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Updated: May 29, 2026
A Three-Dimensional Spheroid Model to Investigate the Tumor-Stromal Interaction in Hepatocellular Carcinoma
Published on: September 30, 2021
Presentation and outcomes of hepatocellular carcinoma patients at a western centre
Krit Kitisin1, Vignesh Packiam, Jennifer Steel
1Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Insights
Surgical intervention, particularly liver transplantation, significantly improves survival for hepatocellular carcinoma (HCC) patients. Most HCC patients received hepatic artery-based therapy, but surgical options offer the best long-term outcomes.
Area of Science:
- Hepatobiliary Surgery
- Medical Oncology
- Gastroenterology
Background:
- Hepatocellular carcinoma (HCC) is a significant health concern.
- Understanding HCC presentation and outcomes is crucial for effective treatment.
- This study analyzes HCC cases at a Western medical center over a decade.
Purpose of the Study:
- To examine the presentation and outcomes of hepatocellular carcinoma (HCC).
- To compare survival rates across different treatment modalities for HCC.
- To identify predictors of survival in HCC patients.
Main Methods:
- Retrospective analysis of 1010 HCC patients treated between 2000 and 2009.
- Classification into four treatment groups: no treatment (NT), systemic therapy (ST), hepatic artery-based therapy (HAT), and surgical intervention (SI).
- Kaplan-Meier and Cox regression analyses were used to assess survival and identify predictors.
Main Results:
- The majority of patients were male, Caucasian, cirrhotic, and diagnosed with hepatitis C.
- Surgical intervention (SI) resulted in the longest median survival (83.5 months), followed by HAT (8.8 months), ST (5.6 months), and NT (3.6 months).
- Liver transplantation rates increased following MELD criteria adjustments; survival was not significantly affected by bridging therapies.
Conclusions:
- Most HCC patients were not surgical candidates and received HAT.
- Surgical intervention, especially liver transplantation, offers the best survival outcomes for HCC.
- Treatment modality is a significant predictor of survival in HCC patients.
Background:
The present study examines the presentation and outcomes of hepatocellular carcinoma (HCC) at a Western centre over the last decade.
Methods:
Between January 2000 and September 2009, 1010 patients with HCC were evaluated at the University of Pittsburgh Medical Center (UPMC). Retrospectively, four treatment groups were classified: no treatment (NT), systemic therapy (ST), hepatic artery-based therapy (HAT) and surgical intervention (SI) including radiofrequency ablation, hepatic resection and transplantation. Kaplan-Meier analysis assessed survival between groups. Cox regression analysis identified factors predicting survival.
Results:
Patients evaluated were 75% male, 87% Caucasian, 84% cirrhotic, and predominantly diagnosed with hepatitis C. In all, 169 patients (16.5%) received NT, 25 (2.4%) received ST, 529 (51.6%) received HAT and 302 (29.5%) received SI. Median survival was 3.6, 5.6, 8.8, and 83.5 months with NT, ST, HAT and SI, respectively (P= 0.001). Transplantation increased from 9.5% to 14.2% after the model for end-stage liver disease (MELD) criteria granted HCC patients priority points. Survival was unaffected by bridging transplantation with HAT or SI (P= 0.111). On multivariate analysis, treatment modality was a robust predictor of survival after adjusting for age, gender, AFP, Child-Pugh classification and cirrhosis (P < 0.001, χ(2) = 460).
Discussion:
Most patients were not surgical candidates and received HAT alone. Surgical intervention, especially transplantation, yields the best survival.