Survival benefit of second line therapies for recurrent hepatocellular carcinoma : repeated hepatectomy, thermoablation and second-line transplant referral in a real life national scenario
Copyright © 2023 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved..
BACKGROUND: Despite second-line transplant(SLT) for recurrent hepatocellular carcinoma(rHCC) leads to the longest survival after recurrence(SAR), its real applicability has never been reported. The aim was to compare the SAR of SLT versus repeated hepatectomy and thermoablation(CUR group).
METHODS: Patients were enrolled from the Italian register HE.RC.O.LE.S. between 2008 and 2021. Two groups were created: CUR versus SLT. A propensity score matching (PSM) was run to balance the groups.
RESULTS: 743 patients were enrolled, CUR = 611 and SLT = 132. Median age at recurrence was 71(IQR 6575) years old and 60(IQR 53-64, p < 0.001) for CUR and SLT respectively. After PSM, median SAR for CUR was 43 months(95%CI = 37 - 93) and not reached for SLT(p < 0.001). SLT patients gained a survival benefit of 9.4 months if compared with CUR. MilanCriteria(MC)-In patients were 82.7% of the CUR group. SLT(HR 0.386, 95%CI = 0.23 - 0.63, p < 0.001) and the MELD score(HR 1.169, 95%CI = 1.07 - 1.27, p < 0.001) were the only predictors of mortality. In case of MC-Out, the only predictor of mortality was the number of nodules at recurrence(HR 1.45, 95%CI= 1.09 - 1.93, p = 0.011).
CONCLUSION: It emerged an important transplant under referral in favour of repeated hepatectomy or thermoablation. In patients with MC-Out relapse, the benefit of SLT over CUR was not observed.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:25 |
|---|---|
| Enthalten in: |
HPB : the official journal of the International Hepato Pancreato Biliary Association - 25(2023), 10 vom: 23. Okt., Seite 1223-1234 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Famularo, Simone [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 23.10.2023 Date Revised 23.10.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.hpb.2023.06.004 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM358584779 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM358584779 | ||
| 003 | DE-627 | ||
| 005 | 20231226075048.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.hpb.2023.06.004 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1195.xml |
| 035 | |a (DE-627)NLM358584779 | ||
| 035 | |a (NLM)37357112 | ||
| 035 | |a (PII)S1365-182X(23)00556-7 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Famularo, Simone |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Survival benefit of second line therapies for recurrent hepatocellular carcinoma |b repeated hepatectomy, thermoablation and second-line transplant referral in a real life national scenario |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 23.10.2023 | ||
| 500 | |a Date Revised 23.10.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved. | ||
| 520 | |a BACKGROUND: Despite second-line transplant(SLT) for recurrent hepatocellular carcinoma(rHCC) leads to the longest survival after recurrence(SAR), its real applicability has never been reported. The aim was to compare the SAR of SLT versus repeated hepatectomy and thermoablation(CUR group) | ||
