دورية أكاديمية
Radiation Segmentectomy for the Treatment of Solitary Hepatocellular Carcinoma: Outcomes Compared with Those of Surgical Resection.
| العنوان: | Radiation Segmentectomy for the Treatment of Solitary Hepatocellular Carcinoma: Outcomes Compared with Those of Surgical Resection. |
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| المؤلفون: | De la Garza-Ramos C; Division of Interventional Radiology, Mayo Clinic, Jacksonville, Florida., Montazeri SA; Division of Interventional Radiology, Mayo Clinic, Jacksonville, Florida., Croome KP; Department of Transplant, Mayo Clinic, Jacksonville, Florida., LeGout JD; Department of Radiology, Mayo Clinic, Jacksonville, Florida., Sella DM; Department of Radiology, Mayo Clinic, Jacksonville, Florida., Cleary S; Division of Hepatobiliary and Pancreatic Surgery, Mayo Clinic, Rochester, Minnesota., Burns J; Department of Transplant, Mayo Clinic, Jacksonville, Florida., Mathur AK; Division of Transplant Surgery, Mayo Clinic, Phoenix, Arizona., Overfield CJ; Division of Interventional Radiology, Mayo Clinic, Jacksonville, Florida., Frey GT; Division of Interventional Radiology, Mayo Clinic, Jacksonville, Florida., Lewis AR; Division of Interventional Radiology, Mayo Clinic, Jacksonville, Florida., Paz-Fumagalli R; Division of Interventional Radiology, Mayo Clinic, Jacksonville, Florida., Ritchie CA; Division of Interventional Radiology, Mayo Clinic, Jacksonville, Florida., McKinney JM; Division of Interventional Radiology, Mayo Clinic, Jacksonville, Florida., Mody K; Division of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, Florida., Patel T; Department of Transplant, Mayo Clinic, Jacksonville, Florida., Devcic Z; Division of Interventional Radiology, Mayo Clinic, Jacksonville, Florida., Toskich BB; Division of Interventional Radiology, Mayo Clinic, Jacksonville, Florida. Electronic address: Toskich.Beau@mayo.edu. |
| المصدر: | Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2022 Jul; Vol. 33 (7), pp. 775-785.e2. Date of Electronic Publication: 2022 Mar 26. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Society of Cardiovascular and Interventional Radiology Country of Publication: United States NLM ID: 9203369 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1535-7732 (Electronic) Linking ISSN: 10510443 NLM ISO Abbreviation: J Vasc Interv Radiol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Reston, Va. : Society of Cardiovascular and Interventional Radiology, c1990- |
| مواضيع طبية MeSH: | Carcinoma, Hepatocellular*/diagnostic imaging , Carcinoma, Hepatocellular*/radiotherapy , Carcinoma, Hepatocellular*/surgery , Liver Neoplasms*/diagnostic imaging , Liver Neoplasms*/radiotherapy , Liver Neoplasms*/surgery, Fibrosis ; Hepatectomy/adverse effects ; Humans ; Pneumonectomy ; Retrospective Studies ; Treatment Outcome |
| مستخلص: | Purpose: To investigate the outcomes of radiation segmentectomy (RS) versus standard-of-care surgical resection (SR). Materials and Methods: A multisite, retrospective analysis of treatment-naïve patients who underwent either RS or SR was performed. The inclusion criteria were solitary hepatocellular carcinoma ≤8 cm in size, Eastern Cooperative Oncology Cohort performance status of 0-1, and absence of macrovascular invasion or extrahepatic disease. Target tumor and overall progression, time to progression (TTP), and overall survival rates were assessed. Outcomes were censored for liver transplantation. Results: A total of 123 patients were included (RS, 57; SR, 66). Tumor size, Child-Pugh class, albumin-bilirubin score, platelet count, and fibrosis stage were significantly different between cohorts (P ≤ .01). Major adverse events (AEs), defined as grade ≥3 per the Clavien-Dindo classification, occurred in 0 patients in the RS cohort vs 13 (20%) patients in the SR cohort (P < .001). Target tumor progression occurred in 3 (5%) patients who underwent RS and 5 (8%) patients who underwent SR. Overall progression occurred in 19 (33%) patients who underwent RS and 21 (32%) patients who underwent SR. The median overall TTP was 21.9 and 29.4 months after RS and SR, respectively (95% confidence interval [CI], 15.5-28.2 and 18.5-40.3, respectively; P = .03). Overall TTP subgroup analyses showed no difference between treatment cohorts with fibrosis stages 3-4 (P = .26) and a platelet count of <150 × 10 9 /L (P = .29). The overall progression hazard ratio for RS versus SR was not significant per the multivariate Cox regression analysis (1.16; 95% CI, 0.51-2.63; P = .71). The median overall survival was not reached for either of the cohorts. Propensity scores were calculated but were too dissimilar for analysis. Conclusions: RS and SR were performed in different patient populations, which limits comparison. RS approached SR outcomes, with a lower incidence of major AEs, in patients who were not eligible for hepatectomy. (Copyright © 2022 SIR. Published by Elsevier Inc. All rights reserved.) |
| تواريخ الأحداث: | Date Created: 20220329 Date Completed: 20220706 Latest Revision: 20220807 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1016/j.jvir.2022.03.021 |
| PMID: | 35346857 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1535-7732 |
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| DOI: | 10.1016/j.jvir.2022.03.021 |