Clinicopathologic Features of Long-Term Survivors and Disease-Free Survivors After Resection of Hepatocellular Carcinoma: A Study of a Prospective Cohort

Poon, Yvette; Ng, Irene Oi–Lin; Fan, Sheung‐Tat; Lai, Edward C. S.; Lo, Chung‐Mau; Liu, Chi‐Leung; Wong, John

doi:10.1200/jco.2001.19.12.3037

Cited by 151 publications

(115 citation statements)

References 38 publications

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“…The exclusion criteria were: (1) poor or absent visualization of the nodule on ultrasound (US); (2) intestinal loops or main bile ducts adjacent to the tumor, because this presentation is considered a relative contraindication for RFA; (3) severe coagulation disorders (prothrombin activity Ͻ 40% or platelet count Ͻ 40,000/ mL); (4) previous HCC treatment; (6) no foreseeable possibility for liver transplantation.…”

Section: Methodsmentioning

confidence: 99%

“…1 This position is based on the oncological assumption that resection is the more suitable option for obtaining the complete tumor ablation including a layer of tissue surrounding it. 2,3 The importance of the local complete response (in other words, the absence of residual neoplastic tissue at the site of the tumor) on the overall survival in patients with HCC had been proved not only for surgery but also for percutaneous ablation therapies (PATs). 4,5 PATs were originally reserved for HCCs that were, for one reason or another, unsuitable for resective surgery, but they are now proving their worth in small operable cases as well.…”

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confidence: 99%

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Sustained complete response and complications rates after radiofrequency ablation of very early hepatocellular carcinoma in cirrhosis: Is resection still the treatment of choice?

et al. 2008

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If liver transplantation is not feasible, partial resection is considered the treatment of choice for hepatocellular carcinoma (HCC) in patients with cirrhosis. However, in some centers the firstline treatment for small, single, operable HCC is now radiofrequency ablation (RFA). In the current study, 218 patients with single HCC < 2.0 cm (very early or T1 stage) underwent RFA. We assessed 2 primary end points that could be easily compared with those reported for resective surgery: (1) the rate of sustained, local, complete response and (2) the rate of treatment-related complications. The secondary end point was 5-year survival in the 100 patients whose tumors had been considered potentially operable. After a median follow-up of 31 months, sustained complete response was observed in 216 patients (97.2%). In the remaining 6, percutaneous ethanol injection, selective intraarterial chemoembolization, or resection were used as salvage therapy. Perioperative mortality, major complication, and 5-year survival rates were 0%, 1.8%, and 68.5%, respectively. Conclusion: Compared with resection, RFA is less invasive and associated with lower complication rate and lower costs. RFA is also just as effective for ensuring local control of stage T1 HCC, and it is associated with similar survival rates (as recently demonstrated by 2 randomized trials). These data indicate that RFA can be considered the treatment of choice for patients with single HCC < 2.0 cm, even when surgical resection is possible. Other approaches can be used as salvage therapy for the few cases in which RFA is unsuccessful or unfeasible. ( on the oncological assumption that resection is the more suitable option for obtaining the complete tumor ablation including a layer of tissue surrounding it. 2,3 The importance of the local complete response (in other words, the absence of residual neoplastic tissue at the site of the tumor) on the overall survival in patients with HCC had been proved not only for surgery but also for percutaneous ablation therapies (PATs). 4,5 PATs were originally reserved for HCCs that were, for one reason or another, unsuitable for resective surgery, but they are now proving their worth in small operable cases as well. 6,7 Radiofrequency ablation (RFA) is currently considered the most effective PAT, [8][9][10][11] and 2 recent randomized trials failed to reveal significant differences between the survival rates associated with resective surgery and RFA in patients with early HCC. 12,13 These considerations have led some centers to adopt RFA as first-line treatment for single HCC nodules less than 3.0 cm in diameter, [14][15][16][17] opening the debate over the best therapeutic option for these small tumors.To clarify this issue, we conducted a multicenter study that included a consecutive series of patients with single HCC 2.0 cm or less in diameter accompanying cirrhosis

