title: Comparing hepatic resection and transarterial chemoembolization for Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma: change for treatment of choice?
abstract: BACKGROUND
  Compared to transarterial chemoembolization (TACE) for patients with hepatocellular carcinoma (HCC), stage B in the Barcelona Clinic Liver Cancer (BCLC) classification, the role of hepatic resection remains unclear. The present study compared the long-term outcome of hepatic resection with TACE in the treatment of BCLC stage B HCC.
  
  
  METHODS
  A total of 171 patients with BCLC stage B, Child's classification A (Child A), HCC were included in this retrospective study. Of these, 93 patients underwent hepatic resection (group I) and 73 patients received TACE (group II). We evaluated the long-term outcome and therapy-related mortality in both groups. The risk factors of mortality were assessed. The survival curve was analyzed by the Kaplan-Meier method.
  
  
  RESULTS
  The 1-, 2-, and 3-year overall survival rates for the two groups after hepatic resection and TACE were 83%, 62%, 49% and 39%, 5%, 2%, respectively (P < 0.0001). We did not observe significant differences in the therapy-related mortality between the two groups (P = 0.78). Treatment modality and serum albumin level were independent risk factors for survival by Cox regression analysis.
  
  
  CONCLUSIONS
  Our study demonstrated that hepatic resection for BCLC stage B, Child A HCC patients had better survival rates than TACE group. Thus, hepatic resection is indicated in selected patients with BCLC stage B.
authors.affiliation: Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec. 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan.
authors.forename: Chin-Ta
authors.initials: CT
authors.lastname: Lin
authors.forename: Kuo-Feng
authors.initials: KF
authors.lastname: Hsu
authors.forename: Teng-Wei
authors.initials: TW
authors.lastname: Chen
authors.forename: Jyh-Cherng
authors.initials: JC
authors.lastname: Yu
authors.forename: De-Chuan
authors.initials: DC
authors.lastname: Chan
authors.forename: Chih-Yung
authors.initials: CY
authors.lastname: Yu
authors.forename: Tsai-Yuan
authors.initials: TY
authors.lastname: Hsieh
authors.forename: Hsiu-Lung
authors.initials: HL
authors.lastname: Fan
authors.forename: Shih-Ming
authors.initials: SM
authors.lastname: Kuo
authors.forename: Kuo-Piao
authors.initials: KP
authors.lastname: Chung
authors.forename: Chung-Bao
authors.initials: CB
authors.lastname: Hsieh
mesh_terms: D000328:Adult; D000465:Algorithms; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000145:classification / Q000401:mortality / Q000601:surgery*; D016461:Chemoembolization, Therapeutic; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000145:classification / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents
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