Should we change the treatment plan in early hepatocellular carcinoma with chronic kidney disease?
Abstract Background Chronic kidney disease (CKD) has been considered to be a poor prognostic factor for hepatocellular carcinoma (HCC). However, few studies have focused on early HCC and the impact of CKD on survival, which should be considered in curative treatment for early HCC. Materials and meth...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | BMC Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12893-023-01983-y |
| _version_ | 1827966484135018496 |
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| author | Wu-Po Chao Shion-Wei Chai Po-Hsing Chiang Ta-Chun Chou Yi-Chan Chen Ruey-Shyang Soong |
| author_facet | Wu-Po Chao Shion-Wei Chai Po-Hsing Chiang Ta-Chun Chou Yi-Chan Chen Ruey-Shyang Soong |
| author_sort | Wu-Po Chao |
| collection | DOAJ |
| description | Abstract Background Chronic kidney disease (CKD) has been considered to be a poor prognostic factor for hepatocellular carcinoma (HCC). However, few studies have focused on early HCC and the impact of CKD on survival, which should be considered in curative treatment for early HCC. Materials and methods Patients with BCLC stage 0/A were enrolled from 2009 to 2019. A total of 383 patients were divided into Control group and CKD group, based on estimated glomerular filtration rate. Overall survival (OS) and disease-free survival (DFS) of different treatments were determined using the Kaplan–Meier method. Results The Control group had a significantly better OS than the CKD group (72.6 months vs. 56.7 months; p = 0.003). DFS was similar between the groups (62.2 months vs. 63.8 months, p = 0.717). In the Control group, the surgically treated (OP) group had significantly superior OS (65.0 months vs. 80.0 months, p = 0.014) and DFS (50.9 months vs. 70.2 months, p = 0.020) than the radiofrequency ablation-treated group. In the CKD group, the OP group showed a survival advantage in OS (70.6 months vs. 49.2 months, p = 0.004), while DFS was similar between treatment groups (56.0 months vs. 62.2 months, p = 0.097). Conclusion CKD should not be considered to be a poor prognostic factor in early HCC patients. Moreover, hepatectomy should be carried out in CKD patient with early HCC for better prognosis if feasible. |
| first_indexed | 2024-04-09T17:50:44Z |
| format | Article |
| id | doaj.art-b9ffb73dc0064a85994051eb237d3c68 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-04-09T17:50:44Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-b9ffb73dc0064a85994051eb237d3c682023-04-16T11:05:45ZengBMCBMC Surgery1471-24822023-04-012311810.1186/s12893-023-01983-yShould we change the treatment plan in early hepatocellular carcinoma with chronic kidney disease?Wu-Po Chao0Shion-Wei Chai1Po-Hsing Chiang2Ta-Chun Chou3Yi-Chan Chen4Ruey-Shyang Soong5Division of General Surgery, Department of Surgery, Keelung Chang Gung Memorial HospitalDivision of General Surgery, Department of Surgery, Keelung Chang Gung Memorial HospitalDivision of General Surgery, Department of Surgery, Keelung Chang Gung Memorial HospitalDivision of General Surgery, Department of Surgery, Keelung Chang Gung Memorial HospitalDivision of General Surgery, Department of Surgery, Keelung Chang Gung Memorial HospitalDivision of General Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical UniversityAbstract Background Chronic kidney disease (CKD) has been considered to be a poor prognostic factor for hepatocellular carcinoma (HCC). However, few studies have focused on early HCC and the impact of CKD on survival, which should be considered in curative treatment for early HCC. Materials and methods Patients with BCLC stage 0/A were enrolled from 2009 to 2019. A total of 383 patients were divided into Control group and CKD group, based on estimated glomerular filtration rate. Overall survival (OS) and disease-free survival (DFS) of different treatments were determined using the Kaplan–Meier method. Results The Control group had a significantly better OS than the CKD group (72.6 months vs. 56.7 months; p = 0.003). DFS was similar between the groups (62.2 months vs. 63.8 months, p = 0.717). In the Control group, the surgically treated (OP) group had significantly superior OS (65.0 months vs. 80.0 months, p = 0.014) and DFS (50.9 months vs. 70.2 months, p = 0.020) than the radiofrequency ablation-treated group. In the CKD group, the OP group showed a survival advantage in OS (70.6 months vs. 49.2 months, p = 0.004), while DFS was similar between treatment groups (56.0 months vs. 62.2 months, p = 0.097). Conclusion CKD should not be considered to be a poor prognostic factor in early HCC patients. Moreover, hepatectomy should be carried out in CKD patient with early HCC for better prognosis if feasible.https://doi.org/10.1186/s12893-023-01983-yhepatocellular carcinomachronic kidney diseasehepatectomyradiofrequency ablationsurvival |
| spellingShingle | Wu-Po Chao Shion-Wei Chai Po-Hsing Chiang Ta-Chun Chou Yi-Chan Chen Ruey-Shyang Soong Should we change the treatment plan in early hepatocellular carcinoma with chronic kidney disease? BMC Surgery hepatocellular carcinoma chronic kidney disease hepatectomy radiofrequency ablation survival |
| title | Should we change the treatment plan in early hepatocellular carcinoma with chronic kidney disease? |
| title_full | Should we change the treatment plan in early hepatocellular carcinoma with chronic kidney disease? |
| title_fullStr | Should we change the treatment plan in early hepatocellular carcinoma with chronic kidney disease? |
| title_full_unstemmed | Should we change the treatment plan in early hepatocellular carcinoma with chronic kidney disease? |
| title_short | Should we change the treatment plan in early hepatocellular carcinoma with chronic kidney disease? |
| title_sort | should we change the treatment plan in early hepatocellular carcinoma with chronic kidney disease |
| topic | hepatocellular carcinoma chronic kidney disease hepatectomy radiofrequency ablation survival |
| url | https://doi.org/10.1186/s12893-023-01983-y |
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