The chances of hepatic resection curing hepatocellular carcinoma.

Cucchetti, Alessandro, Zhong, Jianhong, Berhane, Sarah, Toyoda, Hidenori, Shi, KeQing, Tada, Toshifumi, Chong, Charing CN, Xiang, Bang-De, Li, Le-Qun, Lai, Paul BS
et al (show 7 more authors) (2019) The chances of hepatic resection curing hepatocellular carcinoma. Journal of hepatology, 72 (4). pp. 711-717.

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BACKGROUND AIMS:The popular sense of the word "cure" implies that a patient treated for a specific disease will return to have the same life-expectancy as if he/she had never had the disease. In analytic terms, it translates into the concept of statistical cure which occurs when a group of patients returns to having similar mortality to a reference population. Aim of the study was to assess the probability of being cured from hepatocellular carcinoma (HCC) by hepatic resection. METHODS:Data from 2523 patients undergoing resection for HCC were used to fit statistical cure models to compare disease-free survival (DFS) after surgery to survival expected for chronic hepatitis - cirrhotic patients and the general population, matched by sex, age, race/ethnicity and year of diagnosis. RESULTS:The probability of resection to provide the same life-expectancy of patients with chronic hepatitis - cirrhosis, was 26.3%. The conditional probability to achieve this result was time-dependent, requiring about 8.9 year for being accomplished with 95% certainty. Considering the general population as reference, the cure fraction decreased to 17.1%. Uncured patients had a median DFS of 1.5 years. In multi-variable analysis, patient's age and the risk for early HCC recurrence (within 2 years) were independent determinants of the chance of cure (p<0.001). The chances of being cured ranged between 36.0% for subjects at low risk for early recurrence and only about 3.6% for those at high risk. CONCLUSION:Estimates of the chance of being cured of HCC by resection showed that this goal is achievable and its likelihood increases with the passing of recurrence-free time. Present information can be used to accurately inform patients and make informed clinical decisions.

Item Type: Article
Uncontrolled Keywords: Hepatocellular carcinoma, Recurrence, Hepatic resection, Cure fraction, Relative survival
Depositing User: Symplectic Admin
Date Deposited: 10 Dec 2019 15:28
Last Modified: 19 Jan 2023 00:13
DOI: 10.1016/j.jhep.2019.11.016
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