Outcome of hepatectomy after systemic therapy for hepatocellular carcinoma: a Japanese multicenter study

• Published in: Surgery today (Tokyo, Japan) Vol. 55; no. 4; pp. 510 - 517
• Main Authors: Iseda, Norifumi, Itoh, Shinji, Toshima, Takeo, Yoshiya, Shohei, Bekki, Yuki, Tsutsui, Yuriko, Toshida, Katsuya, Inokuchi, Shoichi, Utsunomiya, Toru, Tomino, Takahiro, Sugimachi, Keishi, Morita, Kazutoyo, Ninomiya, Mizuki, Harada, Noboru, Minagawa, Ryosuke, Yoshizumi, Tomoharu
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.04.2025
• Subjects: Adult; Aged; Aged, 80 and over; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - surgery; Carcinoma, Hepatocellular - therapy; Combined Modality Therapy; Disease-Free Survival; East Asian People; Female; Hepatectomy - methods; Humans; Japan; Liver Neoplasms - drug therapy; Liver Neoplasms - mortality; Liver Neoplasms - surgery; Liver Neoplasms - therapy; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Recurrence, Local; Original Article; Prognosis; Retrospective Studies; Surgery; Surgical Oncology; Survival Rate; Treatment Outcome; Japan; Systemic therapy; Multi-center study; Hepatocellular carcinoma; Hepatectomy
• ISSN: 0941-1291; 1436-2813; 1436-2813
• DOI: 10.1007/s00595-024-02930-x

Background and purpose In recent years, new systemic therapies have been developed for hepatocellular carcinoma (HCC). The aim of this study was to evaluate the prognosis of patients with unresectable HCC treated with R0 hepatectomy after systemic therapy. Methods Data from 27 patients who underwent hepatectomy for HCC after systemic therapy at six facilities were analyzed retrospectively. Cancer-specific survival (CSS) and recurrence-free survival (RFS) after hepatectomy were investigated using Kaplan–Meier curves. We examined the prognostic value of the oncological criteria of resectability for HCC reported by the Japanese Expert Consensus 2023. Results R0 resection was performed in 24 of the 27 patients. Using the Response Evaluation Criteria in Solid Tumors, 0 patient had a complete response, 16 had a partial response, 6 had stable disease, and 2 had progressive disease. Median CSS was not evaluated, but the median RFS was 17.8 months. Patients with resectable and borderline resectable (BR) 1 cancers had a better prognosis than those with BR2 cancers. The group whose oncological criteria were improved by systemic therapy had a lower recurrence rate than the group whose oncological criteria were maintained, but no difference was observed in CSS. Conclusions The findings of this study suggest that hepatectomy after systemic therapy may improve the prognosis of HCC patients.