| 520 | |a METHODS: Patients were enrolled from the Italian register HE.RC.O.LE.S. between 2008 and 2021. Two groups were created: CUR versus SLT. A propensity score matching (PSM) was run to balance the groups | ||
| 520 | |a RESULTS: 743 patients were enrolled, CUR = 611 and SLT = 132. Median age at recurrence was 71(IQR 6575) years old and 60(IQR 53-64, p < 0.001) for CUR and SLT respectively. After PSM, median SAR for CUR was 43 months(95%CI = 37 - 93) and not reached for SLT(p < 0.001). SLT patients gained a survival benefit of 9.4 months if compared with CUR. MilanCriteria(MC)-In patients were 82.7% of the CUR group. SLT(HR 0.386, 95%CI = 0.23 - 0.63, p < 0.001) and the MELD score(HR 1.169, 95%CI = 1.07 - 1.27, p < 0.001) were the only predictors of mortality. In case of MC-Out, the only predictor of mortality was the number of nodules at recurrence(HR 1.45, 95%CI= 1.09 - 1.93, p = 0.011) | ||
| 520 | |a CONCLUSION: It emerged an important transplant under referral in favour of repeated hepatectomy or thermoablation. In patients with MC-Out relapse, the benefit of SLT over CUR was not observed | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Cillo, Umberto |e verfasserin |4 aut | |
| 700 | 1 | |a Lauterio, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Donadon, Matteo |e verfasserin |4 aut | |
| 700 | 1 | |a Vitale, Alessandro |e verfasserin |4 aut | |
| 700 | 1 | |a Serenari, Matteo |e verfasserin |4 aut | |
| 700 | 1 | |a Cipriani, Federica |e verfasserin |4 aut | |
| 700 | 1 | |a Fazio, Federico |e verfasserin |4 aut | |
| 700 | 1 | |a Giuffrida, Mario |e verfasserin |4 aut | |
| 700 | 1 | |a Ardito, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Dominioni, Tommaso |e verfasserin |4 aut | |
| 700 | 1 | |a Garancini, Mattia |e verfasserin |4 aut | |
| 700 | 1 | |a Lai, Quirino |e verfasserin |4 aut | |
| 700 | 1 | |a Nicolini, Daniele |e verfasserin |4 aut | |
| 700 | 1 | |a Molfino, Sarah |e verfasserin |4 aut | |
| 700 | 1 | |a Perri, Pasquale |e verfasserin |4 aut | |
| 700 | 1 | |a Pinotti, Enrico |e verfasserin |4 aut | |
| 700 | 1 | |a Conci, Simone |e verfasserin |4 aut | |
| 700 | 1 | |a Ferrari, Cecilia |e verfasserin |4 aut | |
| 700 | 1 | |a Zanello, Matteo |e verfasserin |4 aut | |
| 700 | 1 | |a Patauner, Stefan |e verfasserin |4 aut | |
| 700 | 1 | |a Zimmitti, Giuseppe |e verfasserin |4 aut | |
| 700 | 1 | |a Germani, Paola |e verfasserin |4 aut | |
| 700 | 1 | |a Chiarelli, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Romano, Maurizio |e verfasserin |4 aut | |
| 700 | 1 | |a De Angelis, Michela |e verfasserin |4 aut | |
| 700 | 1 | |a La Barba, Giuliano |e verfasserin |4 aut | |
| 700 | 1 | |a Troci, Albert |e verfasserin |4 aut | |
| 700 | 1 | |a Ferraro, Valentina |e verfasserin |4 aut | |
| 700 | 1 | |a Izzo, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Antonucci, Adelmo |e verfasserin |4 aut | |
| 700 | 1 | |a Belli, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Memeo, Riccardo |e verfasserin |4 aut | |
| 700 | 1 | |a Crespi, Michele |e verfasserin |4 aut | |
| 700 | 1 | |a Ercolani, Giorgio |e verfasserin |4 aut | |
| 700 | 1 | |a Boccia, Luigi |e verfasserin |4 aut | |
| 700 | 1 | |a Zanus, Giacomo |e verfasserin |4 aut | |
| 700 | 1 | |a Tarchi, Paola |e verfasserin |4 aut | |
| 700 | 1 | |a Hilal, Moh'd Abu |e verfasserin |4 aut | |
