Outcomes of surgical resection and loco‐regional therapy in patients with stage 3A hepatocellular carcinoma: a retrospective review from the national cancer database
| Autor: | John B. Martinie, Erin H. Baker, Ryan Z. Swan, Megan Templin, Ramanathan M. Seshadri, Dionisios Vrochides, David A. Iannitti |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Carcinoma Hepatocellular Databases Factual medicine.medical_treatment Kaplan-Meier Estimate Disease Disease-Free Survival Internal medicine medicine Hepatectomy Humans Stage (cooking) Survival rate Neoplasm Staging Retrospective Studies Hepatology business.industry Liver Neoplasms Puerto Rico Gastroenterology Cancer Retrospective cohort study Original Articles Middle Aged Prognosis medicine.disease Combined Modality Therapy United States Surgery Survival Rate Hepatocellular carcinoma Disease Progression Female Neoplasm Recurrence Local Liver cancer business Follow-Up Studies |
| Zdroj: | HPB. 17:964-968 |
| ISSN: | 1365-182X |
| DOI: | 10.1111/hpb.12466 |
| Popis: | Objectives In advanced stages, hepatocellular carcinoma (HCC) is often associated with major vascular involvement (cava, portal vein). The aim of the present study was to analyse the role of surgical resection (SR) and loco‐regional therapy (LRT) in these advanced stage patients to determine if there was a survival benefit. Methods The study is a retrospective analysis from the Commission on Cancer's National Cancer Data Base (NCDB) from 1998 to 2011. In total, 148 882 patients with liver cancer were identified, of which 126 984 had HCC. Of these, 64 264 patients (1998–2006) had 5‐year survival data available and 8825 patients had Stage 3A disease based on AJCC classification. Of these patients, 884 had SR, 771 had LRT and 7170 patients had neither intervention. Kaplan–Meier curves and log‐rank tests were used for statistical analysis. Results Eight thousand eight hundred and twenty‐five patients met analysis criteria. The mean age (years) in the SR, LRT and no intervention group were 62.5, 64.3 and 64.2, respectively. Most patients were males in all three groups (77.5%, 74.5% and 68.1%). The mean tumour size (cm) in the three groups was 9.8, 6.4 and 8.4, respectively. SR and LRT were primarily performed in major academic and comprehensive cancer programmes compared with community cancer programmes and other centres (SR: 93% versus 7%; LRT: 94.6% versus 5.4%). The median 5‐year survival (months) was 26.6 in SR, 16.5 in LRT and 4.8 in the no intervention group ( P Conclusion A SR and LRT offer a survival benefit in select patients diagnosed with Stage 3A HCC. |
| Databáze: | OpenAIRE |
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