Liver resection or combined chemoembolization and radiofrequency ablation improve survival in patients with hepatocellular carcinoma.
OBJECTIVE
To evaluate the long-term outcome of surgical and non-surgical local treatments of patients with hepatocellular carcinoma (HCC).


METHODS
We stratified a cohort of 278 HCC patients using six independent predictors of survival according to the Vienna survival model for HCC (VISUM-HCC).


RESULTS
Prior to therapy, 224 HCC patients presented with VISUM stage 1 (median survival 18 months) while 29 patients were classified as VISUM stage 2 (median survival 4 months) and 25 patients as VISUM stage 3 (median survival 3 months). A highly significant (p < 0.001) improved survival time was observed in VISUM stage 1 patients treated with liver resection (n = 52; median survival 37 months) or chemoembolization (TACE) and subsequent radiofrequency ablation (RFA) (n = 44; median survival 45 months) as compared to patients receiving chemoembolization alone (n = 107; median survival 13 months) or patients treated by tamoxifen only (n = 21; median survival 6 months). Chemoembolization alone significantly (p < or = 0.004) improved survival time in VISUM stage 1-2 patients but not (p = 0.341) in VISUM stage 3 patients in comparison to those treated by tamoxifen.


CONCLUSIONS
Both liver resection or combined chemoembolization and RFA improve markedly the survival of patients with HCC.
Helmberger
Thomas
T
Department of Radiology, Klinikum Schleswig-Holstein, University of Lübeck, Lübeck, Germany.
Dogan
Selin
S
Straub
Gundula
G
Schrader
Angelika
A
Jüngst
Christoph
C
Reiser
Maximilian
M
Waggershauser
Tobias
T
Jakobs
Tobias
T
Hoffmann
Ralf-Thorsten
RT
Löhe
Florian
F
Graeb
Christian
C
Rau
Horst-Günter
HG
Schauer
Rolf
R
Jauch
Karl-Walter
KW
Caselmann
Wolfgang H
WH
Göke
Burkhard
B
Jüngst
Dieter
D
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D017115:Catheter Ablation; D016461:Chemoembolization, Therapeutic; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D015641:Radiography, Interventional; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome