دورية أكاديمية
Comparison of Surgical Resection and Systemic Treatment for Hepatocellular Carcinoma with Vascular Invasion: National Cancer Database Analysis
| العنوان: | Comparison of Surgical Resection and Systemic Treatment for Hepatocellular Carcinoma with Vascular Invasion: National Cancer Database Analysis |
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| المؤلفون: | Rajalakshmi Govalan, Marie Lauzon, Michael Luu, Joseph C. Ahn, Kambiz Kosari, Tsuyoshi Todo, Irene K. Kim, Mazen Noureddin, Alexander Kuo, Ayoub S. Walid, Vinay Sundaram, Shelly C. Lu, Lewis R. Roberts, Amit G. Singal, Julie K. Heimbach, Vatche G. Agopian, Nicholas Nissen, Ju Dong Yang |
| المصدر: | Liver Cancer, Pp 1-12 (2021) |
| بيانات النشر: | Karger Publishers, 2021. |
| سنة النشر: | 2021 |
| المجموعة: | LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens |
| مصطلحات موضوعية: | hepatocellular carcinoma, vascular invasion, surgical resection, prognosis, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282 |
| الوصف: | Introduction: Small studies from outside of the USA suggest excellent outcomes after surgical resection for hepatocellular carcinoma (HCC) with vascular invasion. The study aims to (1) compare overall survival after surgical resection and systemic therapy among patients with HCC and vascular invasion and (2) determine factors associated with receipt of surgical resection in a US population. Methods: HCC patients with AJCC clinical TNM stage 7th T3BN0M0 diagnosed between 2010 and 2017 from the National Cancer Database were analyzed. Cox and logistic regression analyses identified factors associated with overall survival and receipt of surgical resection. Results: Of 11,259 patients with T3BN0M0 HCC, 325 (2.9%) and 4,268 (37.9%) received surgical resection and systemic therapy, respectively. In multivariable analysis, surgical resection was associated with improved survival compared to systemic therapy (adjusted hazard ratio: 0.496, 95% confidence interval: 0.426–0.578) with a median survival of 21.4 and 8.1 months, respectively. Superiority of surgical resection was observed in noncirrhotic and cirrhotic subgroups and propensity score matching and inverse probability of treatment weighting adjusted analysis. Asians were more likely to receive surgical resection, whereas Charlson comorbidity ≥3, elevated alpha-fetoprotein, smaller tumor size, care in a community cancer program, and the South or West region were associated with a lower likelihood of surgical resection. Conclusion: HCC patients with vascular invasion may benefit from surgical resection compared to systemic therapies. Demographic and clinical features of HCC patients and region and type of treating facility were associated with surgical resection versus systemic treatment. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2235-1795 1664-5553 |
| Relation: | https://www.karger.com/Article/FullText/515554; https://doaj.org/toc/2235-1795; https://doaj.org/toc/1664-5553 |
| DOI: | 10.1159/000515554 |
| URL الوصول: | https://doaj.org/article/467b06b0f4aa4d66b2f0c0188fccf32d |
| رقم الأكسشن: | edsdoj.467b06b0f4aa4d66b2f0c0188fccf32d |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 22351795 16645553 |
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| DOI: | 10.1159/000515554 |