Comparison of hepatic resection and transarterial chemoembolization for UICC stage T3 hepatocellular carcinoma: a propensity score matching study

被引:10
|
作者
Zhong, Chong [1 ,2 ]
Zhang, Yong-Fa [3 ,4 ,6 ]
Huang, Jun-Hai [1 ,2 ]
Xiong, Cheng-Ming [5 ]
Wang, Zi-Yu [5 ]
Chen, Qing-Lian [5 ]
Guo, Rong-Ping [6 ]
机构
[1] Guangzhou Univ Chinese Med, Lingnan Med Res Ctr, 16 Airport Rd, Guangzhou 510405, Guangdong, Peoples R China
[2] Guangzhou Univ Chinese Med, Affiliated Hosp 1, Dept Hepatobiliary Surg, 16 Airport Rd, Guangzhou 510405, Guangdong, Peoples R China
[3] Fudan Univ, Shanghai Canc Ctr, Dept Liver Surg, Shanghai 200032, Peoples R China
[4] Fudan Univ, Shanghai Med Coll, Dept Oncol, Shanghai 200032, Peoples R China
[5] Guangzhou Univ Chinese Med, Sch Clin Med 1, Guangzhou 510405, Guangdong, Peoples R China
[6] Sun Yat Sen Univ, Ctr Canc, Dept Hepatobiliary Oncol, Guangzhou 510060, Guangdong, Peoples R China
来源
BMC CANCER | 2018年 / 18卷
基金
中国国家自然科学基金;
关键词
Hepatocellular carcinoma; Hepatic resection; TACE; Propensity score matching study; TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION; VEIN TUMOR THROMBOSIS; PORTAL-VEIN; MILAN CRITERIA; SURGICAL RESECTION; CLINICAL-PRACTICE; DECISION-MAKING; SURVIVAL; HEPATECTOMY; OUTCOMES;
D O I
10.1186/s12885-018-4557-5
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: The optimal therapeutic strategy in UICC stage T3 hepatocellular carcinoma (HCC) patients that maximizes both safety and long-term outcome has not yet been determined. Our aim was to compare clinical outcomes following hepatic resection (HR) versus transarterial chemoembolization (TACE) for stage T3 HCC. Methods: From 2005 to 2013, 1179 patients with T3 HCC who underwent HR or TACE were divided into two groups, HR group (n = 280) or TACE group (n = 899). The clinical outcomes were compared before and after propensity score matching. Results: The propensity model matched 244 patients in each group for further analyses. After matching, medium overall survival (OS), 1, 3, and 5-year OS rates in TACE group were 11.8 (95%Cl, 9.9-13.7) months, 49.6, 16.5, and 8.4%, respectively; which in HR group were 17.8 (95% CI, 14.8-20.8) months, 63.1, 33.3, and 26.4%, respectively; (log rank = 19.908, P < 0.01). Patients in HR group were more likely to develop pleural effusion, compared with those in TACE group (0.4% vs. 5.3%, P= 0.01). However, no significant differences in other adverse events (AEs) were found between two groups. Similar results were also demonstrated prior to the matched analysis. Multivariate analysis indicated that prothrombin time (PT), tumor size, tumor numbers, UICC staging status, and initial treatment were independent prognostic factors. Conclusions: Our study revealed that TACE was an option for UICC T3 HCC patients. However, HR seemed to be safe and yield a survival benefit compared with TACE, especially for patients with a good underlying liver function.
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页数:10
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