Global and regional long‐term survival following resection for HCC in the recent decade: A meta‐analysis of 110 studies

Abstract

Surgical resection for HCC remains a major curative treatment option, but it is unclear whether there are differences in outcomes by region and whether outcomes have improved over time. We aimed to estimate pooled overall survival (OS), recurrence‐free survival (RFS), and complication rates in patients with hepatocellular carcinoma (HCC) following curative surgical resection and to compare outcomes by region and by time period. In this systematic review and meta‐analysis, we searched Pubmed, Embase, and Cochrane databases from inception to May 15, 2020. We selected studies reporting OS, RFS, and complications in adult patients with HCC undergoing curative surgical resection. Two authors independently searched the literature and extracted the data. We screened 6983 articles and included 110 eligible studies with 82,392 patients, with study periods spanning from 1980–2017. The global pooled 1‐year and 5‐year survival rates were 88.9% (95% confidence interval [CI] 87.1–90.4) and 56.2% (95% CI 52.8–59.6) for OS and 71.1% (95% CI 67.6–74.3) and 35.2% (95% CI 32.5–38.0) for RFS, respectively. Five‐year OS was higher in Asia (57.03%) than in other regions (Europe 48.3%; North America 48.0%; and South America 49.5%); p = 0.002. Five‐year RFS was higher in patients with hepatitis B virus versus patients with hepatitis C virus (34.8% vs. 24.1%; p = 0.02). There was no significant improvement in 5‐year OS and RFS over time. The pooled rate for complications was 27.6% (95% CI 23.4–32.3), with 9.7% (95% CI 6.3–14.7) classified as major. One‐year OS after surgical resection for HCC is excellent (~90%). However, 5‐year OS (~55%) and RFS (~35%) are still poor, suggesting that long‐term care is suboptimal. Greater efforts are required to improve survival through enhanced surveillance and preventing recurrence through antiviral therapy.

Immunotherapy as a Neoadjuvant Therapy for a Patient with Hepatocellular Carcinoma in the Pretransplant Setting: A Case Report

“…According to the world health organization GLOBOCAN database, HCC is rapidly becoming the leading cause of cancer deaths in the United States and is the fourth leading cause of cancer-related deaths worldwide. The tumor prognosis remains poor with a five-year survival rate of around 18% [ 8 ]. In the United States, the annual incidence of HCC is 6 per 100,000 [ 9 ].…”

Global prevalence of depression and anxiety in patients with hepatocellular carcinoma: Systematic review and meta-analysis

“…Despite surveillance programs, the majority of patients with HCC are diagnosed at an advanced stage [ 3 - 7 ]. Overall, the prognosis of HCC is poor, even among patients who have undergone curative treatment [ 8 - 11 ]. Studies have demonstrated poor quality of life (QOL) among patients with HCC due to complications of the cancer and decompensated liver cirrhosis including pruritus, fatigue, sexual dysfunction, and ascites [ 12 , 13 ].…”

Comparable Outcomes in Early Hepatocellular Carcinomas Treated with Trans-Arterial Chemoembolization and Radiofrequency Ablation

“…Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death worldwide [ 1 , 2 ]. The optimal treatment for HCC is oncologic resection or liver transplant [ 3 , 4 , 5 , 6 ]. Unfortunately, this is often limited by poor liver function precluding a safe resection and a shortage of donor livers.…”