Natural History of T1N0M0 Hepatocellular Carcinoma: Large-Scale Study in the United States.

Al-Shamsi HO, Abdel-Wahab R, Hassan MM, Shalaby AS, Dahbour I, Lacin S, Mahvash A, Odisio BC, Murthy R, Avritscher R, Abdelsalam ME, Rashid A, Vauthey JN, Aloia TA, Conrad C, Chun YS, Krishnan S, Das P, Koay EJ, Amin HM, Yao JC, Kaseb AO.
Oncology. 2017;93(4):233-242. doi: 10.1159/000455957. Epub 2017 Jul 6.


Background—Hepatocellular carcinoma (HCC) Prognosis is depending on clinicopathological features in addition to treatment provided. We aimed to assess the natural history of TNM stage I HCC tumors which received different treatment over a period of twenty years.

Methods—Between 1992 till 2011 a total of 397 stage I HCC patients were included. Detailed information were retrieved from MD Anderson Cancer Center patients’ medical records. Kaplan-Meier method was used to calculate Patients’ overall survival (OS). Cox regression analysis was used to calculate the estimate hazard ratio (HR) and 95% confidence interval (CI) of different prognostic factors.

Results—Out of 397 patients, we have 67.5% males, 42.8% hepatitis related HCC, and 59.7% have underlying cirrhosis. After adjustment for confounding factors we found that all therapeutic modalities associated with significant mortality rate reduction with overall survival of 63, 42.03, 34.3, 22.1 months among patients treated with surgery, ablation, local, and systemic therapy respectively. Restricted analysis among cirrhotic and non-cirrhotic patients showed that ablative and local therapy significantly associated with longer OS compared to systemic therapy.

Conclusion—TNM Stage I HCC patients have favorable prognosis regardless of the type of treatment. Notably, ablative and local therapy significantly improved OS compared to systemic therapy.

TNM; Stage I; hepatocellular carcinoma

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