Document Detail


Surgery for hepatocellular carcinoma: does it improve survival?
MedLine Citation:
PMID:  14993025     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The incidence and mortality of hepatocellular carcinoma (HCC) are increasing in the United States. Whether surgery is associated with improved survival at the population level is relatively unknown. To address this question, we used a population-based cancer registry to compare survival outcomes between patients receiving and not receiving surgery with similar tumor sizes and health status. METHODS: By using the Surveillance, Epidemiology, and End Results database, we identified HCC patients who had surgically resectable disease as defined by published expert guidelines. After excluding patients with contraindications to surgery, we performed both survival analysis and Cox regression to identify predictors of improved survival. RESULTS: Of the 4008 patients diagnosed with HCC between 1988 and 1998, 417 were candidates for surgical resection. The mean age was 63.6 years; mean tumor size was 3.3 cm. The 5-year overall survival with surgery was 33% with a mean of 47.1 months; without surgery, the 5-year overall survival was 7% with a mean of 17.9 months (P <.001). In the multivariate Cox regression, surgery was significantly associated with improved survival (P <.001). Specifically, patients who received surgery had a 55% decreased rate of death compared with patients who did not have surgery, even after controlling for tumor size, age, sex, and race. CONCLUSIONS: This study shows that surgical therapy is associated with improved survival in patients with unifocal, nonmetastatic HCC tumors <5 cm. If this is confirmed in future studies, efforts should be made to ensure that appropriate patients with resectable HCC receive high-quality care, as well as the opportunity for potentially curative surgery.
Authors:
Jerome H Liu; Pauline W Chen; Steven M Asch; Ronald W Busuttil; Clifford Y Ko
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Annals of surgical oncology     Volume:  11     ISSN:  1068-9265     ISO Abbreviation:  Ann. Surg. Oncol.     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-03-02     Completed Date:  2004-06-01     Revised Date:  2007-07-18    
Medline Journal Info:
Nlm Unique ID:  9420840     Medline TA:  Ann Surg Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  298-303     Citation Subset:  IM    
Affiliation:
Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA. jerome8@ucla.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Carcinoma, Hepatocellular / pathology*,  surgery*
Female
Humans
Liver Neoplasms / pathology*,  surgery*
Male
Middle Aged
Prognosis
Registries / statistics & numerical data*
Retrospective Studies
SEER Program / statistics & numerical data*
Survival Analysis
Treatment Outcome
Comments/Corrections
Comment In:
Ann Surg Oncol. 2004 May;11(5):460-1   [PMID:  15078638 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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