Clinical Edge Journal Scan

Early-stage HCC: OLT offers better survival outcomes than ablative therapies in the elderly


 

Key clinical point: Compared with liver-directed ablative therapies, orthotopic liver transplantation (OLT) offers a survival advantage for elderly patients with early-stage hepatocellular carcinoma (HCC) and alpha-fetoprotein (AFP) levels <500 ng/mL.

Major finding: Multivariable analysis revealed a significant survival benefit of OLT compared with ablative therapy alone (adjusted hazard ratio [aHR] 0.31; P < .001), with OLT being associated with better survival even after adjusting for imbalanced factors after propensity matching (aHR 0.35; P < .001).

Study details: The data come from a retrospective review study that propensity score matched patients aged ≥70 years with stage I-II HCC and AFP levels of <500 ng/mL receiving OLT (n = 170) with those undergoing liver-directed ablative therapy (n = 170).

Disclosures: No source of funding or conflicts of interest was declared by the authors.

Source: Shah MB et al. Outcomes in elderly patients undergoing liver transplantation compared with liver-directed ablative therapy in early-stage hepatocellular carcinoma. J Am Coll Surg. 2022;234(5):892-899 (Apr 15). Doi: 10.1097/XCS.0000000000000135

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Clinical Edge Journal Scan Commentary: HCC May 2022