Conversion Resection or Direct Resection for Patients with Intermediate-Stage Hepatocellular Carcinoma: A Multicentre...

Area of Science:

• Hepatobiliary Surgery
• Oncology
• Gastroenterology

Background:

• Hepatocellular carcinoma (HCC) often presents at an intermediate stage with poor prognosis.
• Current treatments for intermediate-stage HCC have limitations in improving overall survival.

Purpose of the Study:

• To evaluate the efficacy of conversion therapy followed by resection in intermediate-stage HCC.
• To compare conversion therapy outcomes with direct resection and comprehensive therapy alone.
• To analyze pathological responses and long-term survival in HCC patients.

Main Methods:

• A multicentre study enrolled 248 intermediate-stage HCC patients.
• Patients were divided into conversion resection, direct resection, and comprehensive therapy groups.
• Propensity score matching was used to balance baseline characteristics and evaluate pathological responses.

Main Results:

• The conversion resection group showed significantly improved pathological complete response rates (23.2%) and major pathological response rates (51.8%).
• Lower microvascular invasion (17.9%) and better tumor differentiation were observed in the conversion resection group.
• Conversion resection led to improved recurrence-free survival (not reached vs. 12.3 months) and 3-year overall survival (94.7%).

Conclusions:

• Preoperative conversion therapy significantly enhances pathological responses in intermediate-stage HCC.
• Conversion therapy is an independent prognostic factor, improving both recurrence-free and overall survival.
• This approach offers a promising strategy for improving outcomes in intermediate-stage HCC.