Surgical resection versus transarterial chemoembolization for BCLC stage C hepatocellular carcinoma.
J Surg Oncol
; 111(4): 404-9, 2015 Mar 15.
Article
em En
| MEDLINE
| ID: mdl-25643842
ABSTRACT
BACKGROUND:
Sorafenib 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.METHODS:
A 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.RESULTS:
Of 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).CONCLUSIONS:
SR 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.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Quimioembolização Terapêutica
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Carcinoma Hepatocelular
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Neoplasias Hepáticas
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Aged
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Female
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Humans
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Male
/
Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
J Surg Oncol
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Taiwan