Long‐term survival after surgical resection for huge hepatocellular carcinoma: Comparison with transarterial chemoembolization after propensity score matching. Issue 5 (May 2014)

• Record Type: Journal Article
• Authors: Min, Yang Won; Lee, Jun Hee; Gwak, Geum‐Youn; Paik, Yong Han; Lee, Joon Hyoek; Rhee, Poong‐Lyul; Koh, Kwang Cheol; Paik, Seung Woon; Yoo, Byung Chul; Choi, Moon Seok
• Is Part Of: Journal of gastroenterology and hepatology. Volume 29:Issue 5(2014:May)
• Page Start: 1043
• Page End: 1048
• Publication Date: 2014-05
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.12504
• Languages: English
• ISSNs: 0815-9319

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jgh12504-sec-0001" sec-type="section"> <title>Background and Aims</title> <p>Surgical resection (SR) and transarterial chemoembolization (TACE) have been commonly applied for patients with huge hepatocellular carcinoma (HCC). However, optimal treatment has not been established.</p> </sec> <sec id="jgh12504-sec-0002" sec-type="section"> <title>Methods</title> <p>Between 2000 and 2009, 267 patients with huge HCC (≥ 10 cm) underwent TACE and 84 underwent SR as the first treatment. Propensity score matching generated a matched cohort composed of 152 patients. We investigated overall survival and possible prognostic factors.</p> </sec> <sec id="jgh12504-sec-0003" sec-type="section"> <title>Results</title> <p>At baseline, the surgery group showed a tendency to have solitary tumor (72.6% <italic>vs</italic> 39.3%, <italic>P</italic> < 0.001), less vessel invasion (29.8% <italic>vs</italic> 51.3%, <italic>P</italic> < 0.001), and unilobar tumor extent (77.4% <italic>vs</italic> 50.9%, <italic>P</italic> < 0.001) than TACE group. During median follow up of 10 months (range: 0–103), the surgery group showed higher 1‐, 3‐, and 5‐year overall survival rates than TACE group (73.8%, 54.8%, and 39.8% <italic>vs</italic> 37.8%, 16.3%, and 9.7%, respectively, <italic>P</italic> < 0.001). In the propensity score‐matched cohort, baseline characteristics did not differ between the two groups. Surgery group showed higher 1‐, 2‐, and 3‐year overall survival rates than TACE group (69.7%, 58.6%, and 51.7% <italic>vs</italic> 40.2%, 33.9%, and 18.5%, respectively, <italic>P</italic> < 0.001) during median follow up of 14.5 months (range: 0–103). Multivariate analysis revealed that male (HR 1.90; 95% CI, 1.01–3.58; <italic>P</italic> = 0.048), albumin (HR 0.54; 95% CI, 0.34–0.85; <italic>P</italic> = 0.008), ascites (HR 1.77; 95% CI, 1.02–3.08; <italic>P</italic> = 0.044), and SR (HR 0.44; 95% CI, 0.28–0.70; <italic>P</italic> = 0.001) were the independent prognostic factors associated with survival.</p> </sec> <sec id="jgh12504-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Comparing survival after SR and TACE, we showed that SR would be associated with better outcomes than TACE as the first treatment of huge HCC.</p> </sec> </abstract>