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PMID- 25146737
OWN - NLM
STAT- MEDLINE
DCOM- 20150129
LR  - 20140822
IS  - 0376-2491 (Print)
IS  - 0376-2491 (Linking)
VI  - 94
IP  - 20
DP  - 2014 May 27
TI  - [Comparison of hepatic resection and transarterial chemoembolization for
      hepatocellular carcinoma within the Milan criteria].
PG  - 1526-9
AB  - OBJECTIVE: To compare the long-term survival of hepatocellular carcinoma (HCC)
      patients within the Milan criteria who underwent hepatic resection (HR) or
      transarterial chemoembolization (TACE). METHODS: A total of 159 HR and 42 TACE
      patients with HCC within the Milan criteria were retrospectively evaluated.
      Propensity-score matching (PSM) was used to generate matched controls. Long-term 
      survival was evaluated by the Kaplan-Meier method. And independent prognostic
      predictors were determined by the Cox proportional hazard model. RESULTS: After
      adjusting for baseline differences, 84 HR and 42 TACE patients were selected.
      Median survival time was 42.9 months in HR group versus 34.8 months in TACE
      group. The 1, 3 and 5-years survival rates were significantly higher in HR group 
      (87.8%, 64.0%, 41.9%) than those in TACE group (85.7%, 47.6%, 26.0%; P = 0.028). 
      Subgroup analysis showed that the patients with single-tumor HCC </= 5 cm had 1, 
      3 and 5-year overall survival rates of 86.3%, 61.3% and 42.9% after HR versus
      90.3%, 61.3% and 33.2% after TACE (P = 0.332). Among those with multinodular HCC 
      involving 2-3 tumors </= 3 cm, 1, 3 and 5-years survival rates were 93.8%, 75.0% 
      and 39.3% after HR versus 72.7%, 45.5% and 9.1% after TACE (P = 0.002). Body mass
      index >/= 23 kg/m(2), serum level of alpha-fetoprotein (AFP) >/= 400 microg/L and
      TACE treatment significantly predicted poor survival according to the Cox
      proportional hazard model (all P < 0.05). CONCLUSIONS: Hepatic resection provides
      better long-term survival than TACE for HCC patients within the Milan Criteria.
      In fact, HR provides significant long-term survival benefits for patients with
      multinodular HCC involving 2-3 tumors </= 3 cm. In contrast, both HR and TACE
      have similar survival rates among patients with single-tumor HCC </= 5 cm.
FAU - Guo, Zhe
AU  - Guo Z
AD  - Department of Hepatobiliary Surgery, Affiliated Tumor Hospital, Guangxi Medical
      University, Nanning 530021, China.
FAU - Xiang, Bangde
AU  - Xiang B
FAU - Zhang, Jun
AU  - Zhang J
FAU - Jiang, Jinghang
AU  - Jiang J
FAU - Li, Lequn
AU  - Li L
AD  - Email: [email protected]
LA  - chi
PT  - Comparative Study
PT  - English Abstract
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - China
TA  - Zhonghua Yi Xue Za Zhi
JT  - Zhonghua yi xue za zhi
JID - 7511141
SB  - IM
MH  - Adult
MH  - Carcinoma, Hepatocellular/surgery/*therapy
MH  - *Chemoembolization, Therapeutic
MH  - Female
MH  - Follow-Up Studies
MH  - *Hepatectomy
MH  - Hepatic Artery
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Liver Neoplasms/surgery/*therapy
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Retrospective Studies
MH  - Treatment Outcome
EDAT- 2014/08/26 06:00
MHDA- 2015/01/30 06:00
CRDT- 2014/08/23 06:00
PHST- 2014/08/23 06:00 [entrez]
PHST- 2014/08/26 06:00 [pubmed]
PHST- 2015/01/30 06:00 [medline]
PST - ppublish
SO  - Zhonghua Yi Xue Za Zhi. 2014 May 27;94(20):1526-9.