| 700 | 1 | |a Frena, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Jovine, Elio |e verfasserin |4 aut | |
| 700 | 1 | |a Griseri, Guido |e verfasserin |4 aut | |
| 700 | 1 | |a Ruzzenente, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Zago, Mauro |e verfasserin |4 aut | |
| 700 | 1 | |a Grazi, Gianluca |e verfasserin |4 aut | |
| 700 | 1 | |a Baiocchi, Gian L |e verfasserin |4 aut | |
| 700 | 1 | |a Vivarelli, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Rossi, Massimo |e verfasserin |4 aut | |
| 700 | 1 | |a Romano, Fabrizio |e verfasserin |4 aut | |
| 700 | 1 | |a Maestri, Marcello |e verfasserin |4 aut | |
| 700 | 1 | |a Giuliante, Felice |e verfasserin |4 aut | |
| 700 | 1 | |a Valle, Raffaele D |e verfasserin |4 aut | |
| 700 | 1 | |a Ferrero, Alessandro |e verfasserin |4 aut | |
| 700 | 1 | |a Aldrighetti, Luca |e verfasserin |4 aut | |
| 700 | 1 | |a De Carlis, Luciano |e verfasserin |4 aut | |
| 700 | 1 | |a Cescon, Matteo |e verfasserin |4 aut | |
| 700 | 1 | |a Torzilli, Guido |e verfasserin |4 aut | |
| 700 | 0 | |a HE.RC.O.LE.S. Group Contributors |e verfasserin |4 aut | |
| 700 | 1 | |a Milana, Flavio |e investigator |4 oth | |
| 700 | 1 | |a Bertacco, Alessandra |e investigator |4 oth | |
| 700 | 1 | |a De Carlis, Riccardo |e investigator |4 oth | |
| 700 | 1 | |a Ratti, Francesca |e investigator |4 oth | |
| 700 | 1 | |a Russolillo, Nadia |e investigator |4 oth | |
| 700 | 1 | |a Iaria, Maurizio |e investigator |4 oth | |
| 700 | 1 | |a Razionale, Francesco |e investigator |4 oth | |
| 700 | 1 | |a Tartaglia, Giuseppe |e investigator |4 oth | |
| 700 | 1 | |a Ciulli, Cristina |e investigator |4 oth | |
| 700 | 1 | |a Carissimi, Francesca |e investigator |4 oth | |
| 700 | 1 | |a Laureiro, Zoe L |e investigator |4 oth | |
| 700 | 1 | |a Marinelli, Laura |e investigator |4 oth | |
| 700 | 1 | |a DePeppo, Valerio |e investigator |4 oth | |
| 700 | 1 | |a Montuori, Mauro |e investigator |4 oth | |
| 700 | 1 | |a Marchitelli, Ivan |e investigator |4 oth | |
| 700 | 1 | |a Franceschi, Angelo |e investigator |4 oth | |
| 700 | 1 | |a Notte, Francesca |e investigator |4 oth | |
| 700 | 1 | |a Manzoni, Alberto |e investigator |4 oth | |
| 700 | 1 | |a Cosola, Davide |e investigator |4 oth | |
| 700 | 1 | |a Corleone, Pio |e investigator |4 oth | |
| 700 | 1 | |a Fumagalli, Luca |e investigator |4 oth | |
| 700 | 1 | |a Salvador, Luca |e investigator |4 oth | |
| 700 | 1 | |a Mantovani, Guido |e investigator |4 oth | |
| 700 | 1 | |a Cucchetti, Alessandro |e investigator |4 oth | |
| 700 | 1 | |a Cammarata, Francesco |e investigator |4 oth | |
| 700 | 1 | |a Conticchio, Maria |e investigator |4 oth | |
| 700 | 1 | |a Patrone, Renato |e investigator |4 oth | |
| 700 | 1 | |a Bernasconi, Davide P |e investigator |4 oth | |
| 773 | 0 | 8 | |i Enthalten in |t HPB : the official journal of the International Hepato Pancreato Biliary Association |d 2001 |g 25(2023), 10 vom: 23. Okt., Seite 1223-1234 |w (DE-627)NLM178147761 |x 1477-2574 |7 nnns |
| 773 | 1 | 8 | |g volume:25 |g year:2023 |g number:10 |g day:23 |g month:10 |g pages:1223-1234 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.hpb.2023.06.004 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 25 |j 2023 |e 10 |b 23 |c 10 |h 1223-1234 | ||