Surgical resection versus ablation for early hepatocellular carcinoma: The debate is still open

Kim, Bo Hyun

doi:10.3350/cmh.2021.0400

Cited by 3 publications

(3 citation statements)

References 22 publications

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“…Effectively treating early-stage HCC for the elderly remains a challenging clinical question. There have been extensive debates on the relative effectiveness of different surgical options, and different studies have drawn conflicting conclusions [ 42 ]. To further elucidate this question, in this study, we resorted to real-world evidence contained in SEER-Medicare and evaluated the comparative effectiveness of partial hepatectomy and liver ablation for stage I-II HCC with tumor size less than or equal to 5 cm (or 3 cm) for patients over 66 years old.…”

Section: Discussionmentioning

confidence: 99%

Partial Hepatectomy and Ablation for Survival of Early-Stage Hepatocellular Carcinoma Patients: A Bayesian Emulation Analysis

Wang,

Im,

Wang

et al. 2024

Life

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Partial hepatectomy and ablation therapy are two widely used surgical procedures for localized early-stage hepatocellular carcinoma (HCC) patients. This article aimed to evaluate their relative effectiveness in terms of overall survival. An emulation analysis approach was first developed based on the Bayesian technique. We estimated propensity scores via Bayesian logistic regression and adopted a weighted Bayesian Weibull accelerated failure time (AFT) model incorporating prior information contained in the published literature. With the Surveillance, Epidemiology, and End Results (SEER)-Medicare data, an emulated target trial with rigorously defined inclusion/exclusion criteria and treatment regimens for early-stage HCC patients over 66 years old was developed. For the main cohort with tumor size less than or equal to 5 cm, a total of 1146 patients were enrolled in the emulated trial, with 301 and 845 in the partial hepatectomy and ablation arms, respectively. The analysis suggested ablation to be significantly associated with inferior overall survival (hazard ratio [HR] = 1.35; 95% credible interval [CrI]: 1.14, 1.60). For the subgroup with tumor size less than or equal to 3 cm, there was no significant difference in overall survival between the two arms (HR = 1.15; 95% CrI: 0.88, 1.52). Overall, the comparative treatment effect of ablation and partial hepatectomy on survival remains inconclusive. This finding may provide further insight into HCC clinical treatment.

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Section: Discussionmentioning

confidence: 99%

Partial Hepatectomy and Ablation for Survival of Early-Stage Hepatocellular Carcinoma Patients: A Bayesian Emulation Analysis

Wang,

Im,

Wang

et al. 2024

Life

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“…Compared with resection, thermal ablation is a less morbid procedure and there is comparable overall survival outcomes to surgery in small HCC. 93,94 However, a recently published meta-analysis demonstrated that surgical resection has superior 5-year recurrence-free survival and higher local recurrence compared with RFA. 95 Overall, when considering curative therapies and deciding between resection and ablation techniques, a multidisciplinary discussion is needed to determine the optimal treatment.…”

Section: Ablationmentioning

confidence: 99%

Hepatocellular Carcinoma from a Hepatologist's Perspective

Roldan,

Blomker,

Aby

2023

Semin intervent Radiol

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Hepatocellular carcinoma (HCC), the most common type of primary liver cancer, represents a growing health challenge worldwide. The incidence of HCC is rising, which, in turn, has led to a corresponding increase in the associated number of deaths. HCC will become the third leading cause of cancer-related deaths in the United States by 2030. HCC usually develops in the setting of chronic liver disease. Individuals at increased risk of HCC are recommended to undergo surveillance with ultrasound every 6 months along with serum α-fetoprotein testing. Computed tomography (CT) and magnetic resonance imaging (MRI) are considered alternatives based on specific patient factors. Lesions suspicious for HCC are recommended to undergo a diagnostic testing, which includes contrast-enhanced multiphase CT or MRI and liver biopsy when findings are indeterminate. The Barcelona Clinic Liver Cancer prognosis and treatment strategy is the most used assessment for patients with HCC (Fig. 2). Curative therapies include resection, liver transplantation, and ablation. Locoregional therapies, such as transarterial chemoembolization and radioembolization, can be used for patients with intermediate-stage HCC. For patients with advanced-stage HCC, systemic therapy is often used. This review aims to provide an overview of HCC from a hepatologist's perspective, including epidemiology, screening, surveillance, diagnosis, and management.

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“…Moreover, early cancer detection allows better treatment options for cancer patients, which includes surgical intervention. Previous studies have reported that early cancer detection followed by surgical intervention and adjuvant chemotherapy could improve patient survival remarkably in most solid malignancies [ 18 , 19 , 20 , 21 , 22 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

Mucins as Potential Biomarkers for Early Detection of Cancer

Gautam

Κhan

Gopalakrishnan

et al. 2023

Cancers

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Early detection significantly correlates with improved survival in cancer patients. So far, a limited number of biomarkers have been validated to diagnose cancers at an early stage. Considering the leading cancer types that contribute to more than 50% of deaths in the USA, we discuss the ongoing endeavors toward early detection of lung, breast, ovarian, colon, prostate, liver, and pancreatic cancers to highlight the significance of mucin glycoproteins in cancer diagnosis. As mucin deregulation is one of the earliest events in most epithelial malignancies following oncogenic transformation, these high-molecular-weight glycoproteins are considered potential candidates for biomarker development. The diagnostic potential of mucins is mainly attributed to their deregulated expression, altered glycosylation, splicing, and ability to induce autoantibodies. Secretory and shed mucins are commonly detected in patients’ sera, body fluids, and tumor biopsies. For instance, CA125, also called MUC16, is one of the biomarkers implemented for the diagnosis of ovarian cancer and is currently being investigated for other malignancies. Similarly, MUC5AC, a secretory mucin, is a potential biomarker for pancreatic cancer. Moreover, anti-mucin autoantibodies and mucin-packaged exosomes have opened new avenues of biomarker development for early cancer diagnosis. In this review, we discuss the diagnostic potential of mucins in epithelial cancers and provide evidence and a rationale for developing a mucin-based biomarker panel for early cancer detection.

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Surgical resection versus ablation for early hepatocellular carcinoma: The debate is still open

Cited by 3 publications

References 22 publications

Partial Hepatectomy and Ablation for Survival of Early-Stage Hepatocellular Carcinoma Patients: A Bayesian Emulation Analysis

Partial Hepatectomy and Ablation for Survival of Early-Stage Hepatocellular Carcinoma Patients: A Bayesian Emulation Analysis

Hepatocellular Carcinoma from a Hepatologist's Perspective

Mucins as Potential Biomarkers for Early Detection of Cancer

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