Real-world practice of conversion surgery for unresectable hepatocellular carcinoma - a single center data of 26 consecutive patients
Abstract Aim To understand the proportion of uHCC (unresectable hepatocellular carcinoma) patients who achieve successful conversion resection in a high-volume setting with state of the art treatment options. Methods We retrospectively reviewed all HCC patients hospitalized to our center from June 1...
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-05-01
|
| Series: | BMC Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12885-023-10955-7 |
| _version_ | 1797822783013519360 |
|---|---|
| author | Bo Zhang Xuetao Shi Kai Cui Zhongchao Li Lei Li Zhaogang Liu Chengsheng Zhang Pengfei Sun Jingtao Zhong Zhicheng Sun Zhibin Chang Zhao Ma Alex Gordon-Weeks Mingming Li Lei Zhao |
| author_facet | Bo Zhang Xuetao Shi Kai Cui Zhongchao Li Lei Li Zhaogang Liu Chengsheng Zhang Pengfei Sun Jingtao Zhong Zhicheng Sun Zhibin Chang Zhao Ma Alex Gordon-Weeks Mingming Li Lei Zhao |
| author_sort | Bo Zhang |
| collection | DOAJ |
| description | Abstract Aim To understand the proportion of uHCC (unresectable hepatocellular carcinoma) patients who achieve successful conversion resection in a high-volume setting with state of the art treatment options. Methods We retrospectively reviewed all HCC patients hospitalized to our center from June 1st, 2019 to June 1st, 2022. Conversion rate, clinicopathological features, response to systemic and/or loco-regional therapy and surgical outcomes were analyzed. Results A total of 1,904 HCC patients were identified, with 1672 patients receiving anti-HCC treatment. 328 patients were considered up-front resectable. Of the remaining 1344 uHCC patients, 311 received loco-regional treatment, 224 received systemic treatment, and the remainder (809) received combination systemic plus loco-regional treatment. Following treatment, one patient from the systemic group and 25 patients from the combination group were considered to have resectable disease. A high objective response rate (ORR) was observed in these converted patients (42.3% under RECIST v1.1 and 76.9% under mRECIST criteria). The disease control rate (DCR) reached 100%. 23 patients underwent curative hepatectomy. Major post-operative morbidity was equivalent in the both groups (P=0.76). Pathologic complete response (pCR) was 39.1%. During conversion treatment, grade 3 or higher treatment-related adverse events (TRAEs) were observed in 50% of patients. The median follow-up time was 12.9 months (range, 3.9~40.6) from index diagnosis and 11.4 months (range, 0.9~26.9) from resection. Three patients experienced disease recurrence following conversion surgery. Conclusions By intensive treatment, a small sub-group of uHCC patients (2%) may potentially be converted to curative resection. Loco-regional combined with systemic modality was relative safe and effective in the conversion therapy. Short-term outcomes are encouraging, but long-term follow-up in a larger patient population are required to fully understand the utility of this approach. |
| first_indexed | 2024-03-13T10:14:16Z |
| format | Article |
| id | doaj.art-167238a9b3a9490c8540c0ee9eb01c9c |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-03-13T10:14:16Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-167238a9b3a9490c8540c0ee9eb01c9c2023-05-21T11:18:50ZengBMCBMC Cancer1471-24072023-05-0123111410.1186/s12885-023-10955-7Real-world practice of conversion surgery for unresectable hepatocellular carcinoma - a single center data of 26 consecutive patientsBo Zhang0Xuetao Shi1Kai Cui2Zhongchao Li3Lei Li4Zhaogang Liu5Chengsheng Zhang6Pengfei Sun7Jingtao Zhong8Zhicheng Sun9Zhibin Chang10Zhao Ma11Alex Gordon-Weeks12Mingming Li13Lei Zhao14Department of Hepatobiliary Surgery, Shandong Cancer Hospital Affiliated to Shandong First Medical UniversityDepartment of Hepatobiliary Surgery, Shandong Cancer Hospital Affiliated to Shandong First Medical UniversityDepartment of Hepatobiliary Surgery, Shandong Cancer Hospital Affiliated to Shandong First Medical UniversityDepartment of Hepatobiliary Surgery, Shandong Cancer Hospital Affiliated to Shandong First Medical UniversityDepartment of Hepatobiliary Surgery, Shandong Cancer Hospital Affiliated to Shandong First Medical UniversityDepartment of Hepatobiliary Surgery, Shandong Cancer Hospital Affiliated to Shandong First Medical UniversityDepartment of Hepatobiliary Surgery, Shandong Cancer Hospital Affiliated to Shandong First Medical UniversityDepartment of Hepatobiliary Surgery, Shandong Cancer Hospital Affiliated to Shandong First Medical UniversityDepartment of Hepatobiliary Surgery, Shandong Cancer Hospital Affiliated to Shandong First Medical UniversityDepartment of Hepatobiliary Surgery, Shandong Cancer Hospital Affiliated to Shandong First Medical UniversityDepartment of Hepatobiliary Surgery, Shandong Cancer Hospital Affiliated to Shandong First Medical UniversityThe Fourth People’s Hospital of JinanNuffield Department of Surgical Sciences, University of OxfordDepartment of Hepatobiliary Surgery, Shandong Cancer Hospital Affiliated to Shandong First Medical UniversityDepartment of Hepatobiliary Surgery, Shandong Cancer Hospital Affiliated to Shandong First Medical UniversityAbstract Aim To understand the proportion of uHCC (unresectable hepatocellular carcinoma) patients who achieve successful conversion resection in a high-volume setting with state of the art treatment options. Methods We retrospectively reviewed all HCC patients hospitalized to our center from June 1st, 2019 to June 1st, 2022. Conversion rate, clinicopathological features, response to systemic and/or loco-regional therapy and surgical outcomes were analyzed. Results A total of 1,904 HCC patients were identified, with 1672 patients receiving anti-HCC treatment. 