Evidence map›Paper›PMID 39692983›Full record

ArticleAnnals of surgical oncology2025

Outcomes of Stereotactic Body Radiotherapy Compared with Surgical Resection in Patients with Hepatocellular Carcinoma and Macrovascular Invasion: A Propensity Score-Matched Analysis.

Michael Yan, Zhihao Li, Marco P A W Claasen, Anna T Santiago, Luckshi Rajendran, Pablo Munoz-Schuffenegger, Cameron Lee, Christian T J Magyar, Ian McGilvray, Chaya Shwaartz and 12 more

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Michael Yan *Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Zhihao Li *HBP and Multi-Organ Transplant Program, Division of General Surgery, University Health Network, University of Toronto, Toronto, ON, Canada.
Marco P A W ClaasenHBP and Multi-Organ Transplant Program, Division of General Surgery, University Health Network, University of Toronto, Toronto, ON, Canada.
Anna T SantiagoDepartment of Biostatistics, University Health Network, Toronto, ON, Canada.
Luckshi RajendranHBP and Multi-Organ Transplant Program, Division of General Surgery, University Health Network, University of Toronto, Toronto, ON, Canada.
Pablo Munoz-SchuffeneggerRadiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Cameron LeeRadiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Christian T J MagyarHBP and Multi-Organ Transplant Program, Division of General Surgery, University Health Network, University of Toronto, Toronto, ON, Canada.
Ian McGilvrayHBP and Multi-Organ Transplant Program, Division of General Surgery, University Health Network, University of Toronto, Toronto, ON, Canada.
Chaya ShwaartzHBP and Multi-Organ Transplant Program, Division of General Surgery, University Health Network, University of Toronto, Toronto, ON, Canada.
Trevor ReichmanHBP and Multi-Organ Transplant Program, Division of General Surgery, University Health Network, University of Toronto, Toronto, ON, Canada.
Carol-Anne MoultonHBP and Multi-Organ Transplant Program, Division of General Surgery, University Health Network, University of Toronto, Toronto, ON, Canada.
Sean ClearyHBP and Multi-Organ Transplant Program, Division of General Surgery, University Health Network, University of Toronto, Toronto, ON, Canada.
Grainne O'KaneDivision of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Arndt VogelDivision of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Robert GrantDivision of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Tae Kyoung KimDepartment of Medical Imaging, University of Toronto, Toronto, ON, Canada.
Catherine Soo-Yee NaidooDepartment of Medical Imaging, University of Toronto, Toronto, ON, Canada.
Ali HosniRadiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Aruz MesciRadiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Laura A DawsonRadiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Gonzalo SapisochinHBP and Multi-Organ Transplant Program, Division of General Surgery, University Health Network, University of Toronto, Toronto, ON, Canada. Gonzalo.sapisochin@uhn.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPatients with advanced hepatocellular carcinoma (HCC) and macrovascular invasion (MVI) are recommended to receive systemic therapy according to guidelines. Stereotactic body radiotherapy (SBRT) and surgery are increasingly used in this patient population. This study compares outcomes from these local treatments.

methodsPatients diagnosed with HCC with MVI and treated with surgery or SBRT between 1999 and 2022 were included. Propensity score matching minimized bias from confounders. Overall survival (OS) was analyzed using the Kaplan-Meier method,. and local, regional, and distant recurrences were assessed via competing risk methods. Univariable and multivariable analyses adjusted by the Lasso method evaluated OS predictors.

resultsAmong 175 patients, 38 underwent surgery and 137 received SBRT. The median age was 61 years, tumor volume was 158.6 cc, and α-fetoprotein level was 197 IU/mL. Most surgical patients had major resection (74%) via an open approach (97%). The median biologically effective dose (BED) for SBRT was 53.7 Gy. After matching, 35 patients per group had a median OS of 16 months. Local failure was higher in the SBRT group (20%) than in the surgery group (12%) at 1 year (p = 0.028). Distant failure was more frequent in surgery (54%) compared with SBRT (17%) [p = 0.003]. Excluding SBRT patients receiving adjuvant systemic therapy did not change the results. In-hospital mortality was 9% post-surgery and 14% experienced post-SBRT liver impairment.

conclusionBoth surgery and SBRT offer good long-term OS and control. Surgery provides better local control, while SBRT had lower distant relapse. While SBRT has acceptable toxicity, surgery carries a significant mortality risk.

Indexed as

Carcinoma, HepatocellularHepatectomyLiver NeoplasmsNeoplasm Recurrence, LocalRadiosurgeryAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedNeoplasm InvasivenessPrognosisPropensity ScoreRetrospective StudiesSurvival RateHepatectomyHepatocellular carcinomaMacrovascular invasionPropensity scoreStereotactic body radiotherapy

Identifiers

PMID39692983

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.