Comparison of overall survival on surgical resection versus transarterial chemoembolization with or without radiofrequency ablation in intermediate stage hepatocellular carcinoma: a propensity score matching analysis
Abstract Background Patients with Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma (HCC) are recommended to undergo transcatheter arterial chemoembolization (TACE). However, TACE in combination with radiofrequency ablation (RFA) is not inferior to surgical resection (SR), and th...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-04-01
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| Series: | BMC Gastroenterology |
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| Online Access: | http://link.springer.com/article/10.1186/s12876-020-01235-w |
| _version_ | 1818997266472501248 |
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| author | Chih-Wen Lin Yaw-Sen Chen Gin-Ho Lo Yao-Chun Hsu Chia-Chang Hsu Tsung-Chin Wu Jen-Hao Yeh Pojen Hsiao Pei-Min Hsieh Hung-Yu Lin Chih-Wen Shu Chao-Ming Hung |
| author_facet | Chih-Wen Lin Yaw-Sen Chen Gin-Ho Lo Yao-Chun Hsu Chia-Chang Hsu Tsung-Chin Wu Jen-Hao Yeh Pojen Hsiao Pei-Min Hsieh Hung-Yu Lin Chih-Wen Shu Chao-Ming Hung |
| author_sort | Chih-Wen Lin |
| collection | DOAJ |
| description | Abstract Background Patients with Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma (HCC) are recommended to undergo transcatheter arterial chemoembolization (TACE). However, TACE in combination with radiofrequency ablation (RFA) is not inferior to surgical resection (SR), and the benefits of surgical resection (SR) for BCLC stage B HCC remain unclear. Hence, this study aims to compare the impact of SR, TACE+RFA, and TACE on analyzing overall survival (OS) in BCLC stage B HCC. Methods Overall, 428 HCC patients were included in BCLC stage B, and their clinical data and OS were recorded. OS was analyzed by the Kaplan-Meier method and Cox regression analysis. Results One hundred forty (32.7%) patients received SR, 57 (13.3%) received TACE+RFA, and 231 (53.9%) received TACE. The OS was significantly higher in the SR group than that in the TACE+RFA group [hazard ratio (HR): 1.78; 95% confidence incidence (CI): 1.15–2.75, p = 0.009]. The OS was significantly higher in the SR group than that in the TACE group (HR: 3.17; 95% CI: 2.31–4.36, p < 0.0001). Moreover, the OS was significantly higher in the TACE+RFA group than that in the TACE group (HR: 1.82; 95% CI: 1.21–2.74, p = 0.004). The cumulative OS rates at 1, 3 and 5 years in the SR, TACE+RFA, and TACE groups were 89.2, 69.4 and 61.2%, 86.0, 57.9 and 38.2%, and 69.5, 37.0 and 15.2%, respectively. After propensity score matching, the SR group still had a higher OS than those of the TACE+RFA and TACE groups. The TACE+RFA group had a higher OS than that of the TACE group. Conclusion The SR group had higher OS than the TACE+RFA and TACE groups in BCLC stage B HCC. Furthermore, the TACE+RFA group had higher OS than the TACE group. |
| first_indexed | 2024-12-20T21:42:54Z |
| format | Article |
| id | doaj.art-e8af76bea2e448e08ab126a35344c2a6 |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-20T21:42:54Z |
| publishDate | 2020-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-e8af76bea2e448e08ab126a35344c2a62022-12-21T19:25:45ZengBMCBMC Gastroenterology1471-230X2020-04-012011810.1186/s12876-020-01235-wComparison of overall survival on surgical resection versus transarterial chemoembolization with or without radiofrequency ablation in intermediate stage hepatocellular carcinoma: a propensity score matching analysisChih-Wen Lin0Yaw-Sen Chen1Gin-Ho Lo2Yao-Chun Hsu3Chia-Chang Hsu4Tsung-Chin Wu5Jen-Hao Yeh6Pojen Hsiao7Pei-Min Hsieh8Hung-Yu Lin9Chih-Wen Shu10Chao-Ming Hung11Division of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou UniversitySchool of Medicine, College of Medicine, I-Shou UniversityDivision of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou UniversityDivision of Gastroenterology and Hepatology, Department of Medicine, E-Da Hospital, I-Shou UniversityHealth Examination Center, E-Da Hospital, I-Shou UniversityDivision of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou UniversityDivision of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou UniversityDivision of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou UniversityDepartment of Surgery, E-Da Hospital, I-Shou