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Pathologic complete response to chemoembolization improves survival outcomes after curative surgery for hepatocellular carcinoma: predictive factors of response.
Yang, Keungmo; Sung, Pil S; You, Young K; Kim, Dong G; Oh, Jung S; Chun, Ho J; Jang, Jeong W; Bae, Si H; Choi, Jong Y; Yoon, Seung K.
Afiliação
  • Yang K; Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University Liver Research Center, The Catholic University of Korea, Seoul, 06591, Republic of Korea.
  • Sung PS; Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University Liver Research Center, The Catholic University of Korea, Seoul, 06591, Republic of Korea.
  • You YK; Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, 06591, Republic of Korea.
  • Kim DG; Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, 06591, Republic of Korea.
  • Oh JS; Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, 06591, Republic of Korea.
  • Chun HJ; Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, 06591, Republic of Korea.
  • Jang JW; Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University Liver Research Center, The Catholic University of Korea, Seoul, 06591, Republic of Korea.
  • Bae SH; Department of Internal Medicine, St. Paul's Hospital, The Catholic University Liver Research Center, The Catholic University of Korea, Seoul, 02559, Republic of Korea.
  • Choi JY; Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University Liver Research Center, The Catholic University of Korea, Seoul, 06591, Republic of Korea.
  • Yoon SK; Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University Liver Research Center, The Catholic University of Korea, Seoul, 06591, Republic of Korea. Electronic address: yoonsk@catholic.ac.kr.
HPB (Oxford) ; 21(12): 1718-1726, 2019 12.
Article em En | MEDLINE | ID: mdl-31171489
ABSTRACT

BACKGROUND:

We identified the predictive factors and prognostic significance of transarterial chemoembolization (TACE) for achieving pathologic complete response (pCR) before curative surgery for hepatocellular carcinoma (HCC) in hepatitis B-endemic areas.

METHODS:

Among 753 HCC patients treated with surgery, 124 patients underwent preoperative TACE before liver resection (LR), and 166 before liver transplantation (LT) between 2005 and 2016. Overall survival (OS) and recurrence-free survival (RFS) were analyzed. Pathologic response (PR) was defined as the mean percentage of necrotic area, and pCR was defined as the absence of viable tumor.

RESULTS:

A total of 34 (27%) and 38 (23%) patients had pCR before LR and LT, respectively. Alpha-fetoprotein (AFP) < 100 ng/mL and single tumor were significant preoperative predictors of pCR. OS and RFS were significantly improved in patients with pCR or a PR ≥ 90%, but not in patients with PR ≥ 50% after LR and LT. On multivariate analyses, PR ≥ 90% remained an independent predictor of better OS and RFS in LR and LT groups.

CONCLUSION:

Overall, our data clearly demonstrate that pCR predicts favorable prognosis after curative surgery for HCC, and predictors of pCR are AFP <100 ng/mL and single tumor.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Quimioembolização Terapêutica / Carcinoma Hepatocelular / Neoplasias Hepáticas Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male / Middle aged Idioma: En Revista: HPB (Oxford) Assunto da revista: GASTROENTEROLOGIA Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Quimioembolização Terapêutica / Carcinoma Hepatocelular / Neoplasias Hepáticas Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male / Middle aged Idioma: En Revista: HPB (Oxford) Assunto da revista: GASTROENTEROLOGIA Ano de publicação: 2019 Tipo de documento: Article