Comparison of Chemoembolization, Radioembolization, and Transarterial Ethanol Ablation for Huge Hepatocellular Carcinoma (≥ 10 cm) in Tumour Response and Long-Term Survival Outcome

The clinical efficacy of local ablative treatment for oligometastasis is widely accepted in most cancers. However, due to limited data, this has not been the case for hepatocellular carcinoma (HCC). Here, we report a case of pulmonary oligometastasis of a huge HCC that was treated by multimodality with liver-directed concurrent chemoradiotherapy (CCRT) plus subsequent resection of the primary lesion and local ablative radiotherapy (RT) for subsequent lung oligometastatic lesions. In this patient, liver-directed CCRT induced significant tumor shrinkage with compensatory hypertrophy of the non-tumor liver, followed by curative resection. Surgical resection of the first and second pulmonary metastatic lesions as well as local ablative RT of the third lesion achieved complete tumor regression, which led to long-term survival of 6 years. Therefore, the active use of local ablative RT requires full consideration in cases of oligometastatic HCC.

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Tumor size may influence the prognosis of solitary hepatocellular carcinoma patients with cirrhosis and without macrovascular invasion after hepatectomy

Scientific Reports ◽

10.1038/s41598-021-95835-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Bin-yong Liang ◽

Jin Gu ◽

Min Xiong ◽

Er-lei Zhang ◽

Zun-yi Zhang ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Tumor Size ◽

Staging System ◽

Prognostic Impact ◽

Term Survival ◽

Long Term Survival ◽

Before And After ◽

Cirrhotic Patients ◽

Curative Hepatectomy

AbstractHepatocellular carcinoma (HCC) is usually associated with varying degrees of cirrhosis. Among cirrhotic patients with solitary HCC in the absence of macro-vascular invasion, whether tumor size drives prognosis or not after hepatectomy remains unknown. This study aimed to investigate the prognostic impact of tumor size on long-term outcomes after hepatectomy for solitary HCC patients with cirrhosis and without macrovascular invasion. A total of 813 cirrhotic patients who underwent curative hepatectomy for solitary HCC and without macrovascular invasion between 2001 and 2014 were retrospectively studied. We set 5 cm as the tumor cut-off value. Propensity score matching (PSM) was performed to minimize the influence of potential confounders including cirrhotic severity that was histologically assessed according to the Laennec staging system. Recurrence-free survival (RFS) and overall survival (OS) were compared between the two groups before and after PSM. Overall, 464 patients had tumor size ≤ 5 cm, and 349 had tumor size > 5 cm. The 5-year RFS and OS rates were 38.3% and 61.5% in the ≤ 5 cm group, compared with 25.1% and 59.9% in the > 5 cm group. Long-term survival outcomes were significantly worse as tumor size increased. Multivariate analysis indicated that tumor size > 5 cm was an independent risk factor for tumor recurrence and long-term survival. These results were further confirmed in the PSM cohort of 235 pairs of patients. In cirrhotic patients with solitary HCC and without macrovascular invasion, tumor size may significantly affect the prognosis after curative hepatectomy.

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Long-Term Survival Analysis of Pure Laparoscopic Versus Open Hepatectomy for Hepatocellular Carcinoma in Patients With Cirrhosis

Annals of Surgery ◽

10.1097/sla.0b013e31827b947a ◽

2013 ◽

Vol 257 (3) ◽

pp. 506-511 ◽

Cited By ~ 144

Author(s):

Tan To Cheung ◽

Ronnie T. P. Poon ◽

Wai Key Yuen ◽

Kenneth S. H. Chok ◽

Caroline R. Jenkins ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Survival Analysis ◽

Term Survival ◽

Long Term Survival ◽

Open Hepatectomy

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Postinterventional Tumor Necrosis Predicts Recurrence-Free Long-Term Survival in Liver Transplant Patients with Advanced Hepatocellular Carcinoma

Transplantation Proceedings ◽

10.1016/j.transproceed.2013.01.004 ◽

2013 ◽

Vol 45 (5) ◽

pp. 1913-1915 ◽

Cited By ~ 5

Author(s):

A. Kornberg ◽

U. Witt ◽

B. Küpper ◽

M. Wildgruber ◽

H. Friess

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Transplant ◽

Tumor Necrosis ◽

Advanced Hepatocellular Carcinoma ◽

Term Survival ◽

Long Term Survival ◽

Transplant Patients

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Su1285 Long-Term Survival of Patients With Transplant-Eligible Hepatocellular Carcinoma (HCC) in Post-MELD Exception Era in the United States Between 2004 and 2007

Gastroenterology ◽

10.1016/s0016-5085(13)61652-2 ◽

2013 ◽

Vol 144 (5) ◽

pp. S-447-S-448

Author(s):

Pardha Devaki ◽

Vidyasagargoud Marupakula ◽

Sharad Nangia ◽

Basile Njei ◽

Ivo C. Ditah ◽

...

Keyword(s):

United States ◽

Hepatocellular Carcinoma ◽

The United States ◽

Term Survival ◽

Long Term Survival

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An oncology clinical trial design with randomization adaptive to both short- and long-term responses

Statistical Methods in Medical Research ◽

10.1177/0962280217744816 ◽

2017 ◽

Vol 28 (7) ◽

pp. 2015-2031 ◽

Cited By ~ 2

Author(s):

Hao Liu ◽

Xiao Lin ◽

Xuelin Huang

Keyword(s):

Trial Design ◽

Clinical Trial Design ◽

Therapeutic Benefit ◽

Survival Outcome ◽

Operating Characteristics ◽

Short Term ◽

Term Survival ◽

Long Term Survival ◽

Term Response

In oncology clinical trials, both short-term response and long-term survival are important. We propose an urn-based adaptive randomization design to incorporate both of these two outcomes. While short-term response can update the randomization probability quickly to benefit the trial participants, long-term survival outcome can also change the randomization to favor the treatment arm with definitive therapeutic benefit. Using generalized Friedman’s urn, we derive an explicit formula for the limiting distribution of the number of subjects assigned to each arm. With prior or hypothetical knowledge on treatment effects, this formula can be used to guide the selection of parameters for the proposed design to achieve desirable patient number ratios between different treatment arms, and thus optimize the operating characteristics of the trial design. Simulation studies show that the proposed design successfully assign more patients to the treatment arms with either better short-term tumor response or long-term survival outcome or both.

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