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Stereotactic body radiation therapy versus surgical resection for stage I/II hepatocellular carcinoma

SBRT is an emerging locoregional treatment modality for hepatocellular carcinoma (HCC). Although local tumor control rates seem encouraging, large-scale survival data comparing SBRT to surgical resection are lacking. We identified patients with stage I/II HCC from the National Cancer Database amenab...

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Bibliographic Details
Main Authors: Birgin, Emrullah (Author) , Hetjens, Svetlana (Author) , Tam, Moses (Author) , Correa-Gallego, Camilo (Author) , Rahbari, Nuh Nabi (Author)
Format: Article (Journal)
Language:English
Published: 17 April 2023
In: Cancers
Year: 2023, Volume: 15, Issue: 8, Pages: 1-14
ISSN:2072-6694
DOI:10.3390/cancers15082330
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.3390/cancers15082330
Verlag, kostenfrei, Volltext: https://www.mdpi.com/2072-6694/15/8/2330
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Author Notes:Emrullah Birgin, Svetlana Hetjens, Moses Tam, Camilo Correa-Gallego and Nuh N. Rahbari
Description
Summary:SBRT is an emerging locoregional treatment modality for hepatocellular carcinoma (HCC). Although local tumor control rates seem encouraging, large-scale survival data comparing SBRT to surgical resection are lacking. We identified patients with stage I/II HCC from the National Cancer Database amenable for potential surgical resection. Patients undergoing hepatectomy were matched by propensity score (1:2) with patients who underwent SBRT as primary treatment. A total of 3787 (91%) and 366 (9%) patients underwent surgical resection or SBRT between 2004 and 2015, respectively. After propensity matching, the 5-year overall survival was 24% (95% CI 19-30%) in the SBRT group versus 48% (95% CI 43-53%) in the surgery group (p < 0.001). The association of surgery with overall survival was consistent in all subgroups. In patients treated with SBRT, a biologic effective dose (BED) of ≥100 Gy (31%, 95% CI 22%-40%) compared with BED < 100 Gy (13%, 95% CI 8-22%) was associated with a higher 5-year overall survival rate (hazard ratio of mortality of 0.58, 95% CI 0.43-0.77; p < 0.001). Surgical resection may be associated with prolonged overall survival compared with SBRT in patients with stage I/II HCC.
Item Description:Gesehen am 19.03.2024
Physical Description:Online Resource
ISSN:2072-6694
DOI:10.3390/cancers15082330

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