COMPARATIVE STUDY
JOURNAL ARTICLE

[Comparison of hepatic resection and transarterial chemoembolization for hepatocellular carcinoma within the Milan criteria]

Zhe Guo, Bangde Xiang, Jun Zhang, Jinghang Jiang, Lequn Li
Zhonghua Yi Xue za Zhi [Chinese medical journal] 2014 May 27, 94 (20): 1526-9
25146737

OBJECTIVE: To compare the long-term survival of hepatocellular carcinoma (HCC) patients within the Milan criteria who underwent hepatic resection (HR) or transarterial chemoembolization (TACE).

METHODS: A total of 159 HR and 42 TACE patients with HCC within the Milan criteria were retrospectively evaluated. Propensity-score matching (PSM) was used to generate matched controls. Long-term survival was evaluated by the Kaplan-Meier method. And independent prognostic predictors were determined by the Cox proportional hazard model.

RESULTS: After adjusting for baseline differences, 84 HR and 42 TACE patients were selected. Median survival time was 42.9 months in HR group versus 34.8 months in TACE group. The 1, 3 and 5-years survival rates were significantly higher in HR group (87.8%, 64.0%, 41.9%) than those in TACE group (85.7%, 47.6%, 26.0%; P = 0.028). Subgroup analysis showed that the patients with single-tumor HCC ≤ 5 cm had 1, 3 and 5-year overall survival rates of 86.3%, 61.3% and 42.9% after HR versus 90.3%, 61.3% and 33.2% after TACE (P = 0.332). Among those with multinodular HCC involving 2-3 tumors ≤ 3 cm, 1, 3 and 5-years survival rates were 93.8%, 75.0% and 39.3% after HR versus 72.7%, 45.5% and 9.1% after TACE (P = 0.002). Body mass index ≥ 23 kg/m(2), serum level of alpha-fetoprotein (AFP) ≥ 400 µg/L and TACE treatment significantly predicted poor survival according to the Cox proportional hazard model (all P < 0.05).

CONCLUSIONS: Hepatic resection provides better long-term survival than TACE for HCC patients within the Milan Criteria. In fact, HR provides significant long-term survival benefits for patients with multinodular HCC involving 2-3 tumors ≤ 3 cm. In contrast, both HR and TACE have similar survival rates among patients with single-tumor HCC ≤ 5 cm.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
25146737
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"