Parikh Neehar D, Patel Ravi, Hu Jenny, Stirnadel-Farrant Heide A, Kebede Nehemiah, Wang Cindy, Garcia-Reyes Kirema
Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA.
Oncology Outcomes Research, AstraZeneca, Gaithersburg, MD, USA.
Hepat Oncol. 2025 Dec;12(1):2530377. doi: 10.1080/20450923.2025.2530377. Epub 2025 Jul 24.
Real-world outcomes in early-stage hepatocellular carcinoma (eHCC) are not well characterized. We aimed to evaluate treatment patterns and long-term outcomes in patients with eHCC treated with resection or ablation in the United States.
We conducted a retrospective study with Optum's de-identified Market Clarity Data. Patient characteristics, treatment patterns, and overall survival (OS) were assessed in adults with eHCC treated with resection or ablation between July 2016 and March 2021.
Of 649 patients who met inclusion criteria, 59.3%, 37.3%, and 3.4% underwent ablation only, resection only, or both, as their initial treatment, respectively. Median age was 64.0 years; most patients were male (72.9%) and White (65.5%). Subsequent treatment was received in 47.1% of patients. The median (quartile 1-3) time to first subsequent treatment was 216 (89.3-414.3) days. The most common subsequent treatments included embolization (22.7%) and ablation (15.6%). In total, 35.7% of patients died post-index. Median OS was 67.7 (95% CI: 56.4-not estimable) months. Estimated 24-month OS was 79.0% (95% CI: 75.0-82.0).
Our results highlight the need for post-treatment surveillance and the potential role for neoadjuvant and/or adjuvant treatments to improve outcomes in patients with eHCC treated with resection or ablation.
早期肝细胞癌（eHCC）的真实世界转归尚未得到充分描述。我们旨在评估在美国接受手术切除或消融治疗的eHCC患者的治疗模式和长期转归。
我们使用Optum公司经过去识别处理的市场透明度数据进行了一项回顾性研究。对2016年7月至2021年3月期间接受手术切除或消融治疗的成年eHCC患者的特征、治疗模式和总生存期（OS）进行了评估。
在649例符合纳入标准的患者中，分别有59.3%、37.3%和3.4%的患者最初仅接受消融治疗、仅接受手术切除或两者都接受。中位年龄为64.0岁；大多数患者为男性（72.9%）且为白人（65.5%）。47.1%的患者接受了后续治疗。首次后续治疗的中位（四分位间距1-3）时间为216（89.3-414.3）天。最常见的后续治疗包括栓塞（22.7%）和消融（15.6%）。总共有35.7%的患者在索引事件后死亡。中位OS为67.7（95%CI：56.4-不可估计）个月。估计24个月的OS为79.0%（95%CI：75.0-82.0）。
我们的结果强调了治疗后监测的必要性以及新辅助和/或辅助治疗在改善接受手术切除或消融治疗的eHCC患者转归方面的潜在作用。
