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Hepatic resection or transarterial chemoembolization for hepatocellular carcinoma within Milan criteria: A propensity score matching analysis.

Abstract This study aimed to compare the long-term survival of patients with hepatocellular carcinoma (HCC) within the Milan criteria who underwent hepatic resection (HR) or transarterial chemoembolization (TACE).Medical records were retrospectively analyzed for HCC patients within the Milan criteria treated at Affiliated Tumor Hospital of Guangxi Medical University between March 2003 and March 2008, 159 of whom underwent HR and 42 of whom underwent TACE. Long-term overall survival (OS) was evaluated using the Kaplan-Meier method before and after propensity score matching. Cox proportional hazard modeling was used to identify possible predictors of OS.Propensity score matching was used to generate 32 pairs of patients, for which OS was significantly higher after HR than TACE at 1 year, 96.6% versus 84.4%; 3 years, 75.4% versus 53.1%; 5 years, 48.8% versus 29.7%, respectively (P = .038). Among all patients with multinodular HCC (2-3 tumors ≤3 cm), HR was also associated with significantly higher OS than TACE at 1 year, 95.2% versus 72.7%; 3 years, 71.4% versus 9.1%; 5 years, 35.1% versus 0%, respectively (P < .001). By contrast, among all patients with a single HCC tumor ≤5 cm, HR and TACE were associated with similar OS at 1 year, 85.9% versus 90.3%; 3 years, 62.0% versus 61.3%; 5 years, 42.1% versus 33.2%, respectively (P = .332).HR provides survival benefit over TACE in HCC patients within the Milan criteria, especially patients with multinodular HCC involving 2 to 3 tumors ≤3 cm. However, HR and TACE appear to be similarly effective for patients with single-tumor HCC ≤5 cm.
PMID
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Comparison of hepatic resection and transarterial chemoembolization for hepatocellular carcinoma within the Milan criteria.

Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29390426
OWN - NLM
STAT- In-Process
LR  - 20180210
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 51
DP  - 2017 Dec
TI  - Hepatic resection or transarterial chemoembolization for hepatocellular carcinoma
      within Milan criteria: A propensity score matching analysis.
PG  - e8933
LID - 10.1097/MD.0000000000008933 [doi]
AB  - This study aimed to compare the long-term survival of patients with
      hepatocellular carcinoma (HCC) within the Milan criteria who underwent hepatic
      resection (HR) or transarterial chemoembolization (TACE).Medical records were
      retrospectively analyzed for HCC patients within the Milan criteria treated at
      Affiliated Tumor Hospital of Guangxi Medical University between March 2003 and
      March 2008, 159 of whom underwent HR and 42 of whom underwent TACE. Long-term
      overall survival (OS) was evaluated using the Kaplan-Meier method before and
      after propensity score matching. Cox proportional hazard modeling was used to
      identify possible predictors of OS.Propensity score matching was used to generate
      32 pairs of patients, for which OS was significantly higher after HR than TACE at
      1 year, 96.6% versus 84.4%; 3 years, 75.4% versus 53.1%; 5 years, 48.8% versus
      29.7%, respectively (P = .038). Among all patients with multinodular HCC (2-3
      tumors &lt;/=3 cm), HR was also associated with significantly higher OS than TACE at
      1 year, 95.2% versus 72.7%; 3 years, 71.4% versus 9.1%; 5 years, 35.1% versus 0%,
      respectively (P &lt; .001). By contrast, among all patients with a single HCC tumor 
      &lt;/=5 cm, HR and TACE were associated with similar OS at 1 year, 85.9% versus
      90.3%; 3 years, 62.0% versus 61.3%; 5 years, 42.1% versus 33.2%, respectively (P 
      = .332).HR provides survival benefit over TACE in HCC patients within the Milan
      criteria, especially patients with multinodular HCC involving 2 to 3 tumors &lt;/=3 
      cm. However, HR and TACE appear to be similarly effective for patients with
      single-tumor HCC &lt;/=5 cm.
CI  - Copyright (c) 2017 The Authors. Published by Wolters Kluwer Health, Inc. All
      rights reserved.
FAU - Guo, Zhe
AU  - Guo Z
AD  - Department of Hepatobiliary Surgery, Tumor Hospital of Guangxi Medical
      University, Nanning, Guangxi Zhuang Autonomous Region.
AD  - Department of Thyroid and Breast Surgery, The Central Hospital of Wuhan, Tongji
      Medical College, Huazhong University of Science and Technology, Wuhan.
FAU - Zhong, Yuan
AU  - Zhong Y
AD  - Department of Thyroid and Breast Surgery, The Central Hospital of Wuhan, Tongji
      Medical College, Huazhong University of Science and Technology, Wuhan.
FAU - Hu, Bo
AU  - Hu B
AD  - Department of Thyroid and Breast Surgery, The Central Hospital of Wuhan, Tongji
      Medical College, Huazhong University of Science and Technology, Wuhan.
FAU - Jiang, Jing-Hang
AU  - Jiang JH
AD  - Department of General Surgery, The Second People's Hospital of Jing Men, Jingmen,
      Hubei Province, China.
FAU - Li, Le-Qun
AU  - Li LQ
AD  - Department of Hepatobiliary Surgery, Tumor Hospital of Guangxi Medical
      University, Nanning, Guangxi Zhuang Autonomous Region.
FAU - Xiang, Bang-De
AU  - Xiang BD
AD  - Department of Hepatobiliary Surgery, Tumor Hospital of Guangxi Medical
      University, Nanning, Guangxi Zhuang Autonomous Region.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
PMC - PMC5758128
EDAT- 2018/02/03 06:00
MHDA- 2018/02/03 06:00
CRDT- 2018/02/03 06:00
PHST- 2018/02/03 06:00 [entrez]
PHST- 2018/02/03 06:00 [pubmed]
PHST- 2018/02/03 06:00 [medline]
AID - 10.1097/MD.0000000000008933 [doi]
AID - 00005792-201712220-00013 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Dec;96(51):e8933. doi: 10.1097/MD.0000000000008933.