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Multicenter Study
. 2025 Apr;55(4):510-517.
doi: 10.1007/s00595-024-02930-x. Epub 2024 Aug 27.

Outcome of hepatectomy after systemic therapy for hepatocellular carcinoma: a Japanese multicenter study

Norifumi Iseda  1 , Shinji Itoh  2 , Takeo Toshima  1 , Shohei Yoshiya  1 , Yuki Bekki  1 , Yuriko Tsutsui  1 , Katsuya Toshida  1 , Shoichi Inokuchi  3 , Toru Utsunomiya  3 , Takahiro Tomino  4 , Keishi Sugimachi  4 , Kazutoyo Morita  5 , Mizuki Ninomiya  5 , Noboru Harada  6 , Ryosuke Minagawa  7 , Tomoharu Yoshizumi  1
Affiliations
Multicenter Study

Outcome of hepatectomy after systemic therapy for hepatocellular carcinoma: a Japanese multicenter study

Norifumi Iseda et al. Surg Today. 2025 Apr.

Abstract

Background and purpose: In recent years, new systemic therapies have been developed for hepatocellular carcinoma (HCC). The aim of this study was to evaluate the prognosis of patients with unresectable HCC treated with R0 hepatectomy after systemic therapy.

Methods: Data from 27 patients who underwent hepatectomy for HCC after systemic therapy at six facilities were analyzed retrospectively. Cancer-specific survival (CSS) and recurrence-free survival (RFS) after hepatectomy were investigated using Kaplan-Meier curves. We examined the prognostic value of the oncological criteria of resectability for HCC reported by the Japanese Expert Consensus 2023.

Results: R0 resection was performed in 24 of the 27 patients. Using the Response Evaluation Criteria in Solid Tumors, 0 patient had a complete response, 16 had a partial response, 6 had stable disease, and 2 had progressive disease. Median CSS was not evaluated, but the median RFS was 17.8 months. Patients with resectable and borderline resectable (BR) 1 cancers had a better prognosis than those with BR2 cancers. The group whose oncological criteria were improved by systemic therapy had a lower recurrence rate than the group whose oncological criteria were maintained, but no difference was observed in CSS.

Conclusions: The findings of this study suggest that hepatectomy after systemic therapy may improve the prognosis of HCC patients.

Keywords: Hepatectomy; Hepatocellular carcinoma; Multi-center study; Systemic therapy.

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Conflict of interest statement

Declarations. Conflict of interest: Tomoharu Yoshizumi is editor-in-chief and Shinji Itoh is member of editorial board of Surgery Today. Ethical approval: This study was approved by the Ethics Committee of Kyushu University (approval code: 23040-01), Oita Prefectural Hospital (approval code: 5-106), National Hospital Organization Kyushu Cancer Center (approval code: 2023-19), Fukuoka City Hospital, Fukuoka (approval code: 269), Saiseikai Fukuoka General Hospital (approval code: 2023-10-8), and the Japanese Red Cross Matsuyama Hospital, Matsuyama (approval code: 1060-1). We obtained informed consent from all the patients.

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