TY - JOUR
T1 - Natural history of T1N0M0 hepatocellular carcinoma
T2 - Large-scale study in the United States
AU - Al-Shamsi, Humaid O.
AU - Abdel-Wahab, Reham
AU - Hassan, Manal M.
AU - Shalaby, Ahmed S.
AU - Dahbour, Ibrahim
AU - Lacin, Sahin
AU - Mahvash, Armeen
AU - Odisio, Bruno C.
AU - Murthy, Ravi
AU - Avritscher, Rony
AU - Abdelsalam, Mohamed E.
AU - Rashid, Asif
AU - Vauthey, Jean Nicolas
AU - Aloia, Thomas A.
AU - Conrad, Claudius
AU - Chun, Yun Shin
AU - Krishnan, Sunil
AU - Das, Prajnan
AU - Koay, Eugene J.
AU - Amin, Hesham M.
AU - Yao, James C.
AU - Kaseb, Ahmed O.
PY - 2017/9/1
Y1 - 2017/9/1
N2 - 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.
AB - 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.
KW - Hepatocellular carcinoma
KW - Stage I
KW - TNM
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U2 - 10.1159/000455957
DO - 10.1159/000455957
M3 - Article
C2 - 28683459
AN - SCOPUS:85021901238
VL - 93
SP - 233
EP - 242
JO - Oncology (Williston Park, N.Y.)
JF - Oncology (Williston Park, N.Y.)
SN - 0890-9091
IS - 4
ER -