期刊
JOURNAL OF SURGICAL ONCOLOGY
卷 111, 期 4, 页码 404-409出版社
WILEY
DOI: 10.1002/jso.23854
关键词
BCLC; surgical resection; transarterial chemoembolization; treatment algorithm; hepatocellular carcinoma
资金
- Center of Excellence for Cancer Research at Taipei Veterans General Hospital [DOH102-TD-C-111-007]
- Taipei Veterans General Hospital [V103C-008]
- Ministry of Education, Aiming for the Top University Plan [103AC-P618]
BackgroundSorafenib is the only recommended treatment for patients with Barcelona Clinic Liver Cancer (BCLC) stage C hepatocellular carcinoma (HCC). We aimed to compare surgical resection (SR) and transarterial chemoembolization (TACE) for advanced (BCLC stage C) HCC patients. MethodsA total of 264 and 389 advanced HCC patients received SR and TACE, respectively. Among them, 163 matched pairs of patients were identified from each treatment arm by propensity score matching analysis to compare long-term survival. ResultsOf all patients, the SR group had better liver functional reserve than the TACE group. In the matched propensity model, the baseline characteristics were similar between patients receiving SR and TACE. SR provided significantly better long-term survival than TACE in all patients and in patients selected in the propensity model (both P<0.001). In the Cox proportional hazards model, patients receiving TACE had a 2.393-fold increased risk of mortality compared with patients receiving SR (95% confidence interval: 1.610-3.556, P<0.001). ConclusionsSR provides significantly better long-term survival than TACE in patients with BCLC stage C HCC, and should be an integral part in the management of advanced HCC. Multidisciplinary approaches for these patients and further amendment to the BCLC classification scheme are required. J. Surg. Oncol. 2015 111:404-409. (c) 2015 Wiley Periodicals, Inc.
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