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.

2023-12-07

Abdelmalak, Jonathan

Strasser, Simone I

Ngu, Natalie

Dennis, Claude

Sinclair, Marie

Majumdar, Avik

Collins, Kate

Bateman, Katherine

Dev, Anouk

Abasszade, Joshua H

Valaydon, Zina

Saitta, Daniel

Gazelakis, Kathryn

Byers, Susan

Holmes, Jacinta

Thompson, Alexander J

Pandiaraja, Dhivya

Bollipo, Steven

Sharma, Suresh

Joseph, Merlyn

Nicoll, Amanda

Batt, Nicholas

Sawhney, Rohit

Tang, Myo J

Lubel, John

Riordan, Stephen

Hannah, Nicholas

Haridy, James

Sood, Siddharth

Lam, Eileen

Greenhill, Elysia

Majeed, Ammar

Kemp, William

Zalcberg, John

Roberts, Stuart K

ablation

early

hepatocellular carcinoma

resection

Journal Article

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10.3390/cancers15245741

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.

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Cancers 2023-12-07; 15(24)

Cancers