Efficacy of hepatic resection vs transarterial chemoembolization for solitary huge hepatocellular carcinoma.
OBJECTIVE
To compare the efficacy of hepatic resection (HR) and transarterial chemoembolization (TACE) for patients with solitary huge (≥ 10 cm) hepatocellular carcinoma (HCC).


METHODS
Records were retrospectively analyzed of 247 patients with solitary huge HCC, comprising 180 treated by HR and 67 by TACE. Long-term overall survival (OS) was compared between the two groups using the Kaplan-Meier method, and independent predictors of survival were identified by multivariate analysis. These analyses were performed using all patients in both groups and/or 61 pairs of propensity score-matched patients from the two groups.


RESULTS
OS at 5 years was significantly higher in the HR group than the TACE group, across all patients (P = 0.002) and across propensity score-matched pairs (36.4% vs 18.2%, P = 0.039). The two groups showed similar postoperative mortality and morbidity. Multivariate analysis identified alpha-fetoprotein ≥ 400 ng/mL, presence of vascular invasion and TACE treatment as independent predictors of poor OS.


CONCLUSIONS
Our findings suggest that HR can be safe and more effective than TACE for patients with solitary huge HCC.
Shao-Liang Zhu, Jian-Hong Zhong, Yang Ke, Liang Ma, Xue-Mei You, Le-Qun Li, Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
Shao-Liang
SL
Zhu
Shao-Liang Zhu, Jian-Hong Zhong, Yang Ke, Liang Ma, Xue-Mei You, Le-Qun Li, Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
Jian-Hong
JH
Zhong
Shao-Liang Zhu, Jian-Hong Zhong, Yang Ke, Liang Ma, Xue-Mei You, Le-Qun Li, Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
Yang
Y
Ke
Shao-Liang Zhu, Jian-Hong Zhong, Yang Ke, Liang Ma, Xue-Mei You, Le-Qun Li, Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
Liang
L
Ma
Shao-Liang Zhu, Jian-Hong Zhong, Yang Ke, Liang Ma, Xue-Mei You, Le-Qun Li, Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
Xue-Mei
XM
You
Shao-Liang Zhu, Jian-Hong Zhong, Yang Ke, Liang Ma, Xue-Mei You, Le-Qun Li, Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
Le-Qun
LQ
Li
D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D057216:Propensity Score; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden; D000509:alpha-Fetoproteins / Q000032:analysis
C097353:AFP protein, human; D000509:alpha-Fetoproteins
Hepatic resection; Overall survival; Propensity score matching; Solitary huge hepatocellular carcinoma; Transarterial chemoembolization