Comprehensive Analysis of Radiologic Cancer-Free Status through Various Treatment Approaches in Advanced-Stage Hepatocellular Carcinoma

Introduction: In the realm of oncology, the pinnacle of therapeutic success is achieving a state where the patient is entirely free of cancer, i.e., “cancer free.” This benchmark should not only apply to early-stage malignancies but should also be the standard aim for advanced-stage disea...

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Main Authors: Keisuke Koroki, Sadahisa Ogasawara, Ryo Izai, Takuya Yonemoto, Teppei Akatsuka, Chihiro Miwa, Sae Yumita, Masanori Inoue, Kazufumi Kobayashi, Soichiro Kiyono, Masato Nakamura, Naoya Kanogawa, Takayuki Kondo, Shingo Nakamoto, Shinichiro Nakada, Nozomu Sakai, Masayuki Yokoyama, Masayuki Ohtsuka, Naoya Kato
Format: Article
Language:English
Published: Karger Publishers 2025-01-01
Series:Liver Cancer
Online Access:https://karger.com/doi/10.1159/000542577
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Summary:Introduction: In the realm of oncology, the pinnacle of therapeutic success is achieving a state where the patient is entirely free of cancer, i.e., “cancer free.” This benchmark should not only apply to early-stage malignancies but should also be the standard aim for advanced-stage diseases, including hepatocellular carcinoma (HCC). However, there is a glaring gap in the research landscape concerning the understanding of what cancer-free status truly means for advanced-stage HCC. Our study sheds light on the profound implications of reaching a cancer-free by radiologic assessments in patients with advanced-stage HCC. Methods: We established a database tracking the full clinical course of all patients with HCC (from 2003 to 2022). We identified the initial instances of macrovascular invasion or extrahepatic spread. We defined radiologic cancer-free (rCF) as cases in which no recurrence was observed for at least 2 months following curative treatment or complete response to systemic therapies. The frequency of achieving rCF status was investigated, categorized by patients’ background. Results: We identified 795 patients with advanced-stage HCC. The rCF rate was 8.7%. Patients who achieved rCF status had significantly better prognoses compared to those who did not (p < 0.001). In the decision tree analysis, the number of tumors ≥8 was the strongest factor, making it difficult to achieve rCF status. Analysis of stage progression patterns revealed varying background characteristics at the time of advanced-stage diagnosis, with discrepancies in rCF rates. Conclusions: Despite the low rate of achieving rCF status, the prognostic impact was significant. Patients with certain tumor characteristics had a higher likelihood of achieving rCF status. The distribution of tumor conditions varies based on the pattern of progression, which affects the likelihood of achieving an rCF status.
ISSN:1664-5553