Background/Aims: Adjuvant systemic therapy has been proposed in patients at high-risk of hepatocellular carcinoma (HCC) recurrence. This study assessed the outcomes of a real-world cohort treated with either resection or ablation, stratified according to the IMbrave050 trial criteria. Methods: We selected, from the Italian Liver Cancer database, 1150 patients with HCC treated with upfront resection (n = 483, 64.2 % high-risk) or ablation (n = 667, 49.6 % high risk), fulfilling the inclusion criteria of the IMbrave050 trial. Results: Median recurrence-free survival (RFS) was shorter in high-risk resected patients (29.0 vs. 43.0 months; p = 0.024), while no difference was observed after ablation (27.0 vs. 30.0 months; p = 0.098). Recurrence was borderline higher in high-risk resected patients [Hazard Ratio (HR) 1.26, 0.97–1.23; p = 0.052], but not ablated ones (HR 1.13, 0.92–1.38; p = 0.221). Independent predictors of recurrence were cirrhosis (HR 1.52, 1.13–2.05), multinodular HCC (HR 1.31, 1.14–1.52), and microvascular invasion (HR 1.39, 1.05–1.83) in resected, and alpha-fetoprotein (HR 1.15, 1.07–1.23) in ablated patients. Median overall survival was similar in resected risk-groups (147.0 vs. 130.0 months; p = 0.093), shorter in high-risk ablated patients (79.0 vs. 98.0 months; p = 0.021). Conclusions: The criteria used to assess HCC recurrence risk in the IMbrave050 trial find validation by real-world data in patients treated with resection, while they are inaccurate after ablation.
Recurrence rate, features, and outcome after hepatocellular carcinoma curative resection or ablation according to the IMbrave050 criteria: a real-world study / Giannini, Edoardo G.; Pasta, Andrea; Bucci, Laura; Plaz Torres, Maria Corina; Pieri, Giulia; Celsa, Ciro; Sangiovanni, Angelo; Piscaglia, Fabio; Campani, Claudia; Missale, Gabriele; Vidili, Gianpaolo; Ghittoni, Giorgia; Pelizzaro, Filippo; Foschi, Francesco Giuseppe; Morisco, Filomena; Santi, Valentina; Svegliati-Baroni, Gianluca; Azzaroli, Francesco; Saitta, Carlo; Brunetto, Maurizia Rossana; Sacco, Rodolfo; Ponziani, Francesca Romana; Boninsegna, Sara; Nardone, Gerardo; Martini, Andrea; Mega, Andrea; Sacerdoti, David; Magalotti, Donatella; Vitale, Alessandro; Trevisani, Franco; Biselli, Maurizio; Lani, Lorenzo; Stefanini, Benedetta; Granito, Alessandro; Tovoli, Francesco; Marseglia, Mariarosa; Stefanini, Bernardo; Pinto, Elisa; Farinati, Fabio; Bertellini, Federica; Palano, Giorgio; Kitenge, Maria Piera; Allegrini, Gloria; Cabibbo, Giuseppe; Ciccia, Roberta; Gaudioso, Valeria; Grova, Alessandro; Sparacino, Alba; Rao, Sofia; Caopdicasa, Luigi; Salvato, Mauro; Cusimano, Guido; Quartararo, Alessio; Giusino, Gaetano; Marra, Fabio; Cavoli, Tancredi Li; Ragozzino, Lucia; Gitto, Stefano; Rosi, Martina; Adotti, Valentina; Napoli, Lucia; Borghii, Alberto; Saccomandi, Alice; Conti, Fabio; Ielasi, Luca; Ferronato, Marco; Reggidori, Nicola; Schiadà, Laura; Scorzoni, Chiara; Scandali, Giulia; Santopaolo, Francesco; Cerrito, Lucia; De Matthaeis, Nicoletta; Gasbarrini, Antonio; Grasselli, Sara; Biasini, Elisabetta; Olivani, Andrea; Guarino, Maria; Capasso, Mario; Cossiga, Valentina; Cela, Ester Marina; Facciorusso, Antonio; Graziosi, Camilla; Lauria, Valentina; Pelecca, Giorgio; Chegai, Fabrizio; Raso, Armando; Aloisio, Pierluigi; Dell'Isola, Serena; Franzè, Maria Stella; Filomia, Roberto; Pitrone, Concetta; Raimondo, Giovanni; Arru, Marco; Dajti, Elton; Porro, Alberto; Oliveri, Filippo; Ricco, Gabriele; Romagnoli, Veronica; Inno, Alessandro; Marchetti, Fabiana; Natola, Leonardo; De Marco, Leonardo; Filice, Aldo; Dalbeni, Andrea; Coccoli, Pietro; Rocco, Alba; Cappelli, Alberta; Mosconi, Cristina; Renzulli, Matteo; Marzi, Luca; Guerra, Pietro; Cagnin, Silvia. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - 57:8(2025), pp. 1673-1682. [10.1016/j.dld.2025.05.032]
Recurrence rate, features, and outcome after hepatocellular carcinoma curative resection or ablation according to the IMbrave050 criteria: a real-world study
Svegliati-Baroni, Gianluca;Allegrini, Gloria;Scorzoni, Chiara;Scandali, Giulia;Guarino, Maria;Capasso, Mario;
2025-01-01
Abstract
Background/Aims: Adjuvant systemic therapy has been proposed in patients at high-risk of hepatocellular carcinoma (HCC) recurrence. This study assessed the outcomes of a real-world cohort treated with either resection or ablation, stratified according to the IMbrave050 trial criteria. Methods: We selected, from the Italian Liver Cancer database, 1150 patients with HCC treated with upfront resection (n = 483, 64.2 % high-risk) or ablation (n = 667, 49.6 % high risk), fulfilling the inclusion criteria of the IMbrave050 trial. Results: Median recurrence-free survival (RFS) was shorter in high-risk resected patients (29.0 vs. 43.0 months; p = 0.024), while no difference was observed after ablation (27.0 vs. 30.0 months; p = 0.098). Recurrence was borderline higher in high-risk resected patients [Hazard Ratio (HR) 1.26, 0.97–1.23; p = 0.052], but not ablated ones (HR 1.13, 0.92–1.38; p = 0.221). Independent predictors of recurrence were cirrhosis (HR 1.52, 1.13–2.05), multinodular HCC (HR 1.31, 1.14–1.52), and microvascular invasion (HR 1.39, 1.05–1.83) in resected, and alpha-fetoprotein (HR 1.15, 1.07–1.23) in ablated patients. Median overall survival was similar in resected risk-groups (147.0 vs. 130.0 months; p = 0.093), shorter in high-risk ablated patients (79.0 vs. 98.0 months; p = 0.021). Conclusions: The criteria used to assess HCC recurrence risk in the IMbrave050 trial find validation by real-world data in patients treated with resection, while they are inaccurate after ablation.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
