Recurrence of hepatocellular carcinoma after complete radiologic response to trans-arterial embolization: A retrospective study on patterns, treatments, and prognoses Journal Article

   

Authors:	Ilagan, C. H.; Goldman, D. A.; Gönen, M.; Aveson, V. G.; Babicky, M.; Balachandran, V. P.; Drebin, J. A.; Jarnagin, W. R.; Wei, A. C.; Kingham, T. P.; Abou-Alfa, G. K.; Brown, K. T.; D’Angelica, M. I.
Article Title:	Recurrence of hepatocellular carcinoma after complete radiologic response to trans-arterial embolization: A retrospective study on patterns, treatments, and prognoses
Abstract:	Background: There is limited information about the long-term outcomes and patterns of progression in patients who have unresectable, liver-confined hepatocellular carcinoma (HCC) with complete response (CR) to transarterial embolization and do not undergo resection or transplantation (LT). Methods: A retrospective review analyzed participants in a randomized trial comparing hepatic artery embolization (HAE) and drug-eluting bead transarterial chemoembolization (DEB-TACE) with doxorubicin who had CR according to modified response evaluation criteria in solid tumors (mRECIST). The overall survival (OS), incidence and patterns of progression, and factors associated with progression were assessed. Results: Of the 101 patients in the trial, 37 with CR were included in this study. This cohort had 17 patients treated with HAE (46 %), and 20 patients managed with DEB-TACE (54 %). The median age was 67 years (range, 42–82 years). Most of the cohort were male (86.5 %) and Caucasian (78 %). The median pre-treatment Model for End-Stage Liver Disease (MELD) score was 10, and 70 % of the cohort had Barcelona Clinic Liver Cancer (BCLC) stage B or C. The median follow-up period was 49 months (95 % confidence interval [CI], 9–108 months), and the median OS was 25 months (95 % CI, 18.9–30.9 months). The 3- and 5-year survival rates were respectively 31 % (95 % CI, 16.7–45.9 %) and 18 % (95 % CI, 6.8–32.1 %). The 1- and 2-year cumulative incidences of progression were respectively 76 % (95 % CI, 57.7–86.8 %) and 92 % (95 % CI, 74.5–97.6 %). The most common first site of progression was the previously treated hepatic site or local site (32 %, 12/37). The 3-year cumulative incidence of progression was 65 % (95 % CI, 46.4–78.4 %) for the local site. Conclusion: Patients with advanced-stage HCC and CR to embolization do not have durable responses and experience inevitable disease progression. Most patients with progression have liver-confined disease and should be evaluated for additional consolidative treatments. © 2022, Society of Surgical Oncology.
Keywords:	treatment outcome; aged; retrospective studies; doxorubicin; chemoembolization; liver cell carcinoma; carcinoma, hepatocellular; liver neoplasms; pathology; retrospective study; severity of illness index; liver tumor; chemoembolization, therapeutic; end stage liver disease; humans; prognosis; human; male; female
Journal Title:	Annals of Surgical Oncology
Volume:	29
Issue:	11
ISSN:	1068-9265
Publisher:	Springer
Date Published:	2022-10-01
Start Page:	6815
End Page:	6826
Language:	English
DOI:	10.1245/s10434-022-12036-8
PUBMED:	35838903
PROVIDER:	scopus
PMCID:	PMC9509465
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85134299297&doi=10.1245%2fs10434-022-12036-8&partnerID=40&md5=a9eebd702328ed61e69fe04ff5d93c9d
Notes:	Article -- Export Date: 3 October 2022 -- Source: Scopus

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