title: Liver resection or combined chemoembolization and radiofrequency ablation improve survival in patients with hepatocellular carcinoma.
abstract: 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.
authors.affiliation: Department of Radiology, Klinikum Schleswig-Holstein, University of Lübeck, Lübeck, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Helmberger
authors.forename: Selin
authors.initials: S
authors.lastname: Dogan
authors.forename: Gundula
authors.initials: G
authors.lastname: Straub
authors.forename: Angelika
authors.initials: A
authors.lastname: Schrader
authors.forename: Christoph
authors.initials: C
authors.lastname: Jüngst
authors.forename: Maximilian
authors.initials: M
authors.lastname: Reiser
authors.forename: Tobias
authors.initials: T
authors.lastname: Waggershauser
authors.forename: Tobias
authors.initials: T
authors.lastname: Jakobs
authors.forename: Ralf-Thorsten
authors.initials: RT
authors.lastname: Hoffmann
authors.forename: Florian
authors.initials: F
authors.lastname: Löhe
authors.forename: Christian
authors.initials: C
authors.lastname: Graeb
authors.forename: Horst-Günter
authors.initials: HG
authors.lastname: Rau
authors.forename: Rolf
authors.initials: R
authors.lastname: Schauer
authors.forename: Karl-Walter
authors.initials: KW
authors.lastname: Jauch
authors.forename: Wolfgang H
authors.initials: WH
authors.lastname: Caselmann
authors.forename: Burkhard
authors.initials: B
authors.lastname: Göke
authors.forename: Dieter
authors.initials: D
authors.lastname: Jüngst
mesh_terms: 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