Yuichi Sugino1, Koichiro Yamakado2, Takashi Yamanaka3, Masashi Fujimori3, Atsuhiro Nakatsuka3, Haruyuki Takaki2, Yoshiyuki Takei4, Hajime Sakuma3, Shuji Isaji5. 1. Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan. ysugino23@gmail.com. 2. Department of Radiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. 3. Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan. 4. Department of Gastroenterology and Hepatology, Mie University School of Medicine, Tsu, Mie, Japan. 5. Department of Hepato-Biliary-Pancreas Transplant Surgery, Mie University School of Medicine, Tsu, Mie, Japan.
Abstract
PURPOSE: To retrospectively evaluate the role of curative treatment in patients with intermediate-stage hepatocellular carcinomas (HCCs), and to identify the subgroup having benefit from curative treatment. METHODS: From April 2000 to December 2014, 100 patients with intermediate-stage HCCs underwent either curative treatment (hepatectomy: n = 23, radiofrequency ablation (RFA); n = 29, both: n = 4) or transarterial chemoembolization (TACE): n = 44) as initial treatments for HCCs. Overall survival, influence of treatment allocation on prognosis, and factors affecting treatment allocation were evaluated. RESULTS: The 5-year survival rate was 59.2% [95% confidence interval (CI) 51.6-66.8%] in the curative group, and 25.1% (95% CI 11.5-38.7%) in the TACE group. Treatment allocation was the only significant prognostic factor (p = 0.014, hazard ratio: 0.382, 95% CI 0.177-0.821). The curative group consisted of more patients with Child-Pugh A (p = 0.0016) than the TACE group, a tumor number of 3 or fewer (p < 0.0001), a unilobar tumor location (p = 0.02), within 4 of 7 cm criterion (p = 0.001), and within up-to-7 criterion (p = 0.04). Child-Pugh A, within the 4 of 7 cm criterion, and a unilobar tumor location were significantly linked with treatment allocation in multivariate analysis. CONCLUSIONS: Curative treatment can prolong survival in selected patients with intermediate-stage HCCs.
PURPOSE: To retrospectively evaluate the role of curative treatment in patients with intermediate-stage hepatocellular carcinomas (HCCs), and to identify the subgroup having benefit from curative treatment. METHODS: From April 2000 to December 2014, 100 patients with intermediate-stage HCCs underwent either curative treatment (hepatectomy: n = 23, radiofrequency ablation (RFA); n = 29, both: n = 4) or transarterial chemoembolization (TACE): n = 44) as initial treatments for HCCs. Overall survival, influence of treatment allocation on prognosis, and factors affecting treatment allocation were evaluated. RESULTS: The 5-year survival rate was 59.2% [95% confidence interval (CI) 51.6-66.8%] in the curative group, and 25.1% (95% CI 11.5-38.7%) in the TACE group. Treatment allocation was the only significant prognostic factor (p = 0.014, hazard ratio: 0.382, 95% CI 0.177-0.821). The curative group consisted of more patients with Child-Pugh A (p = 0.0016) than the TACE group, a tumor number of 3 or fewer (p < 0.0001), a unilobar tumor location (p = 0.02), within 4 of 7 cm criterion (p = 0.001), and within up-to-7 criterion (p = 0.04). Child-Pugh A, within the 4 of 7 cm criterion, and a unilobar tumor location were significantly linked with treatment allocation in multivariate analysis. CONCLUSIONS: Curative treatment can prolong survival in selected patients with intermediate-stage HCCs.
Authors: J-L Raoul; B Sangro; A Forner; V Mazzaferro; F Piscaglia; L Bolondi; R Lencioni Journal: Cancer Treat Rev Date: 2010-08-17 Impact factor: 12.111
Authors: G Pelletier; M Ducreux; F Gay; M Luboinski; H Hagège; T Dao; W Van Steenbergen; C Buffet; P Rougier; M Adler; J P Pignon; A Roche Journal: J Hepatol Date: 1998-07 Impact factor: 25.083
Authors: Luigi Bolondi; Andrew Burroughs; Jean-François Dufour; Peter R Galle; Vincenzo Mazzaferro; Fabio Piscaglia; Jean Luc Raoul; Bruno Sangro Journal: Semin Liver Dis Date: 2013-02-08 Impact factor: 6.115