Comparison of outcomes between preoperative and postoperative systemic treatment in patients with hepatocellular carcinoma: a SEER database-based study
BackgroundSignificant advancements in systemic treatment for hepatocellular carcinoma have been made in recent years. However, the optimal timing of systemic treatment before or after surgery remains unknown. This study aims to evaluate the impact of sequencing systemic treatment and surgical interv...
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| Format: | Article |
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Frontiers Media S.A.
2024-03-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2024.1324392/full |
| _version_ | 1797257627334344704 |
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| author | Yadi Liu Shuangshuang Sun Zhaoyin Chu Caixia Liu Lina Chen Zhengshang Ruan |
| author_facet | Yadi Liu Shuangshuang Sun Zhaoyin Chu Caixia Liu Lina Chen Zhengshang Ruan |
| author_sort | Yadi Liu |
| collection | DOAJ |
| description | BackgroundSignificant advancements in systemic treatment for hepatocellular carcinoma have been made in recent years. However, the optimal timing of systemic treatment before or after surgery remains unknown. This study aims to evaluate the impact of sequencing systemic treatment and surgical intervention on the long-term prognosis of hepatocellular carcinoma patients.MethodsIn our study, we analyzed data from patients diagnosed with primary liver cancer (2004-2015) extracted from the SEER database. Patients who underwent both systemic treatment and surgical intervention were selected, divided into preoperative and postoperative systemic therapy groups. The primary endpoint of the study is overall survival(OS), and the secondary endpoint is cancer-specific survival (CSS). Propensity score matching (PSM) reduced the influence of confounding factors, while Kaplan-Meier curves and a multivariable Cox proportional hazards model accounted for variables during survival analysis.ResultsA total of 1918 eligible HCC patients were included, with 1406 cases in the preoperative systemic treatment group and 512 cases in the postoperative systemic treatment group. Survival analysis showed that both the preoperative group demonstrated longer median overall survival (OS) and median cancer-specific survival (CSS) before and after PSM. After conducting multivariate COX regression analysis with stepwise adjustment of input variables, the postoperative systemic treatment group continued to exhibit a higher risk of all-cause mortality (HR: 1.84, 95% CI: 1.55-2.1) and cancer-specific mortality (HR: 2.10, 95% CI: 1.73-2.54). Subgroup analysis indicated consistent results for overall survival (OS) across different subgroups.ConclusionsHepatocellular carcinoma patients from the SEER database who received preoperative systemic therapy had superior OS and CSS compared to those who received postoperative systemic therapy. |
| first_indexed | 2024-04-24T22:40:39Z |
| format | Article |
| id | doaj.art-917a9297dded45019dc9cae2268b9647 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-24T22:40:39Z |
| publishDate | 2024-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-917a9297dded45019dc9cae2268b96472024-03-19T04:23:37ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-03-011410.3389/fonc.2024.13243921324392Comparison of outcomes between preoperative and postoperative systemic treatment in patients with hepatocellular carcinoma: a SEER database-based studyYadi Liu0Shuangshuang Sun1Zhaoyin Chu2Caixia Liu3Lina Chen4Zhengshang Ruan5Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Liver Disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai, ChinaXinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaXinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaXinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaXinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaBackgroundSignificant advancements in systemic treatment for hepatocellular carcinoma have been made in recent years. However, the optimal timing of systemic treatment before or after surgery remains unknown. This study aims to evaluate the impact of sequencing systemic treatment and surgical intervention on the long-term prognosis of hepatocellular carcinoma patients.MethodsIn our study, we analyzed data from patients diagnosed with primary liver cancer (2004-2015) extracted from the SEER database. Patients who underwent both systemic treatment and surgical intervention were selected, divided into preoperative and postoperative systemic therapy groups. The primary endpoint of the study is overall survival(OS), and the secondary endpoint is cancer-specific survival (CSS). Propensity score matching (PSM) reduced the influence of confounding factors, while Kaplan-Meier curves and a multivariable Cox proportional hazards model accounted for variables during survival analysis.ResultsA total of 1918 eligible HCC patients were included, with 1406 cases in the preoperative systemic treatment group and 512 cases in the postoperative systemic treatment group. Survival analysis showed that both the preoperative group demonstrated longer median overall survival (OS) and median cancer-specific survival (CSS) before and after PSM. After conducting multivariate COX regression analysis with stepwise adjustment of input variables, the postoperative systemic treatment group continued to exhibit a higher risk of all-cause mortality (HR: 1.84, 95% CI: 1.55-2.1) and cancer-specific mortality (HR: 2.10, 95% CI: 1.73-2.54). Subgroup analysis indicated consistent results for overall survival (OS) across different subgroups.ConclusionsHepatocellular carcinoma patients from the SEER database who received preoperative systemic therapy had superior OS and CSS compared to those who received postoperative systemic therapy.https://www.frontiersin.org/articles/10.3389/fonc.2024.1324392/fullhepatocellular carcinoma(HCC)preoperative systemic treatmentpostoperative systemic treatmentoverall survival(OS)cancer-specific survival(CSS)SEER database |
| spellingShingle | Yadi Liu Shuangshuang Sun Zhaoyin Chu Caixia Liu Lina Chen Zhengshang Ruan Comparison of outcomes between preoperative and postoperative systemic treatment in patients with hepatocellular carcinoma: a SEER database-based study Frontiers in Oncology hepatocellular carcinoma(HCC) preoperative systemic treatment postoperative systemic treatment overall survival(OS) cancer-specific survival(CSS) SEER database |
| title | Comparison of outcomes between preoperative and postoperative systemic treatment in patients with hepatocellular carcinoma: a SEER database-based study |
| title_full | Comparison of outcomes between preoperative and postoperative systemic treatment in patients with hepatocellular carcinoma: a SEER database-based study |
| title_fullStr | Comparison of outcomes between preoperative and postoperative systemic treatment in patients with hepatocellular carcinoma: a SEER database-based study |
| title_full_unstemmed | Comparison of outcomes between preoperative and postoperative systemic treatment in patients with hepatocellular carcinoma: a SEER database-based study |
| title_short | Comparison of outcomes between preoperative and postoperative systemic treatment in patients with hepatocellular carcinoma: a SEER database-based study |
| title_sort | comparison of outcomes between preoperative and postoperative systemic treatment in patients with hepatocellular carcinoma a seer database based study |
| topic | hepatocellular carcinoma(HCC) preoperative systemic treatment postoperative systemic treatment overall survival(OS) cancer-specific survival(CSS) SEER database |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2024.1324392/full |
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