Work

Significant Improvement in Long-Term Survival after Liver Resection for Hepatocellular Carcinoma: Evolving Outcomes over 20 Years

Year: 2025

Type: article

Abstract: Purpose: Advanced techniques and multidisciplinary approaches have improved hepatocellular carcinoma (HCC) surgical outcomes.This study updates the long-term survival after liver resection (LR) for HCC based on over 20 years of experience.Materials and Methods: Between 1996 and 2017, 1963 patients with HCC underwent LR.After excluding 185 patients who received preoperative therapy, 1778 treatment-naïve HCC patients were included.Clinicopathological characteristics and surgical outcomes were compared across three periods: 1 (1996-2007), 2 (2008-2012), and 3 (2013-2017).Prognostic factors for overall survival (OS) and disease-free survival (DFS) were analyzed using Cox regression analysis.Results: Recent trends indicate increased diagnoses at older ages, number of non-B and non-C HCC cases and decreased incidence of cirrhosis.Minor, non-anatomical, and minimally invasive LR have become more prevalent.In period 3, short-term outcomes improved, as 90-day mortality decreased to 0.3% and major complications to 5.0%.Long-term outcomes improved (5-year OS: 68.1% vs. 80.7% vs. 90.5%,p<0.001; 5-year DFS: 41.4% vs. 50.7%vs. 61.1%,p<0.001), and early recurrence rates decreased in period 3 (34.0%vs. 34.0%vs. 25.8%,p<0.001).Factors such as smaller tumor size, decreased incidence of cirrhosis, fewer intraoperative transfusions, and fewer major complications have contributed to improved OS and DFS.Conclusion: Remarkable improvements in 5-year OS and DFS were observed after curative LR for HCC, particularly in period 3. Advancements in surgical outcomes, including very low short-term mortality, along with improved surgical techniques, early detection, and refined patient selection, are likely key factors in this progress.

Source: Yonsei Medical Journal

DOI: 10.3349/ymj.2024.0087

Authors: Na Reum Kim, Gi Hong Choi, Dai Hoon Han, Kyung Sik Kim, Jin Sub Choi

Institutions: Yonsei University, Yonsei University Health System

Language: English

Topic: Hepatocellular Carcinoma Treatment and Prognosis

Subfield: Hepatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $700