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Curative Intent Treatment of Hepatocellular Carcinoma - 844 Cases Treated in a General Surgery and Liver
Insights
Liver transplantation (LT) offers the best survival outcomes for early hepatocellular carcinoma (HCC) on cirrhosis. For HCC without cirrhosis, liver resection is preferred, while radiofrequency ablation (RFA) suits patients ineligible for surgery.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Transplantation Medicine
Background:
- Hepatocellular carcinoma (HCC) is a significant global health concern.
- Effective treatment strategies are crucial for improving patient outcomes.
- General Surgery and Liver Transplantation Centers play a key role in managing HCC.
Purpose of the Study:
- To evaluate treatment outcomes for hepatocellular carcinoma (HCC) patients.
- To compare the efficacy of liver resection (LR), liver transplantation (LT), and radiofrequency ablation (RFA) for HCC.
- To identify optimal treatment strategies based on patient characteristics, including the presence of liver cirrhosis.
Main Methods:
- Retrospective analysis of 844 patients with surgically treated HCC.
- Treatments included liver resection (LR), liver transplantation (LT), and radiofrequency ablation (RFA).
- Patient data included diagnosis, treatment modality, and presence of liver cirrhosis (73% of patients).
Main Results:
- Overall morbidity was 30% and mortality was 4.3%.
- Five-year overall survival was 39%, with significant differences between treatment groups (p < 0.05).
- Liver transplantation (LT) demonstrated superior survival, followed by liver resection (LR) and radiofrequency ablation (RFA).
Conclusions:
- Liver resection (LR) is the primary treatment for HCC in patients without liver cirrhosis.
- Liver transplantation (LT) provides the best survival for early HCC in patients with cirrhosis.
- Radiofrequency ablation (RFA) is a viable curative option for HCC patients unsuitable for LR or LT.
Abstract:
Background: The objective of this study is to assess the outcome of the patients treated for hepatocellular carcinoma (HCC) in a General Surgery and Liver Transplantation Center. Methods: This retrospective study includes 844 patients diagnosed with HCC and surgically treated with curative intent methods. Curative intent treatment is mainly based on surgery, consisting of liver resection (LR), liver transplantation (LT). Tumor ablation could become the choice of treatment in HCC cases not manageable for surgery (LT or LR). 518 patients underwent LR, 162 patients benefited from LT and in 164 patients radiofrequency ablation (RFA) was performed. 615 patients (73%) presented liver cirrhosis. Results: Mordidity rates of patient treated for HCC was 30% and mortality was 4,3% for the entire study population. Five year overall survival rate was 39 % with statistically significant differences between transplanted, resected, or ablated patients (p 0.05) with better results in case of LT followed by LR and RFA. Conclusions: In HCC patients without liver cirrhosis, liver resection is the treatment of choice. For early HCC occurred on cirrhosis, LT offers the best outcome in terms of overall and disease free survival. RFA colud be a curative method for HCC patients not amenable for LT of LR.
