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. Amin; James C. Yao; Ahmed O. Kaseb

doi:10.1159/000455957

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

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Abstract

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 language	English (US)
Pages (from-to)	233-242
Number of pages	10
Journal	Oncology (Switzerland)
Volume	93
Issue number	4
DOIs	https://doi.org/10.1159/000455957
State	Published - Sep 1 2017

Keywords

Hepatocellular carcinoma
Stage I
TNM

ASJC Scopus subject areas

Oncology
Cancer Research

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Al-Shamsi, H. O., Abdel-Wahab, R., Hassan, M. M., Shalaby, A. S., Dahbour, I., Lacin, S., Mahvash, A., Odisio, B. C., Murthy, R., Avritscher, R., Abdelsalam, M. E., Rashid, A., Vauthey, J. N., Aloia, T. A., Conrad, C., Chun, Y. S., Krishnan, S., Das, P., Koay, E. J., ... Kaseb, A. O. (2017). Natural history of T1N0M0 hepatocellular carcinoma: Large-scale study in the United States. Oncology (Switzerland), 93(4), 233-242. https://doi.org/10.1159/000455957

Al-Shamsi, HO, Abdel-Wahab, R, Hassan, MM, Shalaby, AS, Dahbour, I, Lacin, S, Mahvash, A, Odisio, BC, Murthy, R, Avritscher, R, Abdelsalam, ME, Rashid, A, Vauthey, JN, Aloia, TA, Conrad, C, Chun, YS, Krishnan, S, Das, P, Koay, EJ, Amin, HM, Yao, JC & Kaseb, AO 2017, 'Natural history of T1N0M0 hepatocellular carcinoma: Large-scale study in the United States', Oncology (Switzerland), vol. 93, no. 4, pp. 233-242. https://doi.org/10.1159/000455957

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title = "Natural history of T1N0M0 hepatocellular carcinoma: Large-scale study in the United States",

abstract = "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.",

keywords = "Hepatocellular carcinoma, Stage I, TNM",

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

year = "2017",

month = sep,

day = "1",

doi = "10.1159/000455957",

language = "English (US)",

volume = "93",

pages = "233--242",

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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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DO - 10.1159/000455957

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VL - 93

SP - 233

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JO - Oncology (Williston Park, N.Y.)

JF - Oncology (Williston Park, N.Y.)

SN - 0890-9091

IS - 4

ER -

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

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