Liver Resection vs Nonsurgical Treatments for Patients With Early Multinodular Hepatocellular Carcinoma

作者：Alessandro Vitale, Pierluigi Romano, Umberto Cillo, Writing Group for the HE.RC.O.LE.S Collaborative Group, Writing Group for the ITA.LI.CA Collaborative Group, HE.RC.O.LE.S and ITA.LI.CA Collaborative Groups, Marco Busti, Giulia Nezi, Riccardo De Carlis, Francesca Ratti, Flavio Milana, Matteo Donadon, Laura Marinelli, Francesco Razionale, Francesca Carissimi, Mauro Alessandro Scotti, Cristina Ciuli, Valerio De Peppo, Nadia Russolillo, Mauro Giuffrida, Francesca De Stefano, Jacopo Peverada, Zoe Larghi Laureiro, Angelo Franceschi, Patrizia Pelizzo, Ivan Marchitelli, Annachiara Casella, Alberto Manzoni, Alessia Malagnino, Pietro Calcagno, Francesco Cammarata, Luca Pennacchi, Davide Cosola, Pio Corleone, Alessandro Cucchetti, G. Mantovani, Francesca Notte, Mauro Montuori, Gloria Allegrini, Calogero Cammà, Ciro Celsa, Paolo Giuffrida, Carmelo Marco Giacchetto, Gabriele Rancatore, Maria Vittoria Grassin, Roberta Ciccia, Alessandro Grova, M. Salvato, Elisabetta Biasini, Andrea Olivani, Rusi Chen, Alessandro Granito, Fabio Piscaglia, Bernardo Stefanini, Francesco Tovoli, Maurizio Biselli, Laura Bucci, Lorenzo Lani, Benedetta Stefanini, Vittoria Bevilacqua, Dante Berardinelli, Alberto Borghi, Andrea Casadei‐Gardini, Fabio Conti, A.C. Dall’Aglio, Giorgio Ercolan, Claudia Campani, Chiara Di Bonaventura, Stefano Gitto, Maria Stella Franzè, Assunta Sauchella, Pietro Coccoli, Antonio Malerba, Mario Capasso, Maria Guarino, Valentina Lauria, Giorgia Ghittoni, Giorgio Pelecca, Anna Sartori, A. Imondi, Barbara Penzo, Alessandro Inno, Fabiana Marchetti, Alessandro Di Menno di Bucchianico, Elton Dajti, Federico Ravaioli, Maria Corina Plaz Torres, Giulia Pieri, Filippo Olivieri, V. Romagnoli, Nicoletta De Matthaeis, Ester Marina, Antonio Facciorusso, Francesca Romana Ponziani, Andrea Lauterio, Angelo Sangiovanni, Giuseppe Cabibbo, Gabriele Missale, Mariarosaria Marseglia, Franco Trevisani, Francesco Giuseppe Foschi, Federica Cipriani, Simone Famularo, Fabio Marra, Carlo Saitta, Matteo Serenari, Gianpaolo Vidili, Filomena Morisco, Eugenio Caturelli, Andrea Mega, Filippo Pelizzaro, Daniele Nicolini, Francesco Ardito, Mattia Garancini, Alberto Masotto, Gianluca Svegliati‐Baroni, Francesco Azzaroli, Edoardo G. Giannini, Pasquale Perri, Andrea Scarinci, Andrea Fontana, Maurizia Rossana Brunetto, Maurizio Iaria, Maria Di Marco, Gerardo Nardone, Tommaso Dominioni, Quirino Lai, Cecilia Ferrari, Gian Ludovico Rapaccini, Sacco Rodolfo, Maurizio Romano, Simone Conci, Marco Zoli, Maria Conticchio, Matteo Zanello, Giuseppe Zimmitti, Luca Fumagalli, Albert Troci, Paola Germani, Antonio Gasbarrini, Giuliano La Barba, Michela De Angelis, Stefan Patauner, Sarah Molfino, Mauro Zago, Enrico Pinotti, Anna Chiara Frigo, Gian Luca Baiocchi, Antonio Frena, Luigi Boccia, Giorgio Ercolani, Paola Tarchi, Michele Crespi, Marco Chiarelli, Moh’d Abu Hilal, Matteo Cescon, Riccardo Memeo, Andrea Ruzzenente, Giacomo Zanus, Guido Griseri, Massimo Rossi, Marcello Maestri, Raffaele Della Valle, Alessandro Ferrero, Gian Luca Grazi, Fabrizio Romano, Felice Giuliante, Marco Vivarelli, Elio Jovine, Guido Torzilli, Luca Aldrighetti, Luciano De Carlis · 发表于：JAMA Surgery · 年份：2024 · DOI：10.1001/jamasurg.2024.1184 · 被引用次数：44 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Cholangiocarcinoma and Gallbladder Cancer Studies、Liver Disease Diagnosis and Treatment

Importance: The 2022 Barcelona Clinic Liver Cancer algorithm currently discourages liver resection (LR) for patients with multinodular hepatocellular carcinoma (HCC) presenting with 2 or 3 nodules that are each 3 cm or smaller. Objective: To compare the efficacy of liver resection (LR), percutaneous radiofrequency ablation (PRFA), and transarterial chemoembolization (TACE) in patients with multinodular HCC. Design, Setting, and Participants: This cohort study is a retrospective analysis conducted using data from the HE.RC.O.LE.S register (n = 5331) for LR patients and the ITA.LI.CA database (n = 7056) for PRFA and TACE patients. A matching-adjusted indirect comparison (MAIC) method was applied to balance data and potential confounding factors between the 3 groups. Included were patients from multiple centers from 2008 to 2020; data were analyzed from January to December 2023. Interventions: LR, PRFA, or TACE. Main Outcomes and Measures: Survival rates at 1, 3, and 5 years were calculated. Cox MAIC-weighted multivariable analysis and competing risk analysis were used to assess outcomes. Results: A total of 720 patients with early multinodular HCC were included, 543 males (75.4%), 177 females (24.6%), and 350 individuals older than 70 years (48.6%). There were 296 patients in the LR group, 240 who underwent PRFA, and 184 who underwent TACE. After MAIC, LR exhibited 1-, 3-, and 5-year survival rates of 89.11%, 70.98%, and 56.44%, respectively. PRFA showed rates of 94.01%, 65.20%...