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. 2023 Dec 7;15(24):5741.
doi: 10.3390/cancers15245741.

Improved Survival Outcomes with Surgical Resection Compared to Ablative Therapy in Early-Stage HCC: A Large, Real-World, Propensity-Matched, Multi-Centre, Australian Cohort Study

Jonathan Abdelmalak  1   2 , Simone I Strasser  3 , Natalie Ngu  3 , Claude Dennis  3 , Marie Sinclair  4 , Avik Majumdar  4 , Kate Collins  4 , Katherine Bateman  4 , Anouk Dev  5 , Joshua H Abasszade  5 , Zina Valaydon  6 , Daniel Saitta  6 , Kathryn Gazelakis  6 , Susan Byers  6 , Jacinta Holmes  7   8 , Alexander J Thompson  7   8 , Dhivya Pandiaraja  7 , Steven Bollipo  9 , Suresh Sharma  9 , Merlyn Joseph  9 , Amanda Nicoll  10   11 , Nicholas Batt  10 , Rohit Sawhney  10   11 , Myo J Tang  1 , John Lubel  1 , Stephen Riordan  12 , Nicholas Hannah  13 , James Haridy  13 , Siddharth Sood  13 , Eileen Lam  2   14 , Elysia Greenhill  2   14 , Ammar Majeed  1   2 , William Kemp  1   2 , John Zalcberg  14   15 , Stuart K Roberts  1   2
Affiliations

Improved Survival Outcomes with Surgical Resection Compared to Ablative Therapy in Early-Stage HCC: A Large, Real-World, Propensity-Matched, Multi-Centre, Australian Cohort Study

Jonathan Abdelmalak et al. Cancers (Basel). .

Abstract

The optimal treatment approach in very-early and early-stage hepatocellular carcinoma (HCC) is not precisely defined, and there is ambiguity in the literature around the comparative efficacy of surgical resection versus ablation as curative therapies for limited disease. We performed this real-world propensity-matched, multi-centre cohort study to assess for differences in survival outcomes between those undergoing resection and those receiving ablation. Patients with Barcelona Clinic Liver Cancer (BCLC) 0/A HCC first diagnosed between 1 January 2016 and 31 December 2020 who received ablation or resection as initial treatment were included in the study. A total of 450 patients were included in the study from 10 major liver centres including two transplant centres. Following propensity score matching using key covariates, 156 patients were available for analysis with 78 in each group. Patients who underwent resection had significantly improved overall survival (log-rank test p = 0.023) and local recurrence-free survival (log rank test p = 0.027) compared to those who received ablation. Based on real-world data, our study supports the use of surgical resection in preference to ablation as first-line curative therapy in appropriately selected BCLC 0/A HCC patients.

Keywords: ablation; early; hepatocellular carcinoma; resection.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Summary of study design with number of patients before and after propensity score matching.
Figure 2
Figure 2
Distribution of propensity scores in resection and ablation groups before and after matching.
Figure 3
Figure 3
Recurrence-free survival in propensity-score-matched resection and ablation groups.
Figure 4
Figure 4
Local recurrence-free survival in propensity-score-matched resection and ablation groups.
Figure 5
Figure 5
Overall survival in propensity-score matched resection and ablation groups.
Figure 6
Figure 6
Liver-related survival in propensity-score-matched resection and ablation groups.
See this image and copyright information in PMC

References

    1. Sung H., Ferlay J., Siegel R.L., Laversanne M., Soerjomataram I., Jemal A., Bray F., Bsc M.F.B., Me J.F., Soerjomataram M.I., et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA A Cancer J. Clin. 2021;71:209–249. doi: 10.3322/caac.21660. - DOI - PubMed
    1. Petrick J.L., Kelly S.P., Altekruse S.F., McGlynn K.A., Rosenberg P.S. Future of Hepatocellular Carcinoma Incidence in the United States Forecast through 2030. J. Clin. Oncol. 2016;34:1787–1794. doi: 10.1200/JCO.2015.64.7412. - DOI - PMC - PubMed
    1. Reig M., Forner A., Rimola J., Ferrer-Fàbrega J., Burrel M., Garcia-Criado Á., Kelley R.K., Galle P.R., Mazzaferro V., Salem R., et al. BCLC strategy for prognosis prediction and treatment recommendation Barcelona Clinic Liver Cancer (BCLC) staging system: The 2022 update. J. Hepatol. 2021;76:681–693. doi: 10.1016/j.jhep.2021.11.018. - DOI - PMC - PubMed
    1. Lubel J.S., Strasser S.I., Thompson A.J., Cowie B.C., MacLachlan J., Allard N.L., Holmes J., Kemp W.W., Majumdar A., Iser D., et al. Australian consensus recommendations for the management of hepatitis B. Med. J. Aust. 2022;216:478–486. doi: 10.5694/mja2.51430. - DOI - PubMed
    1. Anonymous. 2022 KLCA-NCC Korea practice guidelines for the management of hepatocellular carcinoma. Clin. Mol. Hepatol. 2022;28:583–705. doi: 10.3350/cmh.2022.0294. - DOI - PMC - PubMed

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