Abstract

BACKGROUND: The impact of a prolonged time-to-surgery (TTS) among patients with resectable hepatocellular carcinoma (HCC) is not well defined.METHODS: Patients who underwent curative-intent hepatectomy for BCLC-0, A and B HCC between 2000 and 2017 were identified using a multi-institutional database. The impact of prolonged TTS on overall survival (OS) and disease-free survival (DFS) was examined.RESULTS: Among 775 patients who underwent resection for HCC, 537 (69.3%) had early surgery (TTS<90 days) and 238 (30.7%) patients had a delayed surgery (TTS=90 days). Patient- and tumor-related characteristics were similar between the two groups except for a higher proportion of patients undergoing major liver resection in the early surgery group (31.3% vs. 23.8%, p=.04). The percentage of patients with delayed surgery varied from 8.8% to 59.1% among different centers (p<.001). Patients with TTS<90 days had similar 5-year OS (63.7% vs. 64.9; p=.79) and 5-year DFS (33.5% vs. 42.4; p=.20) with that of patients with TTS=90 days. On multivariable analysis, delayed surgery was not associated with neither worse OS (BCLC-0/A: adjusted hazards ratio [aHR]=0.90; 95% confidence interval [CI]: 0.65-1.25 and BCLC-B: aHR=0.72; 95%CI: 0.30-1.74) nor DFS (BCLC-0/A: aHR=0.78; 95%CI: 0.60-1.01 and BCLC-B: aHR=0.67; 95% CI: 0.36-1.25).CONCLUSION: Approximately one in three patients diagnosed with resectable HCC had a prolonged TTS. Delayed surgery was not associated with worse outcomes among patients with resectable HCC.

View details for DOI 10.1002/jso.26297

View details for PubMedID 33174627