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  1. Home
  3. Comparison Of Outcomes Between Preoperative And Postoperative Systemic Treatment In Patients With Hepatocellular Carcinoma: A Seer Database-based Study.
  1. Home
  3. Comparison Of Outcomes Between Preoperative And Postoperative Systemic Treatment In Patients With Hepatocellular Carcinoma: A Seer Database-based Study.

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Comparison of outcomes between preoperative and postoperative systemic treatment in patients with hepatocellular

Yadi Liu1, Shuangshuang Sun2, Zhaoyin Chu1

  • 1Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Frontiers in Oncology
|April 3, 2024

View abstract on PubMed

Summary
This summary is machine-generated.
Keywords:
SEER databasecancer-specific survival(CSS)hepatocellular carcinoma(HCC)overall survival(OS)postoperative systemic treatmentpreoperative systemic treatment

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For hepatocellular carcinoma (HCC) patients, receiving systemic therapy before surgery significantly improves overall survival (OS) and cancer-specific survival (CSS) compared to therapy after surgery. This finding impacts treatment sequencing for better long-term outcomes.

Area of Science:

  • Oncology
  • Surgical Oncology
  • Clinical Research

Background:

  • Recent advancements in systemic treatments for hepatocellular carcinoma (HCC).
  • Uncertainty regarding the optimal timing of systemic therapy relative to surgical intervention.
  • Need to evaluate the impact of treatment sequencing on HCC patient prognosis.

Purpose of the Study:

  • To determine the impact of sequencing systemic treatment and surgery on long-term outcomes for hepatocellular carcinoma patients.
  • To compare overall survival (OS) and cancer-specific survival (CSS) between preoperative and postoperative systemic therapy groups.

Main Methods:

  • Analysis of 1918 HCC patients from the SEER database (2004-2015).
  • Comparison of preoperative versus postoperative systemic therapy groups, utilizing propensity score matching (PSM).
  • Survival analysis using Kaplan-Meier curves and multivariable Cox proportional hazards models.

    • Main Results:

    • The preoperative systemic treatment group (1406 patients) showed longer median OS and CSS than the postoperative group (512 patients).
    • Postoperative systemic therapy was associated with a higher risk of all-cause mortality (HR: 1.84) and cancer-specific mortality (HR: 2.10) after PSM and Cox regression.
    • Subgroup analyses confirmed superior OS for the preoperative systemic therapy approach.

    Conclusions:

    • Preoperative systemic therapy for hepatocellular carcinoma patients is associated with superior overall survival and cancer-specific survival.
    • The timing of systemic therapy significantly influences long-term prognosis in HCC patients undergoing surgical intervention.