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- Title
Survival benefit with IMRT following narrow-margin hepatectomy in patients with hepatocellular carcinoma close to major vessels.
- Authors
Wang, Wei ‐ Hu; Wang, Zhi; Wu, Jian ‐ Xiong; Zhang, Tao; Rong, Wei ‐ Qi; Wang, Li ‐ Ming; Jin, Jing; Wang, Shu ‐ Lian; Song, Yong ‐ Wen; Liu, Yue ‐ Ping; Ren, Hua; Fang, Hui; Wang, Wen ‐ Qing; Liu, Xin ‐ Fan; Yu, Zi ‐ Hao; Li, Ye ‐ Xiong
- Abstract
Background & Aims: To investigate the role of post-operative intensity-modulated radiotherapy (IMRT) in patients receiving narrow-margin hepatectomy for hepatocellular carcinoma (HCC) located close to the major vessels. Methods: This exploratory study involved 181 HCC patients. Of them, 116 were treated with narrow-margin (<1.0 cm) hepatectomy. Thirty-three of the 116 underwent postoperative IMRT (Group A), while 83 did not receive radiotherapy (Group B). The remaining 65 patients underwent wide-margin (≥1.0 cm) hepatectomy (Group C). Prognosis and patterns of recurrence were assessed in the three groups. Results: The 3-year overall survival (OS) and disease-free survival (DFS) rates were 89.1 and 64.2% in Group A, 67.7 and 52.2% in Group B and 86.0 and 60.1% in Group C respectively. The OS and DFS of Group A and Group C patients surpassed those of Group B patients (Group A vs. B, P = 0.009 and P = 0.038; and Group C vs. B, P = 0.002 and P = 0.010). Patients in Groups A and C experienced significantly fewer early recurrences than did patients in Group B (P = 0.002). Furthermore, patients in Groups A and C experienced substantially fewer intrahepatic marginal (P = 0.048) and diffuse recurrences (P = 0.018) and extrahepatic metastases (P = 0.038) than did patients in Group B. No patient developed radiation-induced liver disease. Conclusions: Post-operative IMRT following narrow-margin hepatectomy may be a favourable therapy for both its safety profile and clinical benefit in patients with HCC located close to the major vessels.
- Subjects
LIVER cancer; INTENSITY modulated radiotherapy; HEPATECTOMY; RADIOTHERAPY; PROGNOSIS
- Publication
Liver International, 2015, Vol 35, Issue 12, p2603
- ISSN
1478-3223
- Publication type
Article
- DOI
10.1111/liv.12857