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01-09-2014 | Original Article

Surgical Resection Is Better than Transarterial Chemoembolization for Hepatocellular Carcinoma Beyond Milan Criteria Independent of Performance Status

Authors: Po-Hong Liu, Yun-Hsuan Lee, Chia-Yang Hsu, Cheng-Yuan Hsia, Yi-Hsiang Huang, Yi-You Chiou, Han-Chieh Lin, Teh-Ia Huo

Published in: Journal of Gastrointestinal Surgery | Issue 9/2014

Abstract

Background and Aims

Performance status is tightly linked with survival in patients with hepatocellular carcinoma (HCC). We investigated the impact of performance status on HCC patients beyond the Milan criteria receiving surgical resection (SR) or transarterial chemoembolization (TACE).

Methods

A total of 909 patients with HCC beyond the Milan criteria were retrospectively analyzed by using propensity score analysis.

Results

The baseline characteristics were similar between the SR and TACE group for patients with performance status 0 in the propensity model. More patients in the TACE group with performance status ≥1 had Child-Turcotte-Pugh class A compared to the SR group (p = 0.044) in the propensity model. SR provided significantly better long-term overall survival than TACE in patients selected in the propensity model regardless of performance status (both p < 0.05). In the Cox proportional hazards model, TACE was associated with 2.279-fold and 3.066-fold increased risk of mortality in performance status 0 and performance status ≥1 in the propensity model (95 % confidence interval, 1.476–3.591 and 1.570–5.989), respectively.

Conclusions

For either performance status 0 or ≥1 HCC patients beyond the Milan criteria, SR provides significantly better long-term survival than TACE. SR should be considered a priority treatment in these patients independent of performance status.

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Title: Surgical Resection Is Better than Transarterial Chemoembolization for Hepatocellular Carcinoma Beyond Milan Criteria Independent of Performance Status
Authors: Po-Hong Liu
Yun-Hsuan Lee
Chia-Yang Hsu
Cheng-Yuan Hsia
Yi-Hsiang Huang
Yi-You Chiou
Han-Chieh Lin
Teh-Ia Huo
Publication date: 01-09-2014
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 9/2014
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-014-2546-9

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Surgical Resection Is Better than Transarterial Chemoembolization for Hepatocellular Carcinoma Beyond Milan Criteria Independent of Performance Status

Abstract

Background and Aims

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background and Aims

Methods

Results

Conclusions

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