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J Surg Oncol. 2017 Mar;115(4):407-416. doi: 10.1002/jso.24519. Epub 2016 Dec 23.

Therapeutic priorities for solitary large hepatocellular carcinoma in a hepatitis B virus endemic area; an analysis of a nationwide cancer registry database.

Jin YJ1,2, Lee JW1,2.

Author information

1
Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, South Korea.
2
The Korean Liver Cancer Study Group, South Korea.

Abstract

BACKGROUND/AIMS:

We compared overall survival (OS) of patients with a solitary large (>5 cm) hepatocellular carcinoma (HCC) treated surgically or by transarterial chemoembolization (TACE).

METHODS:

The archived records of HCC patients registered at the Korean Central Cancer Registry from 2003 through 2005 (registry A, n = 4 520) or from 2008 through 2010 (registry B, n = 4 596) were retrospectively analyzed. In these registries, 578 and 315 patients had a single large HCC, respectively. In registry A, 442 (cohort A) underwent surgery (n = 96) or TACE (n = 346). In registry B, 253 (cohort B) underwent surgery (n = 110) or TACE (n = 143). Cohort C (n = 695) was constructed by combining cohorts A and B, and thus, 206 and 489 patients received surgery and TACE, respectively.

RESULTS:

In cohort C, cumulative OS rates at 1-, 3-, and 5-years were significantly higher for surgery than TACE (89.3%, 67.4%, and 58.0% vs 67.7%, 38.2%, and 27.2%, respectively, P < 0.001). Similar results were obtained for cohorts A and B, even after propensity-score matching in three cohorts (P values for all <0.05). TACE (HR 2.18, P < 0.001), serum albumin (HR 0.77, P = 0.015), and tumor size (HR 1.06, P < 0.001) were predictors of post-treatment mortality.

CONCLUSIONS:

Surgery is associated with improved OS for a solitary large HCC of BCLC stage A.

KEYWORDS:

barcelona clinic liver cancer; hepatocellular carcinoma; surgery; transarterial chemoembolization

PMID:
28008620
DOI:
10.1002/jso.24519
[Indexed for MEDLINE]

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