Journal
WORLD JOURNAL OF GASTROENTEROLOGY
Volume 21, Issue 32, Pages 9630-9637Publisher
BAISHIDENG PUBLISHING GROUP INC
DOI: 10.3748/wjg.v21.i32.9630
Keywords
Hepatic resection; Transarterial chemoembolization; Solitary huge hepatocellular carcinoma; overall survival; propensity score matching
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Funding
- National Science and Technology Major Special Project [2012ZX10002010001009]
- Self-Raised Scientific Research Fund of the Ministry of Health of Guangxi Province [Z2015621, Z2014241]
- Guangxi University of Science and Technology Research Fund [KY2015LX056]
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AIM: 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. CONCLUSION: Our findings suggest that HR can be safe and more effective than TACE for patients with solitary huge HCC.
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