Detailed Abstract
[E-poster - Liver (Liver Disease/Surgery)]
[EP 021] Clinical Significance of Surgical Resection for Hepatocellular Carcinoma with Portal Vein Invasion: a Nationwide Cohort Study
Hye-Sung JO 1, Pyoung-Jae PARK 2, Young-Dong YU 1, Yoo Jin CHOI 1, Se Hyeon YU 1, Dong-Sik KIM 1
1 Surgery, Korea University Anam Hospita, REPUBLIC OF KOREA, 2 Surgery, Korea University Guro Hospital, REPUBLIC OF KOREA
Background : Although current guidelines recommend systemic treatment for hepatocellular carcinoma (HCC) with portal vein invasion (PVI), surgical resection could produce acceptable outcomes in selected patients. This study aimed to identify the clinical significance of surgical resection for HCC with PVI patients using a large-scale nationwide registry.
Methods : A total of 16,781 patients who were newly diagnosed with HCC between 2008 and 2018 were enrolled in this study from the Korean Primary Liver Cancer Registry. Patients with Child-Turcotte-Pugh scores (≥ 7) or performance status (≥ 2) were excluded. Among them, 998 patients who received treatment for HCC with PVI were included in the analysis and were divided into two groups after matching the number and size of the tumors and MELD score: resection group of 151 (26.6%) and palliative group of 417 (73.4%) who received transarterial and systemic therapy according to the treatment intent.
Results : The number and maximum size of HCC did not differ between the resection and palliative groups after matching (1 [1–5] vs. 1 [1–6], P=0.111 and 5.5 [1.2–20.6] cm vs. 6.0 [1.0–20.5] cm, P=0.246, respectively). The 5-year overall survival (OS) and cancer-specific survival (CSS) rates of the resection and palliative groups were 44.8% and 17.4% (P〈0.001) and 47.7% and 18.6% (P〈0.001), respectively. Multivariate analysis showed that palliative treatment was the most significant risk factor for OS and CSS (hazard ratio, 2.24 [1.66–3.02], P〈0.001 and 2.29 [1.68–3.12], P〈0.001, respectively).
Conclusions : Surgical resection could significantly improve OS and CSS in selected HCC with PVI patients who have preserved liver function and performance status.
Methods : A total of 16,781 patients who were newly diagnosed with HCC between 2008 and 2018 were enrolled in this study from the Korean Primary Liver Cancer Registry. Patients with Child-Turcotte-Pugh scores (≥ 7) or performance status (≥ 2) were excluded. Among them, 998 patients who received treatment for HCC with PVI were included in the analysis and were divided into two groups after matching the number and size of the tumors and MELD score: resection group of 151 (26.6%) and palliative group of 417 (73.4%) who received transarterial and systemic therapy according to the treatment intent.
Results : The number and maximum size of HCC did not differ between the resection and palliative groups after matching (1 [1–5] vs. 1 [1–6], P=0.111 and 5.5 [1.2–20.6] cm vs. 6.0 [1.0–20.5] cm, P=0.246, respectively). The 5-year overall survival (OS) and cancer-specific survival (CSS) rates of the resection and palliative groups were 44.8% and 17.4% (P〈0.001) and 47.7% and 18.6% (P〈0.001), respectively. Multivariate analysis showed that palliative treatment was the most significant risk factor for OS and CSS (hazard ratio, 2.24 [1.66–3.02], P〈0.001 and 2.29 [1.68–3.12], P〈0.001, respectively).
Conclusions : Surgical resection could significantly improve OS and CSS in selected HCC with PVI patients who have preserved liver function and performance status.
SESSION
E-poster
E-Session 03/21 ALL DAY