexander J.
Pandiaraja, Dhivya
Bollipo, Steven
Sharma, Suresh
Joseph, Merlyn
Sawhney, Rohit
Nicoll, Amanda
Batt, Nicholas
Tang, Myo J.
Riordan, Stephen
Hannah, Nicholas
Haridy, James
Sood, Siddharth
Lam, Eileen
Greenhill, Elysia
Lubel, John
Kemp, William
Majeed, Ammar
Zalcberg, John
Roberts, Stuart K.
CANCERS, 2024, 16 (11)
[2] Initial Trans-Arterial Chemo-Embolisation (TACE) Is Associated with Similar Survival Outcomes as Compared to Upfront Percutaneous Ablation Allowing for Follow-Up Treatment in Those with Single Hepatocellular Carcinoma (HCC) ≤ 3 cm: Results of a Real-World Propensity-Matched Multi-Centre Australian Cohort Study
Abdelmalak, Jonathan
Strasser, Simone I.
Ngu, Natalie L.
Dennis, Claude
Sinclair, Marie
Majumdar, Avik
Collins, Kate
Bateman, Katherine
Dev, Anouk
Abasszade, Joshua H.
Valaydon, Zina
Saitta, Daniel
Gazelakis, Kathryn
Byers, Susan
Holmes, Jacinta
Thompson, Alexander J.
Howell, Jessica
Pandiaraja, Dhivya
Bollipo, Steven
Sharma, Suresh
Joseph, Merlyn
Sawhney, Rohit
Nicoll, Amanda
Batt, Nicholas
Tang, Myo J.
Riordan, Stephen
Hannah, Nicholas
Haridy, James
Sood, Siddharth
Lam, Eileen
Greenhill, Elysia
Lubel, John
Kemp, William
Majeed, Ammar
Zalcberg, John
Roberts, Stuart K.
CANCERS, 2024, 16 (17)

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