The Optimal Management for Sub-Centimeter Hepatocellular Carcinoma: Curative Treatments or Follow-Up?

• Published in: Medical science monitor 2019-07, Vol.25, p.4941-4951
• Main Authors: Sun, Xuqi, Zhang, Yaojun, Lyu, Ning, Li, Xiaoxian, Chen, Minshan, Zhao, Ming
• Format: Article
• Language: English
• Subjects: Adult; Aged; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - surgery; Carcinoma, Hepatocellular - therapy; Clinical Research; Female; Follow-Up Studies; Hepatectomy; Humans; Liver Neoplasms - pathology; Liver Neoplasms - therapy; Male; Middle Aged; Neoplasm Recurrence, Local - pathology; Prognosis; Propensity Score; Retrospective Studies; SEER Program; Survival Analysis; Survival Rate; Treatment Outcome
• ISSN: 1643-3750; 1234-1010; 1643-3750
• DOI: 10.12659/MSM.916451

BACKGROUND The optimal strategy for dealing with sub-centimeter hepatic nodules has not yet been established. This study aimed to assess whether there was a need to provide curative treatments for sub-centimeter hepatocellular carcinomas (HCCs) to patients at risk for high false positives. MATERIAL AND METHODS We identified patients with primary pathologically diagnosed HCC ≤2 cm from 2004 to 2015 in the Surveillance, Epidemiology and End Results (SEER) database. They were divided according to the interventions they received: local ablation, surgical resection, or liver transplantation. In each group, overall survival and cancer-specific survival were used as endpoints to compare the prognoses between patients with sub-centimeter HCC and patients with HCC measuring 1 to 2 cm by Kaplan-Meier. Propensity score matching was performed to reduce bias. We also compared the survival of patients with a primary solitary HCC based on interventions, in the different tumor size groups. Bootstrapping was performed to validate the findings. RESULTS Overall, 10.4% of patients (197 out of 1894) had HCCs