Natural history of T1N0M0 hepatocellular carcinoma: Large-scale study in the United States

Humaid O. Al-Shamsi, Reham Abdel-Wahab, Manal M. Hassan, Ahmed S. Shalaby, Ibrahim Dahbour, Sahin Lacin, Armeen Mahvash, Bruno C. Odisio, Ravi Murthy, Rony Avritscher, Mohamed E. Abdelsalam, Asif Rashid, Jean Nicolas Vauthey, Thomas A. Aloia, Claudius Conrad, Yun Shin Chun, Sunil Krishnan, Prajnan Das, Eugene J. Koay, Hesham M. AminJames C. Yao, Ahmed O. Kaseb

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Hepatocellular carcinoma (HCC) prognosis depends on clinicopathological features in addition to the treatment provided. We aimed to assess the natural history of TNM stage I HCC tumors which received different treatment over a period of 20 years. Methods: Between 1992 and 2011, a total of 397 stage I HCC patients were included. Detailed information was retrieved from MD Anderson Cancer Center patients' medical records. The Kaplan-Meier method was used to calculate patients' overall survival (OS). Cox regression analysis was used to calculate the estimated hazard ratio and 95% confidence interval of different prognostic factors. Results: Out of 397 patients, 67.5% were males, 42.8% had hepatitis-related HCC, and 59.7% had underlying cirrhosis. After adjustment for confounding factors, we found that all therapeutic modalities were associated with a significant mortality rate reduction with an OS of 63, 42.03, 34.3, and 22.1 months among patients treated with surgery, ablation, local, and systemic therapy, respectively. A restricted analysis of cirrhotic and noncirrhotic patients showed that ablative and local therapy were significantly associated with a longer OS compared to systemic therapy. Conclusion: TNM stage I HCC patients have a favorable prognosis regardless of the type of treatment. Notably, ablative and local therapy significantly improved OS compared to systemic therapy.

Original languageEnglish (US)
Pages (from-to)233-242
Number of pages10
JournalOncology (Switzerland)
Issue number4
StatePublished - Sep 1 2017


  • Hepatocellular carcinoma
  • Stage I
  • TNM

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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