A nationwide propensity score analysis comparing ablation and resection for hepatocellular carcinoma.
J Surg Oncol
; 127(7): 1125-1134, 2023 Jun.
Article
em En
| MEDLINE
| ID: mdl-36905338
ABSTRACT
BACKGROUND AND OBJECTIVES:
Studies have reported ambiguous results regarding the efficacy of ablation for early-stage hepatocellular carcinoma (HCC). Our study compared outcomes of ablation versus resection for HCC ≤50 mm to identify tumor sizes that would most benefit from ablation in terms of long-term survival.METHODS:
The National Cancer Database was queried for patients with stage I and II HCC ≤50 mm who underwent ablation or resection (2004-2018). Three cohorts were created based on tumor size ≤20, 21-30, and 31-50 mm. A propensity score-matched survival analysis was performed using the Kaplan-Meier method.RESULTS:
In total, 36.47% (n = 4263) and 63.53% (n = 7425) of patients underwent resection and ablation, respectively. After matching, resection was associated with a significant survival benefit compared to ablation (3-year survival 78.13% vs. 67.64%; p < 0.0001) in patients with HCC of ≤20 mm. The impact of resection was even more striking among patients with HCC of 21-30 mm (3-year survival 77.88% vs. 60.53%; p < 0.0001) and 31-50 mm (3-year survival 67.21% vs. 48.55%; p < 0.0001).CONCLUSIONS:
While resection offers a survival benefit over ablation in the treatment of early-stage HCC ≤50 mm, ablation may provide a feasible bridging strategy in patients awaiting transplantation.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ablação por Cateter
/
Carcinoma Hepatocelular
/
Neoplasias Hepáticas
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
J Surg Oncol
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Estados Unidos