External radiation or ablation for solitary hepatocellular carcinoma: A survival analysis of the SEER database

IF 1.9 3区医学 Q3 ONCOLOGY Journal of Surgical Oncology Pub Date : 2017-05-02 DOI:10.1002/jso.24661

Nicholas G. Berger MD, Michael N. Tanious BS, Abdulrahman Y. Hammad MD, John T. Miura MD, Harveshp Mogal MD, Callisia N. Clarke MD, Kathleen K. Christians MD, Susan Tsai MD, MHS, T. Clark Gamblin MD, MS, MBA

{"title":"External radiation or ablation for solitary hepatocellular carcinoma: A survival analysis of the SEER database","authors":"Nicholas G. Berger MD, Michael N. Tanious BS, Abdulrahman Y. Hammad MD, John T. Miura MD, Harveshp Mogal MD, Callisia N. Clarke MD, Kathleen K. Christians MD, Susan Tsai MD, MHS, T. Clark Gamblin MD, MS, MBA","doi":"10.1002/jso.24661","DOIUrl":null,"url":null,"abstract":"<div>\n \n <section>\n \n <h3> Background and Objectives</h3>\n \n <p>Hepatocellular carcinoma (HCC) patients are often not candidates for resection. This study hypothesized that external beam radiation (XRT) could be equally effective compared to ablation therapy (AT) for selected HCC patients.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>The Surveillance, Epidemiology, and End Results (SEER) database was used to identify HCC patients (2004-2012) undergoing XRT or AT for solitary HCC lesions. Propensity score modeling was utilized to adjust for baseline characteristics.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Propensity matching identified 784 patients: 157 (20%) XRT and 627 (80%) AT. Median OS for XRT and AT was 22, and 32 months (<i>P </i>< 0.001), respectively. AT demonstrated improved OS for tumors 3-5 cm (30 vs 16 m, <i>P </i>< 0.001) and >5 cm (25 vs 9 m, <i>P </i>< 0.001). Similar survival was found in patients with tumor size <3 cm (37 vs 47 m <i>P</i> = 0.508). Following multivariate analyses, XRT was associated with an increased hazard ratio (HR = 1.64, <i>P </i>< 0.001). Elevated AFP at diagnosis (HR = 1.54, <i>P</i> = 0.001) and tumor size >3 were identified as negative predictors of survival.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Similar survival for solitary HCC lesions <3 cm exists between XRT and AT. However, AT demonstrates improved survival rates compared to XRT for lesions >3 cm. This 3 cm reference point may serve as a valuable metric to guide treatment decisions and future investigations.</p>\n </section>\n </div>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"116 3","pages":"307-312"},"PeriodicalIF":1.9000,"publicationDate":"2017-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jso.24661","citationCount":"17","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Surgical Oncology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/jso.24661","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 17

Abstract

Background and Objectives

Hepatocellular carcinoma (HCC) patients are often not candidates for resection. This study hypothesized that external beam radiation (XRT) could be equally effective compared to ablation therapy (AT) for selected HCC patients.

Methods

The Surveillance, Epidemiology, and End Results (SEER) database was used to identify HCC patients (2004-2012) undergoing XRT or AT for solitary HCC lesions. Propensity score modeling was utilized to adjust for baseline characteristics.

Results

Propensity matching identified 784 patients: 157 (20%) XRT and 627 (80%) AT. Median OS for XRT and AT was 22, and 32 months (P < 0.001), respectively. AT demonstrated improved OS for tumors 3-5 cm (30 vs 16 m, P < 0.001) and >5 cm (25 vs 9 m, P < 0.001). Similar survival was found in patients with tumor size <3 cm (37 vs 47 m P = 0.508). Following multivariate analyses, XRT was associated with an increased hazard ratio (HR = 1.64, P < 0.001). Elevated AFP at diagnosis (HR = 1.54, P = 0.001) and tumor size >3 were identified as negative predictors of survival.

Conclusions

Similar survival for solitary HCC lesions <3 cm exists between XRT and AT. However, AT demonstrates improved survival rates compared to XRT for lesions >3 cm. This 3 cm reference point may serve as a valuable metric to guide treatment decisions and future investigations.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

孤立性肝细胞癌的外部放疗或消融:SEER数据库的生存分析

背景与目的肝细胞癌(HCC)患者通常不适合手术切除。本研究假设体外放射治疗(XRT)与消融治疗(AT)对肝癌患者同样有效。方法使用监测、流行病学和最终结果(SEER)数据库来识别2004-2012年接受XRT或AT治疗单发HCC病变的HCC患者。倾向评分模型用于调整基线特征。结果倾向匹配确定784例患者:157例(20%)XRT和627例(80%)AT。XRT和AT的中位生存期分别为22个月和32个月(P < 0.001)。AT显示肿瘤3-5 cm (30 vs 16 m, P < 0.001)和5 cm (25 vs 9 m, P < 0.001)的OS得到改善。肿瘤大小为3cm的患者生存率相似(37 vs 47 m P = 0.508)。经过多变量分析，XRT与风险比增加相关(HR = 1.64, P < 0.001)。诊断时AFP升高(HR = 1.54, P = 0.001)和肿瘤大小>3被认为是生存的阴性预测因子。结论XRT和AT治疗单发肝癌(≤3cm)的生存率相似。然而，与XRT相比，AT显示病灶≤3cm的生存率更高。这个3厘米的参考点可以作为指导治疗决策和未来调查的有价值的度量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Journal of Surgical Oncology 医学-外科

CiteScore

4.70

自引率

4.00%

发文量

367

审稿时长

2 months

期刊介绍： The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.