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A comparison of the outcomes between surgical resection and proton beam therapy for single primary hepatocellular carcinoma

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Abstract

Purpose

There are many treatment choices for hepatocellular carcinoma (HCC), one of which is proton beam therapy (PBT). The purpose of this study was to compare surgical resection (SR) and PBT to clarify the prognostic factors for operable HCC based on a single institution’s database.

Methods

Patients with single primary nodular HCC ≤ 100 mm without vessel invasion on pretreatment imaging were divided into the SR group and PBT group. In the PBT group, the patients with unresectable HCC due to their liver function and/or performance status were excluded.

Results

There were 314 and 31 patients who underwent SR and PBT, respectively. The median survival time in the SR group was significantly better than in the PBT group (104.1 vs. 64.6 months, p = 0.008). Regarding the relapse-free survival (RFS), there was no significant difference between the SR and PBT groups (33.8 vs. 14.0 months, p = 0.099).

Conclusion

The RFS was comparable between the PBT and SR groups. However, the PBT group had a significantly worse overall survival than the SR group. SR may therefore be favorable as an initial treatment for HCC compared to PBT.

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Abbreviations

HCC:

Hepatocellular carcinoma

PBT:

Proton beam therapy

SR:

Surgical resection

PS:

Performance status

RFS:

Relapse-free survival

RFA:

Radiofrequency ablation

TACE:

Transarterial chemoembolization

CTCAE:

Common Terminology Criteria for Adverse Events

CD:

Clavien–Dindo

ICG R15:

Indocyanine green retention rate at 15 min

OS:

Overall survival

HR:

Hazard ratio

CI:

Confidence interval

AFP:

Alpha-fetoprotein

PSM:

Propensity score matching

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Authors and Affiliations

  1. Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center Hospital, Shimo-Nagakubo, Sunto-Nagaizumi, Shizuoka, 1007411-8777, Japan

    Shunsuke Tamura, Yukiyasu Okamura, Teiichi Sugiura, Takaaki Ito, Yusuke Yamamoto, Ryo Ashida, Katsuhisa Ohgi & Katsuhiko Uesaka

  2. Division of Proton Therapy, Shizuoka Cancer Center Hospital, Shizuoka, Japan

    Shigeyuki Murayama

Authors
  1. Shunsuke Tamura
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  2. Yukiyasu Okamura
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  3. Teiichi Sugiura
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  4. Takaaki Ito
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  5. Yusuke Yamamoto
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  6. Ryo Ashida
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  7. Katsuhisa Ohgi
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  8. Shigeyuki Murayama
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  9. Katsuhiko Uesaka
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Correspondence to Yukiyasu Okamura.

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Tamura, S., Okamura, Y., Sugiura, T. et al. A comparison of the outcomes between surgical resection and proton beam therapy for single primary hepatocellular carcinoma. Surg Today 50, 369–378 (2020). https://doi.org/10.1007/s00595-019-01888-5

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  • DOI: https://doi.org/10.1007/s00595-019-01888-5

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