Long-term results of surgical treatment of hepatocellular cancer in Russian real practice

Introduction. Hepatocellular cancer (HCC) ranks 3rd in the structure of cancer mortality, remaining a social and economic problem. Surgical treatment is the main radical treatment for HCC in the early stages. Russian data on approaches to selecting patients for surgery and on long-term results of treatment of patients with HCC are not sufficiently presented. Aim. To evaluate the long-term results of surgical treatment of patients with HCC in routine clinical practice in the Russian population. Materials and methods. A multicenter (7 centers) retrospective observational study included 178 patients with a confirmed diagnosis of HCC who underwent surgical treatment. Before treatment, the general condition was assessed according to the ECOG scale, the functional state of the liver according to the Child – Pugh scale, and the prevalence of the tumor process according to the Barcelona classification (BCLC). The end points of the study were overall survival (OS), relapse-free survival (RFS). Results. Resection of various volumes of the liver was performed in 178 patients with HCC: 139 has BCLC 0/A, 29 – BCLC B, 10 – BCLC C. The median RFS was 20.6 months (95% CI 16.7–31.5), median OS – 55.7 months (95% CI 42.4–76.4). RFS significantly depended on the stage of the disease (median RFS at stage BCLC 0/A – 25.6, at B – 10.1, at C – 3.3 months), on the presence of macro- and microvascular invasion (median RFS 7.6 and 13.7 months), from viral or non-viral etiology of HCC (median RFS 18.0 and 22.6 months). OS was negatively affected by disease stage BCLC B and C according to the Barcelona classification (median OS 34.2 versus 5.2 months), viral etiology (median OS 42.4 versus 69.9 months), and occurrence of relapse (median OS 43.3 months). Conclusion. Data from the largest multicenter study on surgical treatment of HCC in Russian clinical practice were obtained. Liver resections of various volumes are also performed outside the scope of clinical recommendations. 3 out of 4 patients have risk factors for relapse. The data obtained are consistent with international experience in the treatment of patients with HCC.