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. 2015 Aug 28;21(32):9630-7.
doi: 10.3748/wjg.v21.i32.9630.

Efficacy of hepatic resection vs transarterial chemoembolization for solitary huge hepatocellular carcinoma

Shao-Liang Zhu  1 , Jian-Hong Zhong  1 , Yang Ke  1 , Liang Ma  1 , Xue-Mei You  1 , Le-Qun Li  1
Affiliations

Efficacy of hepatic resection vs transarterial chemoembolization for solitary huge hepatocellular carcinoma

Shao-Liang Zhu et al. World J Gastroenterol. .

Abstract

Aim: To compare the efficacy of hepatic resection (HR) and transarterial chemoembolization (TACE) for patients with solitary huge (≥ 10 cm) hepatocellular carcinoma (HCC).

Methods: Records were retrospectively analyzed of 247 patients with solitary huge HCC, comprising 180 treated by HR and 67 by TACE. Long-term overall survival (OS) was compared between the two groups using the Kaplan-Meier method, and independent predictors of survival were identified by multivariate analysis. These analyses were performed using all patients in both groups and/or 61 pairs of propensity score-matched patients from the two groups.

Results: OS at 5 years was significantly higher in the HR group than the TACE group, across all patients (P = 0.002) and across propensity score-matched pairs (36.4% vs 18.2%, P = 0.039). The two groups showed similar postoperative mortality and morbidity. Multivariate analysis identified alpha-fetoprotein ≥ 400 ng/mL, presence of vascular invasion and TACE treatment as independent predictors of poor OS.

Conclusion: Our findings suggest that HR can be safe and more effective than TACE for patients with solitary huge HCC.

Keywords: Hepatic resection; Overall survival; Propensity score matching; Solitary huge hepatocellular carcinoma; Transarterial chemoembolization.

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Figures

Figure 1
Figure 1
Flowchart of patient selection. HCC: Hepatocellular carcinoma; HR: Hepatic resection; TACE: Transarterial chemoembolization.
Figure 2
Figure 2
Comparison of overall survival across all study participants with solitary huge hepatocellular carcinoma undergoing hepatic resection or transarterial chemoembolization. HR: Hepatic resection; TACE: Transarterial chemoembolization.
Figure 3
Figure 3
Comparison of overall survival across propensity score-matched study participants with solitary huge hepatocellular carcinoma undergoing hepatic resection or transarterial chemoembolization. HR: Hepatic resection; TACE: Transarterial chemoembolization.
Figure 4
Figure 4
Disease-free survival in propensity score-matched patients with solitary huge hepatocellular carcinoma undergoing hepatic resection.
See this image and copyright information in PMC

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