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Updated: Jul 30, 2025
A Three-Dimensional Spheroid Model to Investigate the Tumor-Stromal Interaction in Hepatocellular Carcinoma
Published on: September 30, 2021
Real world for management of hepatocellular carcinoma: a large population-based study
Supatsri Sethasine1, Nitipon Simasingha1, Sarita Ratana-Amornpin2
1Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.
Insights
Early detection of hepatocellular carcinoma (HCC) through surveillance improves survival. Radiofrequency ablation (RFA) may be a preferred first-line treatment for early-stage HCC, potentially offering longer survival than resection.
Area of Science:
- Hepatology
- Oncology
- Gastroenterology
Background:
- Hepatocellular carcinoma (HCC) is a significant cause of cancer mortality worldwide.
- Understanding real-world treatment patterns and outcomes is crucial for improving patient survival.
Purpose of the Study:
- To investigate risk factors, treatment responses, and survival outcomes in patients with HCC.
- To evaluate the effectiveness of different treatment modalities for HCC based on disease stage and patient characteristics.
Main Methods:
- A retrospective cohort study of 1145 patients with newly diagnosed HCC in Thailand (2011-2020).
- Analysis of patient demographics, Child-Pugh scores, Barcelona Clinic Liver Cancer (BCLC) staging, and treatment modalities (liver resection, radiofrequency ablation).
- Survival time was calculated from diagnosis to death or last follow-up.
Main Results:
- Over half of patients (59.0%) presented with noncurative-stage HCC (BCLC B-D).
- Child-Pugh A patients were more likely to have early-stage HCC (BCLC 0-A) (67.4%).
- Radiofrequency ablation (RFA) monotherapy showed a trend towards increased median survival (55 months) compared to resection (36 months) (p=0.058).
Conclusions:
- Early detection of HCC via surveillance is vital for curative treatment and improved survival.
- RFA may be a suitable first-line treatment for early-stage HCC.
- Sequential multi-modality treatment in the curative stage can lead to favorable 5-year survival rates.
Objectives:
Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer-related death. This study investigated the risk factors, treatment responses and survival outcomes in real-world patients with HCC.
Materials And Methods:
This was a large, retrospective cohort study of patients newly diagnosed with HCC at tertiary referral centers in Thailand between 2011 and 2020. Survival time was defined as the time from the date of HCC diagnosis to the date of death or last follow-up.
Results:
A total of 1145 patients with a mean age of 61.4 ± 11.7 years were included. Next, 568 (48.7%), 401 (34.4%) and 167 (15.1%) patients were classified as Child-Pugh score A, B and C, respectively. Over half of the patients (59.0%) were diagnosed with noncurative-stage HCC (BCLC B-D). Patients with Child-Pugh A scores were more likely to be diagnosed with curative-stage HCC (BCLC 0-A) than noncurative stage (67.4% vs. 37.2%, p < .001). Patients with curative-stage HCC and Child-Pugh A cirrhosis underwent more liver resections than radiofrequency ablation (RFA) (91.8% vs. 69.7%, p < .001). For BCLC 0-A patients with portal hypertension, RFA was selected more frequently than liver resection (52.1% vs. 28.6%, p < .001). Patients who received RFA monotherapy tended to experience increased median survival times compared to those who underwent resection (55 vs. 36 months; p = .058).
Conclusions:
Surveillance programs should be encouraged to detect early-stage HCC, which is suitable for curative treatment improving survival outcomes. RFA may be an appropriate first-line treatment for curative-stage HCC. Sequential multi-modality treatment in the curative stage can achieve favorable 5-year survival.