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Sustained complete response and complications rates after radiofrequency ablation of very early hepatocellular carcinoma in cirrhosis: Is resection still the treatment of choice?

et al. 2008

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“…the cumulative probability of avoiding both death and disease recurrence) predominantly fall within the following ranges: 50-80% at 1 year, 30-50% at 3 years, 15-40% at 5 years and 8-20% at 10 years. 158,166,173,174,[176][177][178][179][180][181][182][183][184][185][186][187][188][189][190][191][192][193] …”

Section: Disease Recurrencementioning

confidence: 99%

Surveillance of cirrhosis for hepatocellular carcinoma: systematic review and economic analysis

Coon¹,

Rogers²,

Hewson³

et al. 2007

Health Technol Assess

152

108

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“…Although operative mortality and morbidity of hepatic resection in patients with HCC have been minimized by advances in surgical techniques, instruments, and perioperative management, therapeutic outcomes remain unsatisfactory due to the high incidence of recurrence (2,3). Therefore, it is important to clarify the predictor of HCC recurrence and prognosis for decision making in additional adjuvant treatment after hepatic resection, preoperatively.…”

Section: Introductionmentioning

confidence: 99%

Glasgow prognostic score predicts therapeutic outcome after hepatic resection for hepatocellular carcinoma

Shiba¹,

Horiuchi²,

Sakamoto³

et al. 2017

Oncology Letters

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Abstract. Systemic inflammation, as evidenced by the Glasgow prognostic score (GPS), predicts cancer-specific survival in various cancer types. The aim of this study was to evaluate the significance of the GPS in the therapeutic outcome of the patient following surgical resection for hepatocellular carcinoma. In total, 144 patients underwent surgical resection for hepatocellular carcinoma. For the assessment of systemic inflammatory response using the GPS, patients were classified into three groups: Patients with normal serum albumin (<3.5 g/dl) and normal serum C-reactive protein (CRP) (≤1.0 mg/dl) were classified as GPS 0 (n=76), those with low serum albumin (<3.5 g/dl) or elevated serum CRP (>1.0 mg/dl) were classified as GPS 1 (n=58), and those with low serum albumin (<3.5 g/dl) and elevated serum CRP (>1.0 mg/dl) were classified as GPS 2 (n=10). Retrospectively, the relationship between patient characteristics including GPS, disease-free as well as overall survival were investigated. In disease-free survival, GPS 2 (P=0.019), with a tumor number ≥3 (P=0.004), and positive portal or venous invasion (P= 0.034) were independent predictors of cancer recurrence in multivariate analysis. In overall survival, GPS 1 (P= 0.042), GPS 2 (P<0.001) and positive portal or venous invasion (P<0.001) were independent predictors of poor patient outcome according to multivariate analysis. To conclude, the GPS in patients with hepatocellular carcinoma is an independent prognostic predictor after hepatic resection.

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Clinicopathologic Features of Long-Term Survivors and Disease-Free Survivors After Resection of Hepatocellular Carcinoma: A Study of a Prospective Cohort

Abstract: This study shows that long-term disease-free survival > 5 years after resection of HCC can be achieved in patients with favorable tumor characteristics. Early pTNM stage was the most reliable predictor of both long-term overall and disease-free survivors.

Cited by 151 publications

References 38 publications

Sustained complete response and complications rates after radiofrequency ablation of very early hepatocellular carcinoma in cirrhosis: Is resection still the treatment of choice?

Sustained complete response and complications rates after radiofrequency ablation of very early hepatocellular carcinoma in cirrhosis: Is resection still the treatment of choice?

Surveillance of cirrhosis for hepatocellular carcinoma: systematic review and economic analysis

Glasgow prognostic score predicts therapeutic outcome after hepatic resection for hepatocellular carcinoma

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