Korea University researchers unveil benefits of perioperative radiotherapy for treating liver cancer with high recurrence risk

Hepatocellular carcinoma (HCC), or liver cancer, is primarily treated by surgically removing the tumor. However, the chances of recurrence of HCC within 5 years are high. This emphasizes the need for an adjuvant treatment like radiotherapy along with surgery for treating HCC patients with a high risk of recurrence. Although the benefits of perioperative treatment have been studied for various cancers, the oncological benefits of radiotherapy for treatment of HCC are less explored.

Now, a team of researchers, including Professor Chai Hong Rim from Korea University Medical College in Korea and his colleagues, have explored the therapeutic effects of perioperative radiotherapy for the treatment of HCC. In their breakthrough work, published in the International Journal of Surgery on November 23, 2023, they found that perioperative radiotherapy or the administration of radiotherapy during a surgical procedure significantly improves survival rates among HCC patients at high risk of recurrence.

“We investigated if perioperative radiotherapy could provide enhanced benefits, in regard to recurrence and survival, compared to surgery by systematically reviewing the studies and evaluating the data using meta-analysis,” explains Prof. Rim.

In the studies examined by the researchers, patients received perioperative radiotherapy for two major reasons. The first was portal vein thrombosis, which refers to the invasion of HCC into the major vessel inside the liver, and the second was narrow resection margin, a condition where there is an inadequate mass of healthy tissue surrounding the tumor which makes complete removal challenging.

The researchers evaluated two separate outcomes of the studies included in the meta-analysis— overall survival (OS) and disease-free survival (DFS). OS refers to the period of time from the start of cancer treatment to the patient’s death, while DFS refers to the period after treatment during which there are no signs of disease recurrence. They found that perioperative radiotherapy provided significant OS and DFS benefits, regardless of the reason, although the OS and DFS differed between the subgroups.

Overall, the findings suggest significant improvements in both outcomes among HCC patients who received perioperative radiotherapy compared to patients who did not receive the adjuvant treatment. “Radiotherapy proves to be a significant adjuvant treatment as it not only reduces the recurrence rate but also improves the survival rate in high-risk groups for recurrence after surgery,” says Prof. Rim.

The benefits of perioperative radiotherapy uncovered by this meta-analysis implies that the incorporation of this adjuvant treatment could improve treatment outcomes for millions of patients.

“Our study lays the foundation for the international use of radiotherapy as an adjuvant with surgery for treatment of HCC,” concludes Prof. Rim.

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Reference                                    

Title of original paper: Benefit of perioperative radiotherapy for hepatocellular carcinoma: a quality-based systematic review and meta-analysis

Journal: International Journal of Surgery

DOI: https://doi.org/10.1097/JS9.0000000000000914

About Korea University College of Medicine

Korea University College of Medicine is the medical school of Korea University. It is located in Seoul, South Korea. As one of the oldest medical schools in South Korea, it has been historically regarded as one of the country's top medical schools. The school was founded as Chosun Women's Medical Training Institute in 1928 by Rosetta Sherwood Hall. The institute was subsequently renamed several times and ultimately merged with Korea University to become Korea University College of Medicine. So far, the school has produced over 7,000 graduates, most of whom are working as prominent physicians and public health advocates worldwide.

Website: https://medicine.korea.ac.kr/en/index.do

About the author

Professor Rim graduated from Korea University School of Medicine and earned his doctorate from Korea University. His research primarily focuses on clinical research and meta-analysis for treatment decisions related to intractable cancer situations. He has contributed to approximately 70 scientific papers in the past five years, as a main author, with a total impact factor of about 330 points.