Comparison of stereotactic body radiation therapy with hepatic resection and radiofrequency ablation as initial treatment in patients with early-stage hepatocellular carcinoma
BackgroundStereotactic body radiation therapy (SBRT) has emerged as a novel intervention for early-stage hepatocellular carcinoma (HCC). The outcomes of SBRT, liver resection (LR), and radiofrequency ablation (RFA) as the initial treatment for AJCC stage I HCC patients remain unclear.MethodsPatients...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.948866/full |
| _version_ | 1811317996663078912 |
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| author | Zi-liang Yang Zi-liang Yang Zi-liang Yang Xu-qi Sun Xu-qi Sun Xu-qi Sun Yu-hao Tang Yu-hao Tang Yu-hao Tang Pei-yao Xiong Pei-yao Xiong Pei-yao Xiong Li Xu Li Xu Li Xu |
| author_facet | Zi-liang Yang Zi-liang Yang Zi-liang Yang Xu-qi Sun Xu-qi Sun Xu-qi Sun Yu-hao Tang Yu-hao Tang Yu-hao Tang Pei-yao Xiong Pei-yao Xiong Pei-yao Xiong Li Xu Li Xu Li Xu |
| author_sort | Zi-liang Yang |
| collection | DOAJ |
| description | BackgroundStereotactic body radiation therapy (SBRT) has emerged as a novel intervention for early-stage hepatocellular carcinoma (HCC). The outcomes of SBRT, liver resection (LR), and radiofrequency ablation (RFA) as the initial treatment for AJCC stage I HCC patients remain unclear.MethodsPatients with AJCC stage I HCC from the Surveillance, Epidemiology and End Results database were analyzed for survival rates using the Kaplan–Meier method and stratified according to tumor size: S subgroup (≤2 cm), M subgroup (>2–3 cm), and L subgroup (>3 cm). For factors including age, year of diagnosis, sex, race, grade, tumor size, AFP, and fibrosis score, propensity score matching was performed to eliminate the imbalance of baseline features and selection bias during groups.ResultsA total of 4,002 patients were included; the difference in median overall survival (mOS) between the SBRT group and the LR or RFA group in the S subgroup was statistically insignificant (p=0.109 and p=0.744), while that of the RFA group was significantly worse than that of the LR group (p <0.001). In the M and L subgroups, the mOS of the SBRT group was worse than that of the RFA group (p=0.040 and p<0.001, respectively). The mOS of LR was the best when compared with either the SBRT or RFA group regardless of the subgroup M or L (all p<0.001).ConclusionFor HCC ≤ 2 cm, SBRT can be used as an alternative treatment for RFA. For patients with HCC larger than 2 cm, RFA can provide better long-term survival than SBRT, while LR remains the best choice. |
| first_indexed | 2024-04-13T12:18:06Z |
| format | Article |
| id | doaj.art-386aeff99344459ab9260bc340b942a1 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-13T12:18:06Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-386aeff99344459ab9260bc340b942a12022-12-22T02:47:17ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-11-011210.3389/fonc.2022.948866948866Comparison of stereotactic body radiation therapy with hepatic resection and radiofrequency ablation as initial treatment in patients with early-stage hepatocellular carcinomaZi-liang Yang0Zi-liang Yang1Zi-liang Yang2Xu-qi Sun3Xu-qi Sun4Xu-qi Sun5Yu-hao Tang6Yu-hao Tang7Yu-hao Tang8Pei-yao Xiong9Pei-yao Xiong10Pei-yao Xiong11Li Xu12Li Xu13Li Xu14Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, ChinaState Key Laboratory of Oncology in South China, Guangzhou, Guangdong, ChinaCollaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, ChinaDepartment of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, ChinaState Key Laboratory of Oncology in South China, Guangzhou, Guangdong, ChinaCollaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, ChinaState Key Laboratory of Oncology in South China, Guangzhou, Guangdong, ChinaCollaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, ChinaDepartment of Radiotherapy, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, ChinaState Key Laboratory of Oncology in South China, Guangzhou, Guangdong, ChinaCollaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, ChinaDepartment of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, ChinaState Key Laboratory of Oncology in South China, Guangzhou, Guangdong, ChinaCollaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, ChinaBackgroundStereotactic body radiation therapy (SBRT) has emerged as a novel intervention for early-stage hepatocellular carcinoma (HCC). The outcomes of SBRT, liver resection (LR), and radiofrequency ablation (RFA) as the initial treatment for AJCC stage I HCC patients remain unclear.MethodsPatients with AJCC stage I HCC from the Surveillance, Epidemiology and End Results database were analyzed for survival rates using the Kaplan–Meier method and stratified according to tumor size: S subgroup (≤2 cm), M subgroup (>2–3 cm), and L subgroup (>3 cm). For factors including age, year of diagnosis, sex, race, grade, tumor size, AFP, and fibrosis score, propensity score matching was performed to eliminate the imbalance of baseline features and selection bias during groups.ResultsA total of 4,002 patients were included; the difference in median overall survival (mOS) between the SBRT group and the LR or RFA group in the S subgroup was statistically insignificant (p=0.109 and p=0.744), while that of the RFA group was significantly worse than that of the LR group (p <0.001). In the M and L subgroups, the mOS of the SBRT group was worse than that of the RFA group (p=0.040 and p<0.001, respectively). The mOS of LR was the best when compared with either the SBRT or RFA group regardless of the subgroup M or L (all p<0.001).ConclusionFor HCC ≤ 2 cm, SBRT can be used as an alternative treatment for RFA. For patients with HCC larger than 2 cm, RFA can provide better long-term survival than SBRT, while LR remains the best choice.https://www.frontiersin.org/articles/10.3389/fonc.2022.948866/fullstereotactic body radiation therapyliver resectionradiofrequency ablationhepatocellular carcinomaoverall survival |
| spellingShingle | Zi-liang Yang Zi-liang Yang Zi-liang Yang Xu-qi Sun Xu-qi Sun Xu-qi Sun Yu-hao Tang Yu-hao Tang Yu-hao Tang Pei-yao Xiong Pei-yao Xiong Pei-yao Xiong Li Xu Li Xu Li Xu Comparison of stereotactic body radiation therapy with hepatic resection and radiofrequency ablation as initial treatment in patients with early-stage hepatocellular carcinoma Frontiers in Oncology stereotactic body radiation therapy liver resection radiofrequency ablation hepatocellular carcinoma overall survival |
| title | Comparison of stereotactic body radiation therapy with hepatic resection and radiofrequency ablation as initial treatment in patients with early-stage hepatocellular carcinoma |
| title_full | Comparison of stereotactic body radiation therapy with hepatic resection and radiofrequency ablation as initial treatment in patients with early-stage hepatocellular carcinoma |
| title_fullStr | Comparison of stereotactic body radiation therapy with hepatic resection and radiofrequency ablation as initial treatment in patients with early-stage hepatocellular carcinoma |
| title_full_unstemmed | Comparison of stereotactic body radiation therapy with hepatic resection and radiofrequency ablation as initial treatment in patients with early-stage hepatocellular carcinoma |
| title_short | Comparison of stereotactic body radiation therapy with hepatic resection and radiofrequency ablation as initial treatment in patients with early-stage hepatocellular carcinoma |
| title_sort | comparison of stereotactic body radiation therapy with hepatic resection and radiofrequency ablation as initial treatment in patients with early stage hepatocellular carcinoma |
| topic | stereotactic body radiation therapy liver resection radiofrequency ablation hepatocellular carcinoma overall survival |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.948866/full |
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