Pathological complete response after conversion therapy in unresectable hepatocellular carcinoma: a retrospective study

• Published in: BMC gastroenterology Vol. 24; no. 1; pp. 242 - 6
• Main Authors: Jia, Junjun, Ding, Chenyuan, Mao, Mengjie, Gao, Feng, Shao, Zhou, Zhang, Min, Zheng, Shusen
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 30-07-2024; BioMed Central; BMC
• Subjects: Adjuvant therapy; Adjuvants; Adult; Aged; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - surgery; Carcinoma, Hepatocellular - therapy; Care and treatment; Chemotherapy; Conversion therapy; Demographics; Disease-Free Survival; Embolization; Female; Hepatectomy; Hepatocellular carcinoma; Hepatoma; Humans; Liver cancer; Liver Neoplasms - mortality; Liver Neoplasms - pathology; Liver Neoplasms - surgery; Liver Neoplasms - therapy; Male; Medical prognosis; Metastasis; Methods; Middle Aged; Neoplasm Staging; Patient outcomes; Patients; Prognosis; Radiation therapy; Retrospective Studies; Statistical analysis; Statistical significance; Surgery; Survival; Survival Rate; Treatment Outcome; Tumors; Veins & arteries; China; Conversion therapy; Hepatocellular carcinoma; Adjuvant therapy
• ISSN: 1471-230X; 1471-230X
• DOI: 10.1186/s12876-024-03298-5

Hepatocellular carcinoma is a highly lethal tumor worldwide, and China has a correspondingly high incidence and mortality rate. For patients with unresectable hepatocellular carcinoma, the prognosis is often poor. The objective of this retrospective study was to investigate the effects of conversion therapies on these patients.
The study included patients between the ages of 18 and 75 who were initially diagnosed with unresectable hepatocellular carcinoma and received conversion therapy. After completing surgery, the patients underwent pathological diagnosis, which showed complete necrosis. The study was conducted retrospectively at the First Affiliated Hospital, Zhejiang University School of Medicine, from January 2019 to December 2021. The main objectives of the study were to evaluate the overall survival and recurrence-free survival.
A total of 60 patients who met the inclusion criteria were enrolled. The median age of the patients was 56.6 ± 9.5 years, and 85% of them were male. The one-year overall survival rate (OS) was 98.3%, and the three-year OS was 95.6%. The one-year recurrence-free survival rate (RFS) was 81.1%, and the three-year RFS was 71.4%. In subgroup analysis, there was no statistically significant difference in RFS between patients with BCLC stages 0-A and BCLC stages B-C (p = 0.296). Additionally, there was no statistically significant difference in RFS between patients who received postoperative new adjuvant therapy and those who did not (p = 0.324).
Conversion therapy followed by surgical resection could be a promising treatment for patients with initially unresectable hepatocellular carcinoma, and the prognosis is good with a pathological complete response.