title: Propensity score-based comparison of hepatic resection and transarterial chemoembolization for patients with advanced hepatocellular carcinoma.
abstract: For patients with advanced hepatocellular carcinoma (HCC), official guidelines recommend palliative treatments such as transarterial chemoembolization (TACE) but not hepatic resection (HR). This study compared short- and long-term outcomes in patients with advanced HCC treated by either HR or TACE. A retrospective analysis was performed for a consecutive series of 444 patients with advanced HCC who underwent HR (n = 339) or TACE (n = 205). Analyses were performed over all participants as well as for propensity score-matched patients to adjust for any baseline differences. When all patients were included in the analysis, the HR and TACE groups showed similar postoperative complication rate and mortality at 30 and 90 days (all P > 0.05). However, median survival time was significantly higher in the HR group (16.4 months) than in the TACE group (11.8 months; P = 0.012). Overall survival at 1, 3, 5, and 7 years was 58, 26, 18, and 18 % in the HR group, higher than the corresponding rates of 49, 14, 12, and 7 % in the TACE group. Similar results were obtained in the analysis of propensity score-matched patients. Therefore, HR can be safe and effective for patients with advanced HCC. Randomized controlled trials are warranted to confirm this finding.
authors.affiliation: Department of General Surgery, Yan'An Hospital Affiliated to Kunming Medical University, Kunming, People's Republic of China.
authors.forename: Bao-Hong
authors.initials: BH
authors.lastname: Yuan
authors.affiliation: Hepatobiliary Surgery Department, Affiliated Tumor Hospital of Guangxi Medical University, He Di Rd. #71, Nanning, 530021, People's Republic of China.
authors.forename: Wei-Ping
authors.initials: WP
authors.lastname: Yuan
authors.affiliation: Department of General Surgery, Yan'An Hospital Affiliated to Kunming Medical University, Kunming, People's Republic of China.
authors.forename: Ru-Hong
authors.initials: RH
authors.lastname: Li
authors.affiliation: Hepatobiliary Surgery Department, Affiliated Tumor Hospital of Guangxi Medical University, He Di Rd. #71, Nanning, 530021, People's Republic of China.
authors.forename: Bang-De
authors.initials: BD
authors.lastname: Xiang
authors.affiliation: Hepatobiliary Surgery Department, Affiliated Tumor Hospital of Guangxi Medical University, He Di Rd. #71, Nanning, 530021, People's Republic of China.
authors.forename: Wen Feng
authors.initials: WF
authors.lastname: Gong
authors.affiliation: Hepatobiliary Surgery Department, Affiliated Tumor Hospital of Guangxi Medical University, He Di Rd. #71, Nanning, 530021, People's Republic of China. xitongpingjia@163.com.
authors.forename: Le-Qun
authors.initials: LQ
authors.lastname: Li
authors.affiliation: Hepatobiliary Surgery Department, Affiliated Tumor Hospital of Guangxi Medical University, He Di Rd. #71, Nanning, 530021, People's Republic of China. zhongjianhong66@163.com.
authors.forename: Jian-Hong
authors.initials: JH
authors.lastname: Zhong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008099:Liver / Q000473:pathology / Q000601:surgery*; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Hepatic resection; Hepatocellular carcinoma; Overall survival; Transarterial chemoembolization