Superselective transarterial chemoembolization vs hepatic resection for resectable early-stage hepatocellular carcinoma in patients with Child-Pugh class a liver function
| Autor: | Ming-Lang Shih, De-Chuan Chan, Kuo-Feng Hsu, C.-H. Chu, Jyh-Cherng Yu, Huan-Fa Hsieh, Tsai-Yuan Hsieh, Chung-Bao Hsieh, Chih-Yung Yu |
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| Rok vydání: | 2012 |
| Předmět: |
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medicine.medical_specialty Carcinoma Hepatocellular Hepatic resection medicine.medical_treatment Group ii Gastroenterology Risk Factors Mean Survival Time Internal medicine medicine Hepatectomy Humans Radiology Nuclear Medicine and imaging In patient Chemoembolization Therapeutic Stage (cooking) Serum Albumin Aged Neoplasm Staging Proportional Hazards Models business.industry Liver Neoplasms General Medicine Middle Aged medicine.disease Survival Rate Treatment Outcome Hepatocellular carcinoma Female Liver function Neoplasm Grading Neoplasm Recurrence Local business |
| Zdroj: | European Journal of Radiology. 81:466-471 |
| ISSN: | 0720-048X |
| DOI: | 10.1016/j.ejrad.2010.12.058 |
| Popis: | In contrast to hepatic resection (HR) for resectable early-stage HCC, the efficacy of transarterial chemoembolization (TACE) is controversial. This study is designed to compare the long-term outcome of TACE using superselective technique with hepatic resection for the treating resectable early-stage HCC and Child-Pugh class A liver function.In total, 185 consecutive patients with resectable early-stage HCC and Child-Pugh class A liver function were included: 73 patients received superselective TACE (group I) and 112 patients underwent HR (group II). We evaluated the therapy-related recurrence and long-term outcome and in both groups. The risk factors of recurrence and mortality were assessed by Cox's model.The mean survival time of group 1 patient was similar to that of group 2 patient (40.8±19.8 vs 46.7±24.6 months respectively, p=0.91). The 1-, 3-, and 5-year overall survival rates after TACE (group I)and HR (group II) were 91%, 66%, and 52% and 93%, 71%, and 57%, respectively (p=0.239). The 1-, 3-, and 5-year recurrence-free survival rates in groups 1 and 2 were 68%, 28%, and 17% and 78%, 55%, and 35%, respectively (p0.0001). Serum albumin, tumour size, tumour number and recurrence interval were independent risk factors for mortality. Serum albumin level, tumour size, tumour number, and treatment modality of TACE or HR could predict HCC recurrence.TACE is an efficient and safe treatment for resectable early-stage HCC with overall survival rates similar to that of HR. Thus, TACE is indicated in selected patients with resectable early-stage HCC. |
| Databáze: | OpenAIRE |
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