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Al B. Benson III, MD, FACP, FASCO
Al B. Benson III, MD, FACP, FASCO
Posted: Wednesday, March 22, 2023
An article published in the British Journal of Cancer explored the curative probabilities of patients with hepatocellular carcinoma who undergo ablation and provided a curative calculator intended to help determine a course of therapy. “Treatment of hepatocellular carcinoma is predicated on early diagnosis such that the ‘potentially curative therapies’ of hepatic resection, liver transplantation, or ablation can be successfully applied. However, the term ‘potentially curative’ is vague and poorly quantified,” said study author Philip J. Johnson, MD, FRCP, of the University of Liverpool, United Kingdom, and colleagues.
Data from a total of 1,571 patients with hepatocellular carcinoma treated with either radiofrequency or microwave ablation were combined with previous estimates of patients undergoing various curative therapies. The retrospective analysis revealed a median follow-up after ablation of 4.7 years, with 925 patients having recurrence and 629 who died. The authors determined an overall cure fraction rate of 18.3%. A parametric regression revealed the 25th percentile of cure fraction is 11.9%, and the 75th percentile is 26%. The authors noted that patients with very early disease had the highest likelihood of cure, with a 39.8% curative fraction rate.
The authors next used an analysis to determine the years of life lost, demonstrating that the rate decreases with age. Male and female patients had similar years of life lost, which is explained by women obtaining a diagnosis at an older age than men. A parametric curve model displayed a 25th percentile, corresponding to 11.5 years of life lost, and a 75th percentile of 22.7 years of life lost. The authors combined both curative fraction and years of life lost analysis in the calculator to determine the best course of therapy.
Disclosure: The study authors reported no conflicts of interest.
