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Survival and prognostic factors after transplantation, resection and ablation in a national cohort of early hepatocellular carcinoma

Sternby Eilard, Malin, 1974 (author)
Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery,Department of Surgery, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden; Department of Transplantation, Sahlgrenska University Hospital, Gothenburg, Sweden,Univ Gothenburg, Dept Surg, Inst Clin Sci, Gothenburg, Sweden.;Sahlgrens Univ Hosp, Dept Transplantat, Gothenburg, Sweden.
Naredi, Peter, 1955 (author)
Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery,Department of Surgery, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden; Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden,Univ Gothenburg, Dept Surg, Inst Clin Sci, Gothenburg, Sweden.;Sahlgrens Univ Hosp, Dept Surg, Gothenburg, Sweden.
Helmersson, Madeleine (author)
Regional Cancer Center West, Western Sweden Health Care Region, Gothenburg, Sweden,Reg Canc Ctr West, Western Sweden Hlth Care Reg, Gothenburg, Sweden.
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Hemmingsson, Oskar, 1975- (author)
Umeå universitet,Kirurgi,Department of Surgical and Perioperative Sciences, Umeå University, Sweden,Umeå Univ, Dept Surg & Perioperat Sci, S-90187 Umeå, Sweden.
Isaksson, Bengt (author)
Uppsala universitet,Gastrointestinalkirurgi
Lindell, Gert (author)
Department of Surgery, Skåne University Hospital, Lund, Sweden,Skane Univ Hosp, Dept Surg, Lund, Sweden.
Sandström, Per (author)
Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US,Linköping Univ, Fac Hlth Sci, Cty Council Ostergotland, Dept Clin & Expt Med,Dept Surg, Linköping, Sweden.
Strömberg, Cecilia (author)
Karolinska Institutet,Division of Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden,Karolinska Inst, Dept Clin Sci Intervent & Technol, Div Surg, Stockholm, Sweden.;Karolinska Univ Hosp, Stockholm, Sweden.
Rizell, Magnus, 1963 (author)
Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery,Department of Surgery, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden; Department of Transplantation, Sahlgrenska University Hospital, Gothenburg, Sweden,Univ Gothenburg, Dept Surg, Inst Clin Sci, Gothenburg, Sweden.;Sahlgrens Univ Hosp, Dept Transplantat, Gothenburg, Sweden.
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 (creator_code:org_t)
Elsevier BV, 2021
2021
English.
In: HPB. - : Elsevier BV. - 1365-182X .- 1477-2574. ; 23:3, s. 394-403
Related links:
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  • Journal article (peer-reviewed)
Abstract Subject headings
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  • © 2020 International Hepato-Pancreato-Biliary Association Inc. Background: In patients with early hepatocellular cancer (HCC) and preserved liver function, the choice between transplantation, resection and ablation and which factors to consider is not obvious and guidelines differ. In this national cohort study, we aimed to compare posttreatment survival in patients fulfilling predefined criteria, and to analyse preoperative risk factors that could influence decision. Methods: We used data from HCC-patients registered with primary transplantation, resection or ablation 2008–2016 in the SweLiv-registry. In Child A-subgroups, 18–75 years, we compared survival after transplantation or resection, with different tumour criteria; either corresponding to our transplantation criteria (N = 257) or stricter with single tumours ≤50 mm (N = 159). A subgroup with single tumours ≤30 mm, compared all three treatments (N = 193). Results: We included 1022 HCC-patients; transplantation n = 223, resection n = 438, ablation n = 361. In the transplant criteria subgroup, differences in five-year survival, adjusted for age and gender, were not significant, with 71.2% (CI 62.3–81.3) after transplantation (n = 109) and 63.5% (CI 54.9–73.5) after resection (n = 148). Good liver function (Child 5 vs. 6, Albumin ≥36), increased the risk after transplantation, but decreased the risk after resection and ablation. Conclusion: Even within Child A, detailed liver function assessment is important before treatment decision, and for stratifying survival comparisons.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

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