Background:Hepatocellular carcinoma (HCC) with hepatic vein invasion (HVI) is classified as advanced stage and palliative management is the primary treatment option. This study compared the long-term outcomes of curative and non-curative treatments in patients of HCC with HVI.Methods:Data were obtained from a retrospective multicenter cohort of the Korean Primary Liver Cancer Registry. We reviewed 18,315 patients newly diagnosed with HCC between 2008 and 2019. After propensity score matching based on the albumin-bilirubin (ALBI) score; tumor number, and tumor size, clinical outcomes were compared between the curative group (n= 42, 29.0%) undergoing surgical resection or local ablation and the non-curative group (n= 103, 71.0%) receiving other treatments.Results:Tumor burdens such as tumor number, maximum tumor size, levels of alpha-fetoprotein (AFP), and protein induced by absence of vitamin K or antagonist-II did not differ significantly between the groups (p= 0.672,p= 0.143,p= 0.153 andp= 0.651, respectively). In long-term outcomes, the overall survival (OS) and cancer-specific survival (CSS) were significantly better in the curative group compared to the non-curative group (p< 0.001, both). Multivariate analysis indicated that non-curative treatment, ALBI grade ≥ 2, and AFP ≥ 400 ng/mL were common risk factors for OS and CSS.Conclusions:Curative-intent treatment has the potential to significantly enhance long-term outcomes in selected patients of HCC with HVI who preserved liver function and performance status.
背景：肝细胞癌（HCC）伴肝静脉侵犯（HVI）被归类为晚期阶段，姑息性治疗是主要治疗选择。本研究比较了HCC伴HVI患者接受根治性与非根治性治疗的长期预后。 方法：数据来源于韩国原发性肝癌登记处的回顾性多中心队列。我们回顾了2008年至2019年间新诊断为HCC的18,315例患者。基于白蛋白-胆红素（ALBI）评分、肿瘤数目和肿瘤大小进行倾向评分匹配后，比较了接受手术切除或局部消融的根治组（n=42，29.0%）与接受其他治疗的非根治组（n=103，71.0%）的临床结局。 结果：两组间肿瘤负荷指标如肿瘤数目、最大肿瘤直径、甲胎蛋白（AFP）水平及维生素K缺乏或拮抗剂-II诱导蛋白水平均无显著差异（p值分别为0.672、0.143、0.153和0.651）。在长期预后方面，根治组的总生存期（OS）和癌症特异性生存期（CSS）均显著优于非根治组（p值均<0.001）。多变量分析显示，非根治性治疗、ALBI分级≥2级及AFP≥400 ng/mL是OS和CSS的共同危险因素。 结论：对于肝功能及体能状态良好的选择性HCC伴HVI患者，根治性治疗可能显著改善其长期预后。
肿瘤(癌症)患者之家