University of Oulu

KAIRALUOMA, V., KARJALAINEN, M., POHJANEN, V.-M., SAARNIO, J., NIEMELÄ, J., HUHTA, H., & HELMINEN, O. (2021). Treatment trends and outcomes of hepatocellular carcinoma in a single center for 35 years [JB]. Minerva Surgery, 76(3). https://doi.org/10.23736/S2724-5691.21.08426-1

Treatment trends and outcomes of hepatocellular carcinoma in a single center for 35 years

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Author: Kairaluoma, Valtteri1; Karjalainen, Mira1; Pohjanen, Vesa-Matti1;
Organizations: 1Unit of Cancer and Translational Medicine Research, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
2Department of Surgery, Oulu University Hospital, Oulu, Finland
3Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland
Format: article
Version: accepted version
Access: embargoed
Persistent link: http://urn.fi/urn:nbn:fi-fe2021090845589
Language: English
Published: Edizioni Minerva Medica, 2021
Publish Date: 2022-06-01
Description:

Abstract

Background: Hepatocellular carcinoma (HCC) is one of the leading causes of cancer mortality. The aim of this study was to examine the trends of HCC treatment and the outcomes in a single tertiary center for 35 years.

Methods: Two hundred seventy–three consecutive HCC patients between 1983–2018 were identified from Oulu University Hospital records. Primary outcomes of the study were postoperative complications within 30 days after the operation, and short– (30–and 90–day) and long-term (1, 3 and 5–year) survival.

Results: Of the 273 patients, 49 underwent surgical resection, 25 local ablation, 48 angiological treatment and 151 had palliative treatment. The rate of surgery declined over time, while other invasive treatments increased. Major complications occurred in 14 (28.6%) patients after surgical resection, in 2 (8.0%) patients after local ablation and in 13 (27.1%) patients after angiological treatment (P=0.022). Recurrence and local recidives were observed especially in local ablation group and in angiological treatment group (P<0.001). Overall survival rates in surgical resection group were at 30 and 90 days, 1–, 3– and 5–years 95.9%, 95.9%, 85.1%, 59.0% and 51.2%. In local ablation group, respective overall survival rates were 100.0%, 100.0%, 86.1%, 43.1% and 18.8%, and in angiological group 95.8%, 93.6%, 56.1%, 26.3% and 6.6%. In cox regression model adjusted for confounding factors, mortality hazard was lowest after surgical resection. Prognosis was poor in palliative group.

Conclusions: Based on this Northern Finland population, the surgical resection of HCC has acceptable complication rate compared to other treatments; and yields the best long-term survival. Overall prognosis of HCC remains poor.

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Series: Minerva surgery
ISSN: 2724-5691
ISSN-E: 2724-5438
ISSN-L: 2724-5691
Volume: 76
Issue: 3
Pages: 252 - 263
DOI: 10.23736/S2724-5691.21.08426-1
OADOI: https://oadoi.org/10.23736/S2724-5691.21.08426-1
Type of Publication: A1 Journal article – refereed
Field of Science: 3122 Cancers
3126 Surgery, anesthesiology, intensive care, radiology
Subjects:
Funding: This work was supported by grants from The Finnish Medical Foundation (V.K.) and Georg C. and Mary Ehrnrooth Foundation and Finnish State Research Fund (O.H.)
Copyright information: This is a postprint version of the article published in Minerva Surgey. This version is free to view and download to private research and study only. Not for redistribution or re-use. © Edizioni Minerva Medica. The final published article is available online on Minerva Medica website at https://doi.org/10.23736/S2724-5691.21.08426-1. Cite this article as Kairaluoma, V., Karjalainen, M., Pohjanen, V.-M., Saarnio, J., Niemelä, J., Huhta, H., & Helminen, O. (2021). Treatment trends and outcomes of hepatocellular carcinoma in a single center for 35 years [JB]. Minerva Surgery, 76(3):252-263.