{"title":"孤立性小肝细胞癌的手术或外束放疗。","authors":"Xiaoxue Wu, Mengchao Wei, Yong Chen, Zhenwei Peng","doi":"10.4103/jcrt.JCRT_1604_20","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>There is little evidence on the efficacy of external beam radiation (EBR) compared to liver resection (LR) for patients with solitary small (≤5 cm) hepatocellular carcinoma (HCC).</p><p><strong>Objective: </strong>We aimed to investigate this clinical question based on the Surveillance, Epidemiology, and End Results (SEER) database.</p><p><strong>Method: </strong>SEER database was used to identify 416 patients with solitary small HCC who underwent LR or EBR. Survival analysis and Cox proportional hazards model were performed to evaluate overall survival (OS) and identify prognostic factors for OS. Propensity score matching (PSM) method was used to adjust the baseline characteristics of the two groups.</p><p><strong>Result: </strong>Before PSM, the 1- and 2-year OS rates were 92.0% and 85.2% in the LR cohort and 76.0% and 60.3% in the EBR cohort, respectively (P < 0.001). After PSM, LR (n = 62) demonstrated improved OS compared to EBR (n = 62) (1-year OS rate: 96.5% vs. 76.0%; 2-year OS rate: 89.3% vs. 60.3%, P < 0.001), despite stratification on tumor size. Multivariate Cox regression analysis indicated that treatment type was the only factor associated with OS (hazard ratio: 5.297; 95% confidence interval: 1.952-14.371, P = 0.001).</p><p><strong>Conclusion: </strong>For patients with solitary small HCC, LR may offer better survival outcomes than EBR.</p>","PeriodicalId":15208,"journal":{"name":"Journal of cancer research and therapeutics","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Surgery or external beam radiation for solitary small hepatocellular carcinoma.\",\"authors\":\"Xiaoxue Wu, Mengchao Wei, Yong Chen, Zhenwei Peng\",\"doi\":\"10.4103/jcrt.JCRT_1604_20\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>There is little evidence on the efficacy of external beam radiation (EBR) compared to liver resection (LR) for patients with solitary small (≤5 cm) hepatocellular carcinoma (HCC).</p><p><strong>Objective: </strong>We aimed to investigate this clinical question based on the Surveillance, Epidemiology, and End Results (SEER) database.</p><p><strong>Method: </strong>SEER database was used to identify 416 patients with solitary small HCC who underwent LR or EBR. Survival analysis and Cox proportional hazards model were performed to evaluate overall survival (OS) and identify prognostic factors for OS. Propensity score matching (PSM) method was used to adjust the baseline characteristics of the two groups.</p><p><strong>Result: </strong>Before PSM, the 1- and 2-year OS rates were 92.0% and 85.2% in the LR cohort and 76.0% and 60.3% in the EBR cohort, respectively (P < 0.001). After PSM, LR (n = 62) demonstrated improved OS compared to EBR (n = 62) (1-year OS rate: 96.5% vs. 76.0%; 2-year OS rate: 89.3% vs. 60.3%, P < 0.001), despite stratification on tumor size. Multivariate Cox regression analysis indicated that treatment type was the only factor associated with OS (hazard ratio: 5.297; 95% confidence interval: 1.952-14.371, P = 0.001).</p><p><strong>Conclusion: </strong>For patients with solitary small HCC, LR may offer better survival outcomes than EBR.</p>\",\"PeriodicalId\":15208,\"journal\":{\"name\":\"Journal of cancer research and therapeutics\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2023-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of cancer research and therapeutics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4103/jcrt.JCRT_1604_20\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of cancer research and therapeutics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4103/jcrt.JCRT_1604_20","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景:对于孤立性小(≤5 cm)肝细胞癌(HCC)患者，外束放疗(EBR)与肝切除术(LR)的疗效比较的证据很少。目的:我们旨在根据监测、流行病学和最终结果(SEER)数据库调查这一临床问题。方法:采用SEER数据库对416例行LR或EBR的孤立性小肝癌患者进行分析。采用生存分析和Cox比例风险模型评估总生存期(OS)并确定OS的预后因素。采用倾向评分匹配(PSM)方法调整两组的基线特征。结果:PSM前，LR组1年和2年OS分别为92.0%和85.2%，EBR组为76.0%和60.3% (P < 0.001)。PSM后，与EBR (n = 62)相比，LR (n = 62)表现出改善的OS(1年OS率:96.5% vs. 76.0%;尽管肿瘤大小分层，2年OS率:89.3% vs. 60.3% (P < 0.001)。多因素Cox回归分析显示，治疗类型是影响OS的唯一因素(风险比:5.297;95%置信区间:1.952-14.371,P = 0.001)。结论:对于孤立性小肝癌患者，LR可能比EBR提供更好的生存结果。
Surgery or external beam radiation for solitary small hepatocellular carcinoma.
Background: There is little evidence on the efficacy of external beam radiation (EBR) compared to liver resection (LR) for patients with solitary small (≤5 cm) hepatocellular carcinoma (HCC).
Objective: We aimed to investigate this clinical question based on the Surveillance, Epidemiology, and End Results (SEER) database.
Method: SEER database was used to identify 416 patients with solitary small HCC who underwent LR or EBR. Survival analysis and Cox proportional hazards model were performed to evaluate overall survival (OS) and identify prognostic factors for OS. Propensity score matching (PSM) method was used to adjust the baseline characteristics of the two groups.
Result: Before PSM, the 1- and 2-year OS rates were 92.0% and 85.2% in the LR cohort and 76.0% and 60.3% in the EBR cohort, respectively (P < 0.001). After PSM, LR (n = 62) demonstrated improved OS compared to EBR (n = 62) (1-year OS rate: 96.5% vs. 76.0%; 2-year OS rate: 89.3% vs. 60.3%, P < 0.001), despite stratification on tumor size. Multivariate Cox regression analysis indicated that treatment type was the only factor associated with OS (hazard ratio: 5.297; 95% confidence interval: 1.952-14.371, P = 0.001).
Conclusion: For patients with solitary small HCC, LR may offer better survival outcomes than EBR.
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The journal will cover technical and clinical studies related to health, ethical and social issues in field of Medical oncology, radiation oncology, medical imaging, radiation protection, non-ionising radiation, radiobiology. Articles with clinical interest and implications will be given preference.
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