Salvage Locoregional Therapy Following Progression After Radiotherapy for Hepatocellular Carcinoma Is Associated with Improved Outcomes
Purpose To evaluate the impact of salvage locoregional therapy (salvage-LT) on survival of hepatocellular carcinoma (HCC) patients presenting with intrahepatic tumor progression following radiotherapy. Methods This single-institution retrospective analysis included consecutive HCC patients having intrahepatic tumor progression following radiotherapy during 2015–2019. Overall survival (OS) was calculated from the date of intrahepatic tumor progression after initial radiotherapy by using the Kaplan–Meier method. Log-rank tests and Cox regression models were used for univariable and multivariable analyses. An inverse probability weighting was used to estimate treatment effect of salvage-LT considering confounding factors. Results A total of 123 patients (mean age ± SD, 70 years ± 10; 97 men) were evaluated. Among those, 35 patients underwent 59 sessions of salvage-LT, including transarterial embolization/chemoembolization (n = 33), ablation (n = 11), selective internal radiotherapy (n = 7), and external beam radiotherapy (n = 8). At a median follow-up of 15.1 months (range, 3.4–54.5 months), the median OS was 23.3 months in patients who received salvage-LT and 6.6 months who did not. At multivariate analysis, ECOG performance status, Child–Pugh class, albumin-bilirubin grade, extrahepatic disease, and lack of salvage-LT were independent predictors of worse OS. After inverse probability weighting, salvage-LT was associated with a survival benefit of 8.9 months (95% CI: 1.1, 16.7 months; p = 0.03). Conclusions Salvage locoregional therapy is associated with increased survival in HCC patients suffering from intrahepatic tumor progression following initial radiotherapy..
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:27 |
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| Enthalten in: |
Journal of gastrointestinal surgery - 27(2023), 9 vom: 02. Juni, Seite 1867-1875 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Lin, Yuan-Mao [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
Carcinoma, Hepatocellular |
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| Anmerkungen: |
© The Society for Surgery of the Alimentary Tract 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
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| doi: |
10.1007/s11605-023-05712-x |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
OLC2145652183 |
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| 520 | |a Purpose To evaluate the impact of salvage locoregional therapy (salvage-LT) on survival of hepatocellular carcinoma (HCC) patients presenting with intrahepatic tumor progression following radiotherapy. Methods This single-institution retrospective analysis included consecutive HCC patients having intrahepatic tumor progression following radiotherapy during 2015–2019. Overall survival (OS) was calculated from the date of intrahepatic tumor progression after initial radiotherapy by using the Kaplan–Meier method. Log-rank tests and Cox regression models were used for univariable and multivariable analyses. An inverse probability weighting was used to estimate treatment effect of salvage-LT considering confounding factors. Results A total of 123 patients (mean age ± SD, 70 years ± 10; 97 men) were evaluated. Among those, 35 patients underwent 59 sessions of salvage-LT, including transarterial embolization/chemoembolization (n = 33), ablation (n = 11), selective internal radiotherapy (n = 7), and external beam radiotherapy (n = 8). At a median follow-up of 15.1 months (range, 3.4–54.5 months), the median OS was 23.3 months in patients who received salvage-LT and 6.6 months who did not. At multivariate analysis, ECOG performance status, Child–Pugh class, albumin-bilirubin grade, extrahepatic disease, and lack of salvage-LT were independent predictors of worse OS. After inverse probability weighting, salvage-LT was associated with a survival benefit of 8.9 months (95% CI: 1.1, 16.7 months; p = 0.03). Conclusions Salvage locoregional therapy is associated with increased survival in HCC patients suffering from intrahepatic tumor progression following initial radiotherapy. | ||
| 650 | 4 | |a Carcinoma, Hepatocellular | |
| 650 | 4 | |a Liver neoplasms | |
| 650 | 4 | |a Salvage therapy | |
| 650 | 4 | |a Radiotherapy | |
| 650 | 4 | |a Survival analysis | |
| 700 | 1 | |a Fellman, Bryan M. |4 aut | |
| 700 | 1 | |a Taiji, Ryosuke |4 aut | |
| 700 | 1 | |a Paolucci, Iwan |4 aut | |
| 700 | 1 | |a Silva, Jessica Albuquerque Marques |4 aut | |
| 700 | 1 | |a Koay, Eugene J. |4 aut | |
| 700 | 1 | |a Avritscher, Rony |4 aut | |
| 700 | 1 | |a Mahvash, Armeen |4 aut | |
| 700 | 1 | |a Holliday, Emma B. |4 aut | |
| 700 | 1 | |a Lee, Sunyoung S. |4 aut | |
| 700 | 1 | |a Kaseb, Ahmed O. |4 aut | |
| 700 | 1 | |a Das, Prajnan |4 aut | |
| 700 | 1 | |a Vauthey, Jean-Nicolas |4 aut | |
| 700 | 1 | |a Odisio, Bruno C. |0 (orcid)0000-0002-1771-8233 |4 aut | |
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