Hepatic resection versus transarterial chemoembolization for patients with Barcelona Clinic Liver Cancer intermediate stage Child-Pugh A hepatocellular carcinoma

Zhao,Yin‑Nong; Zhang,Yong‑Quan; Ye,Jia‑Zhou; Liu,Xing; Yang,Hong‑Zhi; Cong,Feng‑Yun; Xiang,Bang‑De; Wu,Fei‑Xiang; Ma,Liang; Li,Le‑Qun; Ye,Hai‑Hong

doi:10.3892/etm.2016.3810

Hepatic resection versus transarterial chemoembolization for patients with Barcelona Clinic Liver Cancer intermediate stage Child-Pugh A hepatocellular carcinoma

Authors:
- Yin‑Nong Zhao
- Yong‑Quan Zhang
- Jia‑Zhou Ye
- Xing Liu
- Hong‑Zhi Yang
- Feng‑Yun Cong
- Bang‑De Xiang
- Fei‑Xiang Wu
- Liang Ma
- Le‑Qun Li
- Hai‑Hong Ye
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Affiliations: Department of Hepatobilliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China, Department of Hepatobilliary Surgery, The Affiliated Minzu Hospital of Guangxi Medical University, Nanning, Guangxi 530001, P.R. China
Published online on: October 17, 2016 https://doi.org/10.3892/etm.2016.3810
Pages: 3813-3819

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Abstract

The present study aimed to compare the overall and recurrence-free survival rates following hepatic resection (HR) and transcatheter arterial chemoembolization (TACE) in patients with Barcelona Clinic Liver Cancer (BCLC) classified intermediate‑stage Child‑Pugh A hepatocellular carcinoma (HCC). A total of 443 patients were examined, among whom 274 underwent HR, whereas 169 received TACE. The overall survival, recurrence‑free survival between groups and subgroups, and risk factors with respect to mortality and recurrence, were analyzed. The 1‑, 3‑ and 5‑year overall and recurrence‑free survival rates were 70, 46 and 37% and 73, 52, and 37%, respectively after HR, compared with 38, 15, and 12% and 44, 25 and 16%, respectively after TACE. Overall and recurrence‑free survival rates were significantly increased following HR compared with TACE. Subgroup analysis in the multi‑nodule group showed that the 1‑, 3‑ and 5‑year overall survival rates were 68, 38 and 30% after HR, compared with 36, 10 and 0% following TACE. In the solitary tumor group, 1‑, 3‑ and 5‑year overall survival rates were 71, 50 and 38% after HR, and 41, 22 and 15% after TACE. The overall survival rate after HR was significantly increased compared with that after TACE in the solitary tumor and multi‑nodule groups. The risk factors for mortality include solitary tumor diameter >10 cm, multi‑nodules, serum albumin level ≥35 g/l, prothrombin time >13 sec, alphafetoprotein levels >400 ng/ml, and patients with hepatitis B virus. Solitary tumor diameter >10 cm, multi‑nodules, and hepatitis B virus (P<0.001) were found to be associated with higher recurrence of HCC. Overall and recurrence‑free survival rates were improved after HR compared with those after TACE in BCLC stage B, Child-Pugh A, HCC patients.

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