Department of Radiotherapy, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, Guangdong, China.
Department of Hepatic Surgery, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, Guangdong, China.
J Cancer Res Ther. 2023 Apr;19(Supplement):S166-S171. doi: 10.4103/jcrt.JCRT_1604_20.
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).
We aimed to investigate this clinical question based on the Surveillance, Epidemiology, and End Results (SEER) database.
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.
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).
For patients with solitary small HCC, LR may offer better survival outcomes than EBR.
对于单发小肝癌（≤5cm）患者，与肝切除术（LR）相比，外照射放疗（EBR）的疗效证据有限。
我们旨在基于监测、流行病学和最终结果（SEER）数据库来研究这一临床问题。
我们使用 SEER 数据库确定了 416 例接受 LR 或 EBR 治疗的单发小 HCC 患者。进行生存分析和 Cox 比例风险模型，以评估总生存率（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。
在 PSM 之前，LR 组的 1 年和 2 年 OS 率分别为 92.0%和 85.2%，EBR 组分别为 76.0%和 60.3%（P < 0.001）。PSM 后，LR（n = 62）组的 OS 较 EBR（n = 62）组改善（1 年 OS 率：96.5%比 76.0%；2 年 OS 率：89.3%比 60.3%，P < 0.001），尽管在肿瘤大小上进行了分层。多因素 Cox 回归分析表明，治疗类型是唯一与 OS 相关的因素（风险比：5.297；95%置信区间：1.952-14.371，P = 0.001）。
对于单发小 HCC 患者，LR 可能比 EBR 提供更好的生存结果。
