Early HCC: resection best for elderly with tumors over 2 cm

  • Jiang YQ & al.
  • Front Oncol
  • 1 Jan 2019

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • Patients with early- or very early-stage hepatocellular carcinoma (HCC) aged >65 years had better OS with resection if their tumors were 21-50 mm. There was no survival advantage for resection over radiofrequency ablation (RFA) in elderly with tumors ≤20 mm.
  • In patients ≤65 years, resection produced better OS regardless of tumor size.

Why this matters

  • The study is the first to compare hepatic resection (HR) and RFA in patients aged >65 and ≤65 years in a large sample and subdivided by tumor size.

Study design

  • Retrospective cohort drawn from the Surveillance, Epidemiology, and End Results (SEER) database (2004-2015, n=6076).
  • Funding: Various nonindustry sources.

Key results

  • In patients aged >65 years, after propensity score matching:
    • Tumors ≤20 mm: RFA and HR were associated with similar 3- and 5-year OS and disease-specific survival (DSS).
    • Tumors 21-30 mm: 3- and 5-year OS was better in the HR group (aHR, 1.30; P=.03). 3- and 5-year DSS did not differ significantly.
    • Tumors 31-50 mm: 3- and 5-year OS was better in the HR group (aHR, 2.00; P<.001 as was dss p>
  • In patients aged ≤65 years, after propensity score matching:
    • OS and DSS were significantly better with HR than with RFA in all tumor sizes.

Limitations

  • Retrospective analysis.

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