Not resecting ideal candidates ups mortality in liver cancer
Sasan Roayaie, M.D., from Lenox Hill Hospital in New York City, and colleagues examined how frequently guidelines recommending surgical resection as the primary treatment for a single HCC were followed. Data were obtained from the multiregional BRIDGE cohort study, which included 8,656 patients from 20 sites. Patients were classified into four groups: 718 ideal resection candidates who were resected (A); 144 ideal candidates who were not resected (B); 1,624 non-ideal candidates who were resected (C); and 6,170 non-ideal candidates who were not resected (D).
The researchers found that during a median follow-up of 27 months, the risk of mortality was higher with treatments other than resection for ideal resection candidates (groups A and B). Portal hypertension and bilirubin >1 mg/dL were not associated with mortality in all resected patients (groups A and C). Resection correlated with better survival than embolization and "other" treatments, but was inferior to ablation and transplantation for all patients who were non-ideal candidates for resection (groups C and D).
"The study suggests that selection criteria for resection may be modestly expanded without compromising outcomes, and that some non-ideal candidates may still potentially benefit from resection over other treatment modalities," the authors write.
Several authors disclosed financial ties to pharmaceutical companies, including Bristol-Meyers Squibb, which funded the BRIDGE database and data collection.
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