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Front Oncol: The impact of the severity of liver cirrhosis on surgery (LR) and microwave ablation (PMCT) in patients with hepatocellular carcinoma

 Last Update: 2021-10-20
 Source: Internet
 Author: User

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Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in the world, and its incidence has been increasing in recent years
.

It is worth noting that the best treatment for patients with early liver cancer is still controversial, especially those with different degrees of liver cirrhosis

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in the world, and its incidence has been increasing in recent years

This study retrospectively analyzed 230 patients with single HCC lesions ≤3 cm and Child-Pugh A liver function
.

Among these patients, 122 patients received LR and 108 received PMCT

This study retrospectively analyzed 230 patients with single HCC lesions ≤3 cm and Child-Pugh A liver function

CSS score

The liver function of all patients was Child-Pugh A, and there was no statistical difference in baseline characteristics between the two groups
.

Approximately 88.

The liver function of all patients was Child-Pugh A, and there was no statistical difference in baseline characteristics between the two groups

Kaplan-Meier curve analysis showed that OS and disease-free survival (DFS) of the LR group were better than those of the PMCT group

DFS and OS

In multivariate analysis, serum bilirubin (HR=2.
114, 95% CI: 1.
076-4.
155, p<0.
05), liver cirrhosis (HR=3.
022, 95% CI: 1.
132-8.
064, p<0.
05) and CSS (HR =4.
570, 95% CI: 1.
499-13.
934, p <0.
01) were independent risk factors for DFS
.

Multivariate analysis showed that the independent prognostic factors of OS included serum bilirubin (HR=1.

In multivariate analysis, serum bilirubin (HR=2.

Prognostic factors of DFS and OS

Further analysis of the subgroup based on the CSS assessment of liver cirrhosis, when the CSS score ≥ 4, the 5-year DFS rates of LR and PMCT treatment were 22.
8% and 16.
2%, respectively (p=0.
818)
.

The 5-year OS rates in the LR group and PMCT group were 41.

Further analysis of the subgroup based on the CSS assessment of liver cirrhosis, when the CSS score ≥ 4, the 5-year DFS rates of LR and PMCT treatment were 22.

OS and DFS in patients with CSS≥4

In the first 90 days after treatment, there was no death in both groups
.
Hepatic bleeding (10/122 vs.
0/108) and pain (58/122 vs.
13/108) in the LR group were significantly higher than those in the PMCT group (p<0.
05)
.
Pleural effusion (9/122 vs.
1/108) and ascites (15/122 vs.
5/108) in the LR group were significantly more common (p<0.
05)
.
No serious complications such as liver abscess, abdominal hemorrhage, liver infarction, biliary peritonitis, etc.
occurred
.
The main complications in the LR group were significantly more than those in the PMCT group (18.
8% vs.
4.
6%, p<0.
001)
.
Among patients with CSS≥4, the incidence of major complications in the LR group and PMCT group were 28.
4% and 5.
9%, respectively (p = 0.
001)
.
The length of hospital stay in the LR group was significantly longer than that in the PMCT group, and the total hospitalization cost was significantly higher than that in the PMCT group
.
Hepatic bleeding (10/122 vs.
0/108) and pain (58/122 vs.
13/108) in the LR group were significantly higher than those in the PMCT group (p<0.
05)
.
Pleural effusion (9/122 vs.
1/108) and ascites (15/122 vs.
5/108) in the LR group were significantly more common (p<0.
05)
.
The main complications in the LR group were significantly more than those in the PMCT group (18.
8% vs.
4.
6%, p<0.
001)
.
Among patients with CSS≥4, the incidence of major complications in the LR group and PMCT group were 28.
4% and 5.
9%, respectively (p = 0.
001)
.
The length of hospital stay in the LR group was significantly longer than that in the PMCT group, and the total hospitalization cost was significantly higher than that in the PMCT group
.
Among patients with CSS≥4, the incidence of major complications in the LR group and PMCT group were 28.
4% and 5.
9%, respectively (p = 0.
001)
.
The length of hospital stay in the LR group was significantly longer than that in the PMCT group, and the total hospitalization cost was significantly higher than that in the PMCT group
.

In summary, studies have shown that for HCC with a single nodule ≤ 3 cm and liver function Child-Pugh A, the OS and DFS of LR treatment are better than PMCT
.
But for patients with severe liver cirrhosis, PMCT may be better
.
Studies have shown that for HCC with a single nodule ≤ 3 cm and liver function Child-Pugh A, the OS and DFS of LR treatment are better than PMCT
.
But for patients with severe liver cirrhosis, PMCT may be better
.
Studies have shown that for HCC with a single nodule ≤ 3 cm and liver function Child-Pugh A, the OS and DFS of LR treatment are better than PMCT
.
But for patients with severe liver cirrhosis, PMCT may be better
.

Original source:

Li J, Tao Hs, Li J, Wang Wq, Sheng Ww, Huang Zy and Zhang El (2021) Effect of Severity of Liver Cirrhosis on Surgical Outcomes of Hepatocellular Carcinoma After Liver Resection and Microwave Coagulation.
Front.
Oncol.
11:745615.
doi: 10.
3389/fonc.
2021.
745615

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