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Survival benefit with IMRT following narrow‐margin hepatectomy in patients with hepatocellular carcinoma close to major vessels
Author(s) -
Wang WeiHu,
Wang Zhi,
Wu JianXiong,
Zhang Tao,
Rong WeiQi,
Wang LiMing,
Jin Jing,
Wang ShuLian,
Song YongWen,
Liu YuePing,
Ren Hua,
Fang Hui,
Wang WenQing,
Liu XinFan,
Yu ZiHao,
Li YeXiong
Publication year - 2015
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.12857
Subject(s) - medicine , hepatocellular carcinoma , hepatectomy , group b , group a , gastroenterology , surgical margin , radiation therapy , carcinoma , surgery , oncology , resection , cancer
Background & Aims To investigate the role of post‐operative intensity‐modulated radiotherapy ( IMRT ) in patients receiving narrow‐margin hepatectomy for hepatocellular carcinoma ( HCC ) located close to the major vessels. Methods This exploratory study involved 181 HCC patients. Of them, 116 were treated with narrow‐margin (<1.0 cm) hepatectomy. Thirty‐three of the 116 underwent postoperative IMRT (Group A), while 83 did not receive radiotherapy (Group B). The remaining 65 patients underwent wide‐margin (≥1.0 cm) hepatectomy (Group C). Prognosis and patterns of recurrence were assessed in the three groups. Results The 3‐year overall survival ( OS ) and disease‐free survival ( DFS ) rates were 89.1 and 64.2% in Group A, 67.7 and 52.2% in Group B and 86.0 and 60.1% in Group C respectively. The OS and DFS of Group A and Group C patients surpassed those of Group B patients (Group A vs. B, P = 0.009 and P = 0.038; and Group C vs. B, P = 0.002 and P = 0.010). Patients in Groups A and C experienced significantly fewer early recurrences than did patients in Group B ( P = 0.002). Furthermore, patients in Groups A and C experienced substantially fewer intrahepatic marginal ( P = 0.048) and diffuse recurrences ( P = 0.018) and extrahepatic metastases ( P = 0.038) than did patients in Group B. No patient developed radiation‐induced liver disease. Conclusions Post‐operative IMRT following narrow‐margin hepatectomy may be a favourable therapy for both its safety profile and clinical benefit in patients with HCC located close to the major vessels.