HEPATOCELLULAR CARCINOMA (HCC): RESECTION WITH ADJUVANT HEPATIC ARTERY INFUSION CHEMOTHERAPY (HAIC) VERSUS RESECTION ALONE. A SYSTEMATIC REVIEW AND META-ANALYSIS.
Abstract
BACKGROUND: HCC has a recurrence rate of up to 70% in 5 years after resection detrimentally lowering survival. The role of adjuvant HAIC in management of HCC is controversial. METHODS: A comprehensive search of multiple... [ view full abstract ]
BACKGROUND: HCC has a recurrence rate of up to 70% in 5 years after resection detrimentally lowering survival. The role of adjuvant HAIC in management of HCC is controversial. METHODS: A comprehensive search of multiple databases was conducted (Jan 1994 - August 2016). Comparative studies including patients with HCC, not transplant candidates, undergoing surgical resection with HAIC vs surgical resection alone were reviewed. Pooled risk ratios and 95% CI for overall and disease-free survival at 1, 3 and 5 years were calculated. RESULTS: 10 studies with 595 HCC patients were included; 283 underwent resection with HAIC and 312 underwent resection alone. Mean age was 61 years with a male/female ratio of 6/1. Meta-analysis showed better OS in the adjuvant group at 1-YR (RR:1.15, CI:1.07 – 1.24, p=0.095, NS), 3-YR (RR:1.57, CI:1.34 – 1.77, p<0.01) and 5-YR (RR:1.71, CI:1.33 – 2.20, p<0.01). Median survival time for the adjuvant group was 54.94 months compared to 31.5 months in the control group. In addition, DFS was better with HAIC at 1-YR (RR:1.36, CI:1.21 – 1.54, p<0.01), 3-YR (RR:1.59, CI:1.27 – 1.98, p<0.01) and 5-YR (RR:1.85, CI:132. – 2.61, p=0.011). The median DFS time for the adjuvant group was 17.5 months compared to 7.35 months for the group. Subgroup analysis showed that this survival advantage was more significant in patients with tumors ³7cm (p<0.05). CONCLUSION: Combination of HCC resection with HAIC improve overall and disease-free survival of patients with HCC who are not candidates for transplantation, especially in tumors ³ 7cm.
Authors
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Alexandra Moran
(University of Miami – Miller School of Medicine, Miami, Florida, USA)
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Lorena Flor Ramos
(University of Miami Leonard M. Miller School of Medicine, Miami, Florida, U.S.A.)
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Omar Picado
(University of Miami Leonard M. Miller School of Medicine, Miami, Florida, U.S.A.)
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Cynthia Da Costa
(University of Miami Leonard M. Miller School of Medicine, Miami, Florida, U.S.A.)
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Vikas Dudeja
(University of Miami Leonard M. Miller School of Medicine, Miami, Florida, U.S.A.)
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Danny Sleeman
(University of Miami Leonard M. Miller School of Medicine, Miami, Florida, U.S.A.)
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Nipun Merchant
(University of Miami Leonard M. Miller School of Medicine, Miami, Florida, U.S.A.)
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Danny Yakoub
(University of Miami – Miller School of Medicine, Miami, Florida, USA)
Topic Areas
Surgical Oncology , Other
Session
QS-SurgOnc » Quick-Shot Presentations: Surgical Oncology (15:00 - Thursday, 21st September, Lee 404)