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Aggressive surgical approach in patients with adrenal-only metastases from hepatocellular carcinoma enables higher survival rates than standard systemic therapy

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Hepatobiliary & Pancreatic Diseases International 2021年第1期20卷 28-33页

作者： Sorin T Alexandrescu Adina E Croitoru Razvan T Grigorie Dana R Tomescu gabriela droc Mugur C Grasu Irinel Popescu Dan Setlacec Centre of General Surgery and Liver Transplantation Fundeni Clinical InstituteBucharest 022328Romania Carol Davila University of Medicine and Pharmacy Bucharest 020021Romania Department of Oncology Fundeni Clinical InstituteBucharest 022328Romania Faculty of Medicine Titu Maiorescu UniversityBucharest 031593Romania Dan Tulbure Centre of Anesteziology and Intensive Care Fundeni Clinical InstituteBucharest 022328Romania Department of Radiology Fundeni Clinical InstituteBucharest 022328Romania

Background:Although guidelines recommend systemic therapy even in patients with limited extrahepatic metastases from hepatocellular carcinoma(HCC),a few recent studies suggested a potential benefit for resection of extrahepatic ***,the benefit of adrenal resection(AR)for adrenal-only metastases(AOM)from HCC was not proved *** is the first study to compare long-term outcomes of AR to those of sorafenib in patients with AOM from ***:The patients with adrenal metastases(AM)from HCC were identified from the electronic records of the institution between January 2002 and December *** who presented AM and other sites of extrahepatic disease were ***,the patients with AOM who received other therapies than AR or sorafenib were ***:A total of 34 patients with AM from HCC were *** of these,22 patients had AOM,6 receiving other treatment than AR or ***,8 patients with AOM underwent AR(AR group),while 8 patients were treated with sorafenib(SOR group).The baseline characteristics of the two groups were not significantly different in terms of age,sex,number and size of the primary tumor,timing of AM diagnosis,Child-Pugh and ECOG *** a median follow-up of 15.5 months,in the AR group,the 1-,3-,and 5-year overall survival rates(85.7%,42.9%,and 0%,respectively)were significantly higher than those achieved in the SOR group(62.5%,0%and 0%at 1-,3-and 5-year,respectively)(P=0.009).The median progression-free survival after AR(14 months)was significantly longer than that after sorafenib therapy(6 months,P=0.002).Conclusions:In patients with AOM from HCC,AR was associated with significantly higher overall and progression-free survival rates than systemic therapy with *** results could represent a starting-point for future phase II/III clinical trials.

关键词： Adrenal metastases Hepatocellular carcinoma Adrenal resection Sorafenib Survival

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