What Is the Best Local Therapy for HCC?: It Actually Matters More How They All Work Together
Menée à l'aide de données 2008-2020 de registres portant sur 720 patients atteints d'un carcinome hépatocellulaire et présentant 2 ou 3 nodules (75,4 % d'hommes), cette étude compare la survie en fonction du traitement (résection hépatique, ablation percutanée par radiofréquence ou chimio-embolisation transartérielle)
Screening and surveillance strategies allow us to diagnose hepatocellular carcinoma (HCC) at early stages. This disease, which is the third highest killer of human cancers, is now being diagnosed when the tumor is small and highly treatable. However, even when discovered by surveillance and screening, the presentation of HCC is often multinodular. This has led to a debate on which local therapy is best in the setting of multifocal presentation. Most Eastern guidelines recommend resection of the hepatic resection when possible, while Western guidelines often recommend thermal ablation or transarterial chemoembolization. The article in this issue of JAMA Surgery by Vitale et al is a superb multicenter collected series composed of data from 2 large Italian registries collected between 2008 and 2020. By univariate and multivariate analysis, the investigators present convincing data that liver resection leads to superior 3- and 5-year survivals. They also demonstrate on multivariate analysis that outside of baseline liver function, resection is the most important factor for long-term survival.