SPONTANEOUS REGRESSION OF HEPATOCELLULAR CARCINOMA: FOCUSING IN THE ASSOCIATED RISK FACTORS

Area of Science:

• Hepatology
• Oncology
• Immunology

Background:

• Spontaneous regression (SR) of tumors, defined as partial or complete disappearance without specific treatment, is exceptionally rare in hepatocellular carcinoma (HCC).
• Understanding the mechanisms behind SR in HCC is crucial for advancing cancer treatment strategies.

Purpose of the Study:

• To review and characterize all documented cases of spontaneous regression of hepatocellular carcinoma (HCC) within two major South Brazilian reference centers over a five-year period.
• To identify common features and potential contributing factors in patients experiencing HCC regression.

Main Methods:

• A retrospective review of 433 hepatocellular carcinoma (HCC) cases diagnosed over the last five years in two tertiary centers.
• Inclusion criteria required confirmation of HCC and documented spontaneous regression, defined as tumor involution without specific therapy.
• Patient data, including demographics, etiology (e.g., Hepatitis C virus - HCV), regression status, and potential influencing factors, were analyzed.

Main Results:

• Five cases (1.15%) of spontaneous regression (SR) of HCC were identified among 433 patients.
• The majority of patients experiencing SR were male (60%), with a mean age of 62.6 years, and HCV was the primary etiology (60%).
• Complete regression occurred in 60% of cases, partial regression in 20%, and 20% relapsed and died; one notable case followed a COVID-19 infection.

Conclusions:

• Spontaneous regression of HCC, though rare, presents a unique opportunity to investigate the underlying pathophysiological mechanisms of tumor behavior.
• Further research into these mechanisms, including immunological and hypoxic factors, could reveal novel therapeutic targets for HCC.