BACKGROUND/AIMS: The aim of this study was to compare the outcomes of surgery and transarterial chemoembolization (TACE) for a solitary huge hepatocellular carcinoma (HCC) of Barcelona Clinic Liver Cancer (BCLC) stage A. METHODS: One hundred twenty-three consecutive patients with a solitary large (>5 cm) HCC classified at the BCLC stage A were analyzed. The posttreatment survival outcomes of patients that underwent surgery or TACE were compared. RESULTS: The median age was 58 years (range, 29-90 years). The most common cause of HCC is hepatitis B virus infection (61.8%). Median tumor size was 8.0 cm (range, 5.1-25 cm), and 97 patients (78.9%) were of Child-Turcotte-Pugh class A. Median posttreatment follow-up duration was 18 months (range, 0.1-136 months). Of the 123 patients, 62 (50.4%) underwent surgery and 61 (49.6%) underwent TACE. Cumulative overall survival rates in the surgical group at 1, 3, and 5 years were significantly higher than those in the TACE group (83.2, 75.7, and 65.0% vs 68.5, 45.0, and 17.5%, respectively, P < 0.01). In subgroup analysis, the cumulative overall survival in both surgical groups was significantly greater than in corresponding TACE subgroups (P = 0.04 for ≥ 8-cm subgroup and P < 0.01 for 5- to 8-cm-sized subgroups). Multivariate analysis showed that a larger tumor size (≥ 8 cm) (hazard ratio [HR] 2.14, P = 0.02) was significantly associated with posttreatment mortality, whereas surgery (HR 0.37, P < 0.01) compared with TACE was inversely associated with posttreatment mortality. CONCLUSIONS: Surgery may be the more effective treatment modality than TACE for a solitary large HCC of the BCLC stage A, regardless of tumor size.
BACKGROUND/AIMS: The aim of this study was to compare the outcomes of surgery and transarterial chemoembolization (TACE) for a solitary huge hepatocellular carcinoma (HCC) of Barcelona Clinic Liver Cancer (BCLC) stage A. METHODS: One hundred twenty-three consecutive patients with a solitary large (>5 cm) HCC classified at the BCLC stage A were analyzed. The posttreatment survival outcomes of patients that underwent surgery or TACE were compared. RESULTS: The median age was 58 years (range, 29-90 years). The most common cause of HCC is hepatitis B virus infection (61.8%). Median tumor size was 8.0 cm (range, 5.1-25 cm), and 97 patients (78.9%) were of Child-Turcotte-Pugh class A. Median posttreatment follow-up duration was 18 months (range, 0.1-136 months). Of the 123 patients, 62 (50.4%) underwent surgery and 61 (49.6%) underwent TACE. Cumulative overall survival rates in the surgical group at 1, 3, and 5 years were significantly higher than those in the TACE group (83.2, 75.7, and 65.0% vs 68.5, 45.0, and 17.5%, respectively, P < 0.01). In subgroup analysis, the cumulative overall survival in both surgical groups was significantly greater than in corresponding TACE subgroups (P = 0.04 for ≥ 8-cm subgroup and P < 0.01 for 5- to 8-cm-sized subgroups). Multivariate analysis showed that a larger tumor size (≥ 8 cm) (hazard ratio [HR] 2.14, P = 0.02) was significantly associated with posttreatment mortality, whereas surgery (HR 0.37, P < 0.01) compared with TACE was inversely associated with posttreatment mortality. CONCLUSIONS: Surgery may be the more effective treatment modality than TACE for a solitary large HCC of the BCLC stage A, regardless of tumor size.
Authors: S Arii; Y Yamaoka; S Futagawa; K Inoue; K Kobayashi; M Kojiro; M Makuuchi; Y Nakamura; K Okita; R Yamada Journal: Hepatology Date: 2000-12 Impact factor: 17.425
Authors: Emmanuel Gabriel; Jin Kim; Katherine T Ostapoff; Kristopher Attwood; Sergei Kurenov; Boris Kuvshinoff; Steven N Hochwald; Steven J Nurkin Journal: J Gastrointest Oncol Date: 2018-04