Detailed Abstract
[E-poster - Liver (Liver Disease/Surgery)]
[EP 029] Association of adjuvant radiotherapy with long-term overall and recurrence-free survival following hepatectomy for hepatocellular carcinoma: A multicenter propensity-matched study
Xiao-Xue GOU1 , Hong-Yun SHI1 , Chao LI2 , Zheng-Liang CHEN3 , Wei OUYANG4 , Li-Yang SUN5 , Timothy M. PAWLIK6 , Wan Yee LAU7 , Feng SHEN2 , Jun XUE8 , Tian YANG*2
1 Radiotherapy, Affiliated Hospital Of Hebei University, CHINA
2 Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), CHINA
3 Hepatobiliary Surgery, The First Affiliated Hospital Of Harbin Medical University, CHINA
4 Medical Oncology, The First Affiliated Hospital Of Soochow University, CHINA
5 Hepatobiliary Surgery, Zhejiang Provincial People's Hospital, People's Hospital Of Hangzhou Medical College, CHINA
6 Surgery, Ohio State University, Wexner Medical Center, UNITED STATES OF AMERICA
7 Faculty Of Medicine, The Chinese University Of Hong Kong, CHINA
8 Cancer Center, Union Hospital, Tongji Medical College, Huazhong University Of Science And Technology, CHINA
Background : R0 resection with wide margins is the gold standard for hepatocellular carcinoma (HCC), yet R0 resection with narrow-margin and even R1 resection is not uncommon in real-world clinical practice. We sought to characterize the efficacy of adjuvant radiotherapy on long-term oncological survival following hepatectomy for HCC with close/positive surgical margins using propensity-matched analysis.
Methods : Using a multi-institutional database, patients with HCC who underwent hepatectomy with close margins (0.1~1.0cm) or pathologically positive margins were analyzed. Using propensity score matching (PSM) and multivariate Cox-regression analysis, the effect of adjuvant radiotherapy on long-term overall survival (OS) and recurrence-free survival (RFS) was evaluated.
Results : Among 683 patients who met inclusion criteria, 82 patients received adjuvant radiotherapy within 10 weeks after surgery. Radiotherapy-related major toxicity was minimal among patients receiving adjuvant radiotherapy. PSM analysis created 78 matched pairs of patients. In the PSM cohort, median OS and RFS among patients treated with adjuvant radiotherapy were more favorable than individuals who were not treated (72.5 and 37.3 months vs. 52.5 and 24.0 months, both P<0.05). After adjustment for other confounding factors on multivariate analyses, adjuvant radiotherapy remained independently associated with favorable OS and RFS following hepatectomy with close/positive margins for HCC (HRs: 0.821 and 0.827, respectively).
Conclusions : Despite the lack of consensus on the role of adjuvant radiotherapy following HCC resection, this PSM analysis suggested improved OS and RFS with adjuvant radiotherapy following hepatectomy with close/positive margins for HCC. Future randomized controlled trials are needed to further define the survival benefit of adjuvant radiotherapy for patients with HCC.
Methods : Using a multi-institutional database, patients with HCC who underwent hepatectomy with close margins (0.1~1.0cm) or pathologically positive margins were analyzed. Using propensity score matching (PSM) and multivariate Cox-regression analysis, the effect of adjuvant radiotherapy on long-term overall survival (OS) and recurrence-free survival (RFS) was evaluated.
Results : Among 683 patients who met inclusion criteria, 82 patients received adjuvant radiotherapy within 10 weeks after surgery. Radiotherapy-related major toxicity was minimal among patients receiving adjuvant radiotherapy. PSM analysis created 78 matched pairs of patients. In the PSM cohort, median OS and RFS among patients treated with adjuvant radiotherapy were more favorable than individuals who were not treated (72.5 and 37.3 months vs. 52.5 and 24.0 months, both P<0.05). After adjustment for other confounding factors on multivariate analyses, adjuvant radiotherapy remained independently associated with favorable OS and RFS following hepatectomy with close/positive margins for HCC (HRs: 0.821 and 0.827, respectively).
Conclusions : Despite the lack of consensus on the role of adjuvant radiotherapy following HCC resection, this PSM analysis suggested improved OS and RFS with adjuvant radiotherapy following hepatectomy with close/positive margins for HCC. Future randomized controlled trials are needed to further define the survival benefit of adjuvant radiotherapy for patients with HCC.
SESSION
E-poster
E-Session 03/03 ~ 03/05 ALL DAY