HEPATOCELLULAR CARCINOMA IN VERACRUZ: A SURVEILLANCE COMPARISON BETWEEN TREATMENTS

Abstract

In Mexico, hepatocellular carcinoma (HC) represents >90% of primary hepatic tumors. The diagnosis is determined by imaging findings (CT or MR). A biopsy is necessary for specific situations. The staging method is the Barcelona classification (BCLC) which considers hepatic biomarkers, the tumor burden and the performance status. Treatment options include transplantation, liver resection (LR), radiofrequency ablation (RFA), transarterial embolization (TACE/TAE) and systemic treatment (ST). Nonetheless, there are few surveillance studies in Mexico. The study aims to describe the surveillance of HC subjects after different therapeutic approaches. Descriptive and retrospective study with a database including 130 patients diagnosed with HC by imaging findings (or biopsy if needed) between 2005 and 2021 in Veracruz. For statistical analysis, surveillance data was first summarized by descriptive statistics and 5-year-overall survival rates (5OS). Subsequently, a comparison of surveillance between therapeutic options was made by Log-Rank, Cox regression and χ2. We considered statistical significance at p<0.05. A total of 130 patients were diagnosed with HC,128 patients were analyzed after 2 exclusions due to missing data, 45 (35%) of them died during the follow-up. The distribution of descriptive data is detailed in Table 1. We observed longer accumulated overall surveillance in patients who underwent LR (5OS: 73%), followed by RFA (5OS: 28%), χ2: 10.7, p=0.02. When analyzing data by BCLC we found a poor difference in surveillance between treatments (p>0.05). Recurrence of the tumor was only observed in stage B: 5 cases after LR (29.4%), and 2 cases after RFA (22.2%), χ2=12.084 p=0.017. The mean time for recurrence detection was 19 months and five months for LR and RFA, respectively. Discussion: This analysis showed higher accumulated surveillance for patients with LR, followed by RFA. Furthermore, Log-Rank curve of RFA showed a pronounced inclination of surveillance around the 25th month, after which it reached a plateau and deceleration until the 75th month. However, five year-OSr seemed to be lower than in other studies. Our results suggest that LR is a feasible treatment alternative. In the meantime, RFA seems a worthy option when patients are not candidates for LR, showing promising results. The authors declare that there is no conflict of interest.