328 patients were considered up-front resectable. Of the remaining 1344 uHCC patients, 311 received loco-regional treatment, 224 received systemic treatment, and the remainder (809) received combination systemic plus loco-regional treatment. Following treatment, one patient from the systemic group and 25 patients from the combination group were considered to have resectable disease. A high objective response rate (ORR) was observed in these converted patients (42.3% under RECIST v1.1 and 76.9% under mRECIST criteria). The disease control rate (DCR) reached 100%. 23 patients underwent curative hepatectomy. Major post-operative morbidity was equivalent in the both groups (P=0.76). Pathologic complete response (pCR) was 39.1%. During conversion treatment, grade 3 or higher treatment-related adverse events (TRAEs) were observed in 50% of patients. The median follow-up time was 12.9 months (range, 3.9~40.6) from index diagnosis and 11.4 months (range, 0.9~26.9) from resection. Three patients experienced disease recurrence following conversion surgery. Conclusions By intensive treatment, a small sub-group of uHCC patients (2%) may potentially be converted to curative resection. Loco-regional combined with systemic modality was relative safe and effective in the conversion therapy. Short-term outcomes are encouraging, but long-term follow-up in a larger patient population are required to fully understand the utility of this approach.https://doi.org/10.1186/s12885-023-10955-7Hepatocellular carcinomaConversion therapyTumor responseTreatment-related adverse events (TRAEs) |
| spellingShingle | Bo Zhang Xuetao Shi Kai Cui Zhongchao Li Lei Li Zhaogang Liu Chengsheng Zhang Pengfei Sun Jingtao Zhong Zhicheng Sun Zhibin Chang Zhao Ma Alex Gordon-Weeks Mingming Li Lei Zhao Real-world practice of conversion surgery for unresectable hepatocellular carcinoma - a single center data of 26 consecutive patients BMC Cancer Hepatocellular carcinoma Conversion therapy Tumor response Treatment-related adverse events (TRAEs) |
| title | Real-world practice of conversion surgery for unresectable hepatocellular carcinoma - a single center data of 26 consecutive patients |
| title_full | Real-world practice of conversion surgery for unresectable hepatocellular carcinoma - a single center data of 26 consecutive patients |
| title_fullStr | Real-world practice of conversion surgery for unresectable hepatocellular carcinoma - a single center data of 26 consecutive patients |
| title_full_unstemmed | Real-world practice of conversion surgery for unresectable hepatocellular carcinoma - a single center data of 26 consecutive patients |
| title_short | Real-world practice of conversion surgery for unresectable hepatocellular carcinoma - a single center data of 26 consecutive patients |
| title_sort | real world practice of conversion surgery for unresectable hepatocellular carcinoma a single center data of 26 consecutive patients |
| topic | Hepatocellular carcinoma Conversion therapy Tumor response Treatment-related adverse events (TRAEs) |
| url | https://doi.org/10.1186/s12885-023-10955-7 |
| work_keys_str_mv | AT bozhang realworldpracticeofconversionsurgeryforunresectablehepatocellularcarcinomaasinglecenterdataof26consecutivepatients AT xuetaoshi realworldpracticeofconversionsurgeryforunresectablehepatocellularcarcinomaasinglecenterdataof26consecutivepatients AT kaicui realworldpracticeofconversionsurgeryforunresectablehepatocellularcarcinomaasinglecenterdataof26consecutivepatients AT zhongchaoli realworldpracticeofconversionsurgeryforunresectablehepatocellularcarcinomaasinglecenterdataof26consecutivepatients AT leili realworldpracticeofconversionsurgeryforunresectablehepatocellularcarcinomaasinglecenterdataof26consecutivepatients AT zhaogangliu realworldpracticeofconversionsurgeryforunresectablehepatocellularcarcinomaasinglecenterdataof26consecutivepatients AT chengshengzhang realworldpracticeofconversionsurgeryforunresectablehepatocellularcarcinomaasinglecenterdataof26consecutivepatients AT pengfeisun realworldpracticeofconversionsurgeryforunresectablehepatocellularcarcinomaasinglecenterdataof26consecutivepatients AT jingtaozhong realworldpracticeofconversionsurgeryforunresectablehepatocellularcarcinomaasinglecenterdataof26consecutivepatients AT zhichengsun realworldpracticeofconversionsurgeryforunresectablehepatocellularcarcinomaasinglecenterdataof26consecutivepatients AT zhibinchang realworldpracticeofconversionsurgeryforunresectablehepatocellularcarcinomaasinglecenterdataof26consecutivepatients AT zhaoma realworldpracticeofconversionsurgeryforunresectablehepatocellularcarcinomaasinglecenterdataof26consecutivepatients AT alexgordonweeks realworldpracticeofconversionsurgeryforunresectablehepatocellularcarcinomaasinglecenterdataof26consecutivepatients AT mingmingli realworldpracticeofconversionsurgeryforunresectablehepatocellularcarcinomaasinglecenterdataof26consecutivepatients AT leizhao realworldpracticeofconversionsurgeryforunresectablehepatocellularcarcinomaasinglecenterdataof26consecutivepatients |