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Open Access 01-12-2020 | Hepatitis B | Research article

Comparison of overall survival on surgical resection versus transarterial chemoembolization with or without radiofrequency ablation in intermediate stage hepatocellular carcinoma: a propensity score matching analysis

Authors: Chih-Wen Lin, Yaw-Sen Chen, Gin-Ho Lo, Yao-Chun Hsu, Chia-Chang Hsu, Tsung-Chin Wu, Jen-Hao Yeh, Pojen Hsiao, Pei-Min Hsieh, Hung-Yu Lin, Chih-Wen Shu, Chao-Ming Hung

Published in: BMC Gastroenterology | Issue 1/2020

Abstract

Background

Patients with Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma (HCC) are recommended to undergo transcatheter arterial chemoembolization (TACE). However, TACE in combination with radiofrequency ablation (RFA) is not inferior to surgical resection (SR), and the benefits of surgical resection (SR) for BCLC stage B HCC remain unclear. Hence, this study aims to compare the impact of SR, TACE+RFA, and TACE on analyzing overall survival (OS) in BCLC stage B HCC.

Methods

Overall, 428 HCC patients were included in BCLC stage B, and their clinical data and OS were recorded. OS was analyzed by the Kaplan-Meier method and Cox regression analysis.

Results

One hundred forty (32.7%) patients received SR, 57 (13.3%) received TACE+RFA, and 231 (53.9%) received TACE. The OS was significantly higher in the SR group than that in the TACE+RFA group [hazard ratio (HR): 1.78; 95% confidence incidence (CI): 1.15–2.75, p = 0.009]. The OS was significantly higher in the SR group than that in the TACE group (HR: 3.17; 95% CI: 2.31–4.36, p < 0.0001). Moreover, the OS was significantly higher in the TACE+RFA group than that in the TACE group (HR: 1.82; 95% CI: 1.21–2.74, p = 0.004). The cumulative OS rates at 1, 3 and 5 years in the SR, TACE+RFA, and TACE groups were 89.2, 69.4 and 61.2%, 86.0, 57.9 and 38.2%, and 69.5, 37.0 and 15.2%, respectively. After propensity score matching, the SR group still had a higher OS than those of the TACE+RFA and TACE groups. The TACE+RFA group had a higher OS than that of the TACE group.

Conclusion

The SR group had higher OS than the TACE+RFA and TACE groups in BCLC stage B HCC. Furthermore, the TACE+RFA group had higher OS than the TACE group.

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Title: Comparison of overall survival on surgical resection versus transarterial chemoembolization with or without radiofrequency ablation in intermediate stage hepatocellular carcinoma: a propensity score matching analysis
Authors: Chih-Wen Lin
Yaw-Sen Chen
Gin-Ho Lo
Yao-Chun Hsu
Chia-Chang Hsu
Tsung-Chin Wu
Jen-Hao Yeh
Pojen Hsiao
Pei-Min Hsieh
Hung-Yu Lin
Chih-Wen Shu
Chao-Ming Hung
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Hepatitis B
Hepatocellular Carcinoma
Hepatitis C
Hepatocellular Carcinoma
Published in: BMC Gastroenterology / Issue 1/2020
Electronic ISSN: 1471-230X
DOI: https://doi.org/10.1186/s12876-020-01235-w

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