Cancers (Dec 2023)
Improved Survival Outcomes with Surgical Resection Compared to Ablative Therapy in Early-Stage HCC: A Large, Real-World, Propensity-Matched, Multi-Centre, Australian Cohort Study
- Jonathan Abdelmalak,
- Simone I. Strasser,
- Natalie Ngu,
- Claude Dennis,
- Marie Sinclair,
- Avik Majumdar,
- Kate Collins,
- Katherine Bateman,
- Anouk Dev,
- Joshua H. Abasszade,
- Zina Valaydon,
- Daniel Saitta,
- Kathryn Gazelakis,
- Susan Byers,
- Jacinta Holmes,
- Alexander J. Thompson,
- Dhivya Pandiaraja,
- Steven Bollipo,
- Suresh Sharma,
- Merlyn Joseph,
- Amanda Nicoll,
- Nicholas Batt,
- Rohit Sawhney,
- Myo J. Tang,
- John Lubel,
- Stephen Riordan,
- Nicholas Hannah,
- James Haridy,
- Siddharth Sood,
- Eileen Lam,
- Elysia Greenhill,
- Ammar Majeed,
- William Kemp,
- John Zalcberg,
- Stuart K. Roberts
Affiliations
- Jonathan Abdelmalak
- Department of Gastroenterology, Alfred Health, Melbourne, VIC 3004, Australia
- Simone I. Strasser
- Department of Gastroenterology, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW 2050, Australia
- Natalie Ngu
- Department of Gastroenterology, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW 2050, Australia
- Claude Dennis
- Department of Gastroenterology, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW 2050, Australia
- Marie Sinclair
- Department of Gastroenterology, Austin Hospital, Heidelberg, VIC 3084, Australia
- Avik Majumdar
- Department of Gastroenterology, Austin Hospital, Heidelberg, VIC 3084, Australia
- Kate Collins
- Department of Gastroenterology, Austin Hospital, Heidelberg, VIC 3084, Australia
- Katherine Bateman
- Department of Gastroenterology, Austin Hospital, Heidelberg, VIC 3084, Australia
- Anouk Dev
- Department of Gastroenterology, Monash Health, Clayton, VIC 3168, Australia
- Joshua H. Abasszade
- Department of Gastroenterology, Monash Health, Clayton, VIC 3168, Australia
- Zina Valaydon
- Department of Gastroenterology, Western Health, Footscray, VIC 3011, Australia
- Daniel Saitta
- Department of Gastroenterology, Western Health, Footscray, VIC 3011, Australia
- Kathryn Gazelakis
- Department of Gastroenterology, Western Health, Footscray, VIC 3011, Australia
- Susan Byers
- Department of Gastroenterology, Western Health, Footscray, VIC 3011, Australia
- Jacinta Holmes
- Department of Gastroenterology, St. Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia
- Alexander J. Thompson
- Department of Gastroenterology, St. Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia
- Dhivya Pandiaraja
- Department of Gastroenterology, St. Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia
- Steven Bollipo
- Department of Gastroenterology, John Hunter Hospital, New Lambton Heights, NSW 2305, Australia
- Suresh Sharma
- Department of Gastroenterology, John Hunter Hospital, New Lambton Heights, NSW 2305, Australia
- Merlyn Joseph
- Department of Gastroenterology, John Hunter Hospital, New Lambton Heights, NSW 2305, Australia
- Amanda Nicoll
- Department of Gastroenterology, Eastern Health, Box Hill, VIC 3128, Australia
- Nicholas Batt
- Department of Gastroenterology, Eastern Health, Box Hill, VIC 3128, Australia
- Rohit Sawhney
- Department of Gastroenterology, Eastern Health, Box Hill, VIC 3128, Australia
- Myo J. Tang
- Department of Gastroenterology, Alfred Health, Melbourne, VIC 3004, Australia
- John Lubel
- Department of Gastroenterology, Alfred Health, Melbourne, VIC 3004, Australia
- Stephen Riordan
- Department of Gastroenterology, Prince of Wales Hospital, Randwick, NSW 2031, Australia
- Nicholas Hannah
- Department of Gastroenterology, Royal Melbourne Hospital, Parkville, VIC 3052, Australia
- James Haridy
- Department of Gastroenterology, Royal Melbourne Hospital, Parkville, VIC 3052, Australia
- Siddharth Sood
- Department of Gastroenterology, Royal Melbourne Hospital, Parkville, VIC 3052, Australia
- Eileen Lam
- Department of Medicine, Central Clinical School, Monash University, Melbourne, VIC 3004, Australia
- Elysia Greenhill
- Department of Medicine, Central Clinical School, Monash University, Melbourne, VIC 3004, Australia
- Ammar Majeed
- Department of Gastroenterology, Alfred Health, Melbourne, VIC 3004, Australia
- William Kemp
- Department of Gastroenterology, Alfred Health, Melbourne, VIC 3004, Australia
- John Zalcberg
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
- Stuart K. Roberts
- Department of Gastroenterology, Alfred Health, Melbourne, VIC 3004, Australia
- DOI
- https://doi.org/10.3390/cancers15245741
- Journal volume & issue
-
Vol. 15,
no. 24
p. 5741
Abstract
The optimal treatment approach in very-early and early-stage hepatocellular carcinoma (HCC) is not precisely defined, and there is ambiguity in the literature around the comparative efficacy of surgical resection versus ablation as curative therapies for limited disease. We performed this real-world propensity-matched, multi-centre cohort study to assess for differences in survival outcomes between those undergoing resection and those receiving ablation. Patients with Barcelona Clinic Liver Cancer (BCLC) 0/A HCC first diagnosed between 1 January 2016 and 31 December 2020 who received ablation or resection as initial treatment were included in the study. A total of 450 patients were included in the study from 10 major liver centres including two transplant centres. Following propensity score matching using key covariates, 156 patients were available for analysis with 78 in each group. Patients who underwent resection had significantly improved overall survival (log-rank test p = 0.023) and local recurrence-free survival (log rank test p = 0.027) compared to those who received ablation. Based on real-world data, our study supports the use of surgical resection in preference to ablation as first-line curative therapy in appropriately selected BCLC 0/A HCC patients.
Keywords
