Wenxuan Xie1, Jiehui Tan2, Bin Li3, Shuling Chen4, Baoxian Liu4, Jingxian Shen5, Shunjun Fu6, Ming Kuang1,4, Kaiyu Sun7, Xuezhen Zeng8,9. 1. Center of Hepato-Pancreato-Biliary Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China. 2. Organ Transplant Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China. 3. Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China. 4. Division of Interventional Ultrasound, Department of Medical Ultrasound, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China. 5. Department of Medical Imaging, Sun Yat-Sen University Cancer Center, Guangzhou, China. 6. Department of Hepatobiliary Surgery II, Zhujiang Hospital, Southern Medical University, Guangzhou, China. 7. Department of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-Sen University, No.58, Zhongshan Road 2, Guangzhou, 510080, People's Republic of China. sunky5@mail.sysu.edu.cn. 8. Institute of Precision Medicine, The First Affiliated Hospital, Sun Yat-Sen University, No.58, Zhongshan Road 2, Guangzhou, 510080, People's Republic of China. zengxzh7@mail.sysu.edu.cn. 9. Department of Pharmacy, The First Affiliated Hospital, Sun Yat-Sen University, No.58, Zhongshan Road 2, Guangzhou, 510080, People's Republic of China. zengxzh7@mail.sysu.edu.cn.
Abstract
PURPOSE: We aimed to compare the efficacy of hepatic resection and percutaneous ablation for resectable caudate HCC within Milan criteria and to investigate the prognostic factors. METHODS: Between August 2006 and August 2020, a total of 67 eligible patients with resectable caudate HCC within Milan criteria in three centers were retrospectively analyzed and divided into hepatic resection group (n = 46) and percutaneous ablation group (n = 21). Recurrence-free survival (RFS) and overall survival (OS) rates were compared between groups of hepatic resection and percutaneous ablation for these resectable caudate HCC patients with Kaplan-Meier curves and log-rank test. Univariable and multivariable Cox regression analyses were performed to identify the prognostic factors of RFS and OS. RESULTS: The 1-, 3-, and 5-year OS rates were 97.6%, 83.6%, and 71.5% for the hepatic resection group, and 89.4%, 58.5%, and 48.8% for the percutaneous ablation group (P = 0.032). The corresponding RFS rates were 77.6%, 47.9%, and 42.6% for the hepatic resection group, and 40.5%, 23.2%, and 15.4% for the percutaneous ablation group (P = 0.010). According to the univariable and multivariable analyses, tumor type (first recurrence) (HR = 3.54; 95%CI, 1.49-8.37; P = 0.004) was a significant independent prognostic factor of RFS for caudate HCC patients after resection or ablation, while total bilirubin (HR = 1.02; 95%CI, 1.01-1.04; P = 0.006) and treatment strategy (HR = 5.97; 95%CI, 1.48-24.12; P = 0.012) were significant independent prognostic factors of OS. CONCLUSIONS: Hepatic resection appears to outperform percutaneous ablation for caudate HCC patients within Milan criteria.
PURPOSE: We aimed to compare the efficacy of hepatic resection and percutaneous ablation for resectable caudate HCC within Milan criteria and to investigate the prognostic factors. METHODS: Between August 2006 and August 2020, a total of 67 eligible patients with resectable caudate HCC within Milan criteria in three centers were retrospectively analyzed and divided into hepatic resection group (n = 46) and percutaneous ablation group (n = 21). Recurrence-free survival (RFS) and overall survival (OS) rates were compared between groups of hepatic resection and percutaneous ablation for these resectable caudate HCC patients with Kaplan-Meier curves and log-rank test. Univariable and multivariable Cox regression analyses were performed to identify the prognostic factors of RFS and OS. RESULTS: The 1-, 3-, and 5-year OS rates were 97.6%, 83.6%, and 71.5% for the hepatic resection group, and 89.4%, 58.5%, and 48.8% for the percutaneous ablation group (P = 0.032). The corresponding RFS rates were 77.6%, 47.9%, and 42.6% for the hepatic resection group, and 40.5%, 23.2%, and 15.4% for the percutaneous ablation group (P = 0.010). According to the univariable and multivariable analyses, tumor type (first recurrence) (HR = 3.54; 95%CI, 1.49-8.37; P = 0.004) was a significant independent prognostic factor of RFS for caudate HCC patients after resection or ablation, while total bilirubin (HR = 1.02; 95%CI, 1.01-1.04; P = 0.006) and treatment strategy (HR = 5.97; 95%CI, 1.48-24.12; P = 0.012) were significant independent prognostic factors of OS. CONCLUSIONS: Hepatic resection appears to outperform percutaneous ablation for caudate HCC patients within Milan criteria.