The chances of hepatic resection curing hepatocellular carcinoma. Journal of hepatology

Alessandro Cucchetti, Jianhong Zhong, Sarah Berhane, Hidenori Toyoda, KeQing Shi, Toshifumi Tada, Charing C. N. Chong, Bang-De Xiang, Le-Qun Li, Paul B. S. Lai, Giorgio Ercolani, Vincenzo Mazzaferro, Masatoshi Kudo, Matteo Cescon, Antonio Daniele Pinna, Takashi Kumada, Philip J. Johnson

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND & AIMS: The popular sense of the word "cure" implies that a patient treated for a specific disease will return to have the same life expectancy as if he/she had never had the disease. In analytic terms, it translates into the concept of statistical cure which occurs when a group of patients returns to having similar mortality to a reference population. The aim of this study was to assess the probability of being cured from hepatocellular carcinoma (HCC) by hepatic resection. METHODS: Data from 2,523 patients undergoing resection for HCC were used to fit statistical cure models, to compare disease-free survival (DFS) after surgery to the survival expected for patients with chronic hepatitis and/or cirrhosis and the general population, matched by sex, age, race/ethnicity and year of diagnosis. RESULTS: The probability of resection enabling patients with HCC to achieve the same life expectancy as those with chronic hepatitis and/or cirrhosis was 26.3%. The conditional probability of achieving this result was time-dependent, requiring about 8.9 years to be accomplished with 95% certainty. Considering the general population as a reference, the cure fraction decreased to 17.1%. Uncured patients had a median DFS of 1.5 years. In multivariable analysis, patient's age and the risk of early HCC recurrence (within 2 years) were independent determinants of the chance of cure (p
Original languageEnglish
Pages (from-to)711-717
Number of pages7
JournalJournal of Hepatology
Volume72
Issue number4
DOIs
Publication statusPublished - 2020

Keywords

  • *Recurrence
  • *Cure fraction
  • *Hepatic resection
  • *Hepatocellular carcinoma
  • *Relative survival

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