UniversitySchool of Medicine, College of Medicine, I-Shou UniversitySchool of Medicine, College of Medicine, I-Shou UniversitySchool of Medicine, College of Medicine, I-Shou UniversityAbstract Background Patients with Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma (HCC) are recommended to undergo transcatheter arterial chemoembolization (TACE). However, TACE in combination with radiofrequency ablation (RFA) is not inferior to surgical resection (SR), and the benefits of surgical resection (SR) for BCLC stage B HCC remain unclear. Hence, this study aims to compare the impact of SR, TACE+RFA, and TACE on analyzing overall survival (OS) in BCLC stage B HCC. Methods Overall, 428 HCC patients were included in BCLC stage B, and their clinical data and OS were recorded. OS was analyzed by the Kaplan-Meier method and Cox regression analysis. Results One hundred forty (32.7%) patients received SR, 57 (13.3%) received TACE+RFA, and 231 (53.9%) received TACE. The OS was significantly higher in the SR group than that in the TACE+RFA group [hazard ratio (HR): 1.78; 95% confidence incidence (CI): 1.15–2.75, p = 0.009]. The OS was significantly higher in the SR group than that in the TACE group (HR: 3.17; 95% CI: 2.31–4.36, p < 0.0001). Moreover, the OS was significantly higher in the TACE+RFA group than that in the TACE group (HR: 1.82; 95% CI: 1.21–2.74, p = 0.004). The cumulative OS rates at 1, 3 and 5 years in the SR, TACE+RFA, and TACE groups were 89.2, 69.4 and 61.2%, 86.0, 57.9 and 38.2%, and 69.5, 37.0 and 15.2%, respectively. After propensity score matching, the SR group still had a higher OS than those of the TACE+RFA and TACE groups. The TACE+RFA group had a higher OS than that of the TACE group. Conclusion The SR group had higher OS than the TACE+RFA and TACE groups in BCLC stage B HCC. Furthermore, the TACE+RFA group had higher OS than the TACE group.http://link.springer.com/article/10.1186/s12876-020-01235-wHepatocellular carcinomaBarcelona clinic liver Cancer stage BOverall survivalSurgical resectionTranscatheter arterial chemoembolizationRadiofrequency ablation |
| spellingShingle | Chih-Wen Lin Yaw-Sen Chen Gin-Ho Lo Yao-Chun Hsu Chia-Chang Hsu Tsung-Chin Wu Jen-Hao Yeh Pojen Hsiao Pei-Min Hsieh Hung-Yu Lin Chih-Wen Shu Chao-Ming Hung Comparison of overall survival on surgical resection versus transarterial chemoembolization with or without radiofrequency ablation in intermediate stage hepatocellular carcinoma: a propensity score matching analysis BMC Gastroenterology Hepatocellular carcinoma Barcelona clinic liver Cancer stage B Overall survival Surgical resection Transcatheter arterial chemoembolization Radiofrequency ablation |
| title | Comparison of overall survival on surgical resection versus transarterial chemoembolization with or without radiofrequency ablation in intermediate stage hepatocellular carcinoma: a propensity score matching analysis |
| title_full | Comparison of overall survival on surgical resection versus transarterial chemoembolization with or without radiofrequency ablation in intermediate stage hepatocellular carcinoma: a propensity score matching analysis |
| title_fullStr | Comparison of overall survival on surgical resection versus transarterial chemoembolization with or without radiofrequency ablation in intermediate stage hepatocellular carcinoma: a propensity score matching analysis |
| title_full_unstemmed | Comparison of overall survival on surgical resection versus transarterial chemoembolization with or without radiofrequency ablation in intermediate stage hepatocellular carcinoma: a propensity score matching analysis |
| title_short | Comparison of overall survival on surgical resection versus transarterial chemoembolization with or without radiofrequency ablation in intermediate stage hepatocellular carcinoma: a propensity score matching analysis |
| title_sort | comparison of overall survival on surgical resection versus transarterial chemoembolization with or without radiofrequency ablation in intermediate stage hepatocellular carcinoma a propensity score matching analysis |
| topic | Hepatocellular carcinoma Barcelona clinic liver Cancer stage B Overall survival Surgical resection Transcatheter arterial chemoembolization Radiofrequency ablation |
| url | http://link.springer.com/article/10.1186/s12876-020-01235-w |
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