Kazuya Kariyama1, Kazuhiro Nouso1, Akiko Wakuta1, Ayano Oonishi1, Hidenori Toyoda2, Toshifumi Tada2, Atsushi Hiraoka3, Kunihiko Tsuji4, Ei Itobayashi5, Toru Ishikawa6, Koichi Takaguchi7, Akemi Tsutsui7, Noritomo Shimada8, Takashi Kumada2. 1. aDepartment of Gastroenterology and Liver Disease Center, Okayama City Hospital, Okayama, Japan. 2. bDepartment of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Gifu, Japan. 3. cGastroenterology Center, Ehime Prefectural Central Hospital, Ehime, Japan. 4. dCenter of Gastroenterology, Teine Keijinkai Hospital, Hokkaido, Japan. 5. eDepartment of Gastroenterology, Asahi General Hospital, Chiba, Japan. 6. fDepartment of Gastroenterology, Saiseikai Niigata Daini Hospital, Niigata, Japan. 7. gDepartment of Hepatology, Kagawa Prefectural Central Hospital, Kagawa, Japan. 8. hDepartment of Gastroenterology and Hepatology, Otakanomori Hospital, Chiba, Japan.
Abstract
BACKGROUND: Transcatheter arterial chemoembolization (TACE) is the standard therapy for intermediate-stage (IM) hepatocellular carcinoma (HCC). However, IM-HCC includes various clinical conditions, and various therapies were conducted in practice. In this study, we retrospectively analyzed the actually conducted treatments for IM-HCC and their efficacies to elucidate the treatment strategies suitable for IM-HCC. METHODS: This study included 627 IM-HCC of 5,260 HCC from 9 hospitals. We examined the treatment strategies of these patients and analyzed the efficacy of each therapy with the Cox proportional hazard model and propensity score-matched analysis. RESULTS: Liver resection, radiofrequency ablation (RFA), and TACE were performed in 165, 108, and 351 patients, respectively. Liver resection and RFA were preferably selected in cases of Barcelona Clinic Liver Cancer (BCLC)-B1/B2, and patient survival was significantly longer than in those treated with TACE (p< 0.0001). However, no beneficial effect of these active therapies was observed in cases of BCLC-B3/B4. Multivariate analysis revealed that surgical resection (hazard ratio = 0.384) and RFA (hazard ratio = 0.597) were negative risk factors for survival. Propensity score-matching analysis revealed that -survival of RFA-treated patients was longer than that of TACE-treated patients (p = 0.036). CONCLUSION: RFA and surgical resection were effective for IM-HCC, particularly in BCLC-B1/B2 cases.
BACKGROUND: Transcatheter arterial chemoembolization (TACE) is the standard therapy for intermediate-stage (IM) hepatocellular carcinoma (HCC). However, IM-HCC includes various clinical conditions, and various therapies were conducted in practice. In this study, we retrospectively analyzed the actually conducted treatments for IM-HCC and their efficacies to elucidate the treatment strategies suitable for IM-HCC. METHODS: This study included 627 IM-HCC of 5,260 HCC from 9 hospitals. We examined the treatment strategies of these patients and analyzed the efficacy of each therapy with the Cox proportional hazard model and propensity score-matched analysis. RESULTS: Liver resection, radiofrequency ablation (RFA), and TACE were performed in 165, 108, and 351 patients, respectively. Liver resection and RFA were preferably selected in cases of Barcelona Clinic Liver Cancer (BCLC)-B1/B2, and patient survival was significantly longer than in those treated with TACE (p< 0.0001). However, no beneficial effect of these active therapies was observed in cases of BCLC-B3/B4. Multivariate analysis revealed that surgical resection (hazard ratio = 0.384) and RFA (hazard ratio = 0.597) were negative risk factors for survival. Propensity score-matching analysis revealed that -survival of RFA-treated patients was longer than that of TACE-treated patients (p = 0.036). CONCLUSION: RFA and surgical resection were effective for IM-HCC, particularly in BCLC-B1/B2 cases.
Authors: R Yamada; M Sato; H Nakatsuka; K Nakamura; I Shibakiri; M Itami; N Kobayashi; S Takashima; K Minakuchi; S Yamaguchi; Y Onoyama Journal: Nihon Igaku Hoshasen Gakkai Zasshi Date: 1981
Authors: Myung Han Hyun; Young-Sun Lee; Ji Hoon Kim; Chan Uk Lee; Young Kul Jung; Yeon Seok Seo; Hyung Joon Yim; Jong Eun Yeon; Kwan Soo Byun Journal: Hepatology Date: 2018-05-21 Impact factor: 17.425
Authors: Anna Pecorelli; Barbara Lenzi; Annagiulia Gramenzi; Francesca Garuti; Fabio Farinati; Edoardo G Giannini; Francesca Ciccarese; Fabio Piscaglia; Gian Lodovico Rapaccini; Maria Di Marco; Eugenio Caturelli; Marco Zoli; Franco Borzio; Rodolfo Sacco; Giuseppe Cabibbo; Martina Felder; Filomena Morisco; Antonio Gasbarrini; Gianluca Svegliati Baroni; Francesco G Foschi; Elisabetta Biasini; Alberto Masotto; Roberto Virdone; Mauro Bernardi; Franco Trevisani Journal: Liver Int Date: 2016-10-02 Impact factor: 5.828