Survival rates for patients with hepatocellular carcinoma are associated to some extent with choice of primary local treatment, with the best outcomes achieved using complete hepatic resection with transplantation, according to a presentation at the 2007 Gastrointestinal Cancers Symposium.

The current analysis used information from the USA Surveillance Epidemiology and End Results (SEER) database for 46,065 patients treated between 1970 and 2003. A multivariate analysis examined many prognostic factors, including tumor size and grade, extent of disease spread, patient age and gender, and the type of local treatment received.

Researchers noted that they were not able to determine whether patients had liver disease (such as cirrhosis or hepatitis B or C), preoperative liver function, and overall health, factors that can strongly influence both the type of treatment patients are offered and overall survival rates.

The investigators found that after adjusting for other known factors, patient survival rates were linked to type of local treatment. The five-year overall survival rate was 67 percent for patients who underwent liver transplants, 38 percent for patients who underwent less than full surgical removal of the liver, 19 percent for patients who underwent ablation, and 3 percent for patients who received no treatment.

The researchers noted that the superior outcomes seen after transplantation and surgery are due in part to the fact that patients receiving these treatments generally have less advanced disease, higher-functioning livers, and few additional health complications.

“These data suggest that transplantation and resection should still be preferentially considered for all hepatocellular carcinoma patients,” said Roderich E. Schwarz, MD, Director of the Pancreatic Cancer Program and Associate Professor of Surgery at the Cancer Institute of New Jersey, the study’s lead author. “However, because many patients cannot undergo these procedures, it is important to continue to explore less invasive options in order to find the optimal treatment for these patients.”