Surgery for hepatocellular carcinoma: does it improve survival?
| Autor: | Steven M. Asch, Ronald W. Busuttil, Clifford Y. Ko, Jerome H. Liu, Pauline W. Chen |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Oncology
Male medicine.medical_specialty Carcinoma Hepatocellular Population Surgical oncology Internal medicine Carcinoma Medicine Humans Registries education Survival analysis Aged Retrospective Studies education.field_of_study business.industry Liver Neoplasms Cancer Middle Aged medicine.disease Prognosis Survival Analysis Surgery Cancer registry Treatment Outcome Hepatocellular carcinoma Female business Liver cancer SEER Program |
| Zdroj: | Annals of surgical oncology. 11(3) |
| ISSN: | 1068-9265 |
| Popis: | The incidence and mortality of hepatocellular carcinoma (HCC) are increasing in the United States. Whether surgery is associated with improved survival at the population level is relatively unknown. To address this question, we used a population-based cancer registry to compare survival outcomes between patients receiving and not receiving surgery with similar tumor sizes and health status.By using the Surveillance, Epidemiology, and End Results database, we identified HCC patients who had surgically resectable disease as defined by published expert guidelines. After excluding patients with contraindications to surgery, we performed both survival analysis and Cox regression to identify predictors of improved survival.Of the 4008 patients diagnosed with HCC between 1988 and 1998, 417 were candidates for surgical resection. The mean age was 63.6 years; mean tumor size was 3.3 cm. The 5-year overall survival with surgery was 33% with a mean of 47.1 months; without surgery, the 5-year overall survival was 7% with a mean of 17.9 months (P.001). In the multivariate Cox regression, surgery was significantly associated with improved survival (P.001). Specifically, patients who received surgery had a 55% decreased rate of death compared with patients who did not have surgery, even after controlling for tumor size, age, sex, and race.This study shows that surgical therapy is associated with improved survival in patients with unifocal, nonmetastatic HCC tumors5 cm. If this is confirmed in future studies, efforts should be made to ensure that appropriate patients with resectable HCC receive high-quality care, as well as the opportunity for potentially curative surgery. |
| Databáze: | OpenAIRE |
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