Shandong First Medical University and Shandong Academy of Medical Sciences, 6699 Qingdao Road, Huaiyin District, Jinan, 250117, China.
Department of Hepatobiliary Surgery, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical sciences, 440 Jiyan Road, Jinan, 250117, China.
BMC Gastroenterol. 2024 Oct 17;24(1):369. doi: 10.1186/s12876-024-03457-8.
The purpose of this study was to interpret real-world clinical data to analyze the surgical safety and survival outcomes of patients with initial unresectable hepatocellular carcinoma (uHCC) after conversion therapy.
A retrospective analysis was performed on 2984 hepatocellular carcinoma (HCC) patients hospitalized in Shandong Cancer Hospital Affiliated to Shandong First Medical University from June 1st, 2019 to June 1st, 2023. Clinicopathological features, response to systemic and/or loco-regional treatments, surgical resection rate after conversion therapy, surgical safety, and postoperative recurrence were analyzed.
A total of 38 patients were successfully converted to obtain surgical resection. 35 patients underwent radical resection. A high objective response rate (ORR) (52.6% under RECIST v1.1 and 78.9% under mRECIST criteria) was observed in patients under conversion therapy, and the disease control rate (DCR) was 100%. Pathologic complete response (pCR) was 42.9%. Treatment-related adverse events (TRAEs) of any grade were observed in 37 patients (97.4%). Safety of conversion or direct surgery continues to improve. The median follow-up time was 19.3 months. The 1-year Disease-free survival (DFS) rate of patients with direct surgery and patients with conversion surgery were 91.4% and 86.8%, respectively.
With conversion therapy, a small percentage (1.81%) of uHCC patients are likely to be converted to radical resection. Local combined systemic therapy is a relatively safe and effective conversion therapy, and the safety of surgery is gradually improved after successful conversion. Preliminary follow-up data showed satisfactory survival benefits for patients undergoing conversion surgery.
This was a retrospective study and it did not interfere with treatment decisions.
本研究旨在解读真实世界的临床数据，分析初始不可切除肝细胞癌（uHCC）患者经转化治疗后的手术安全性和生存结局。
回顾性分析 2019 年 6 月 1 日至 2023 年 6 月 1 日期间在山东省肿瘤医院住院的 2984 例肝细胞癌（HCC）患者的临床病理特征、全身和/或局部治疗的反应、转化治疗后手术切除率、手术安全性以及术后复发情况。
共有 38 例患者成功转化并获得手术切除。35 例患者接受根治性切除术。转化治疗患者的客观缓解率（ORR）较高（RECIST v1.1 下为 52.6%，mRECIST 标准下为 78.9%），疾病控制率（DCR）为 100%。病理完全缓解（pCR）率为 42.9%。37 例患者（97.4%）观察到与治疗相关的不良事件（TRAEs）任何级别。转化或直接手术的安全性持续提高。中位随访时间为 19.3 个月。直接手术和转化手术患者的 1 年无病生存率（DFS）分别为 91.4%和 86.8%。
通过转化治疗，少数（1.81%）uHCC 患者可能转化为根治性切除。局部联合全身治疗是一种相对安全有效的转化治疗方法，成功转化后手术安全性逐渐提高。初步随访数据显示，转化手术患者的生存获益令人满意。
这是一项回顾性研究，不影响治疗决策。
