Liver Resection Improves the Survival of Patients with Multiple Hepatocellular Carcinomas |
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Authors: | Ming-Chih Ho MD PhD Guan-Tarn Huang MD PhD Yuk-Ming Tsang MD Po-Huang Lee MD PhD Ding-Shinn Chen MD Jin-Chuan Sheu MD PhD Chien-Hung Chen MD PhD |
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Institution: | (1) Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan;(2) Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan;(3) Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan;(4) Graduate Institute of Clinical Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan;(5) Hepatitis Research Center, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; |
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Abstract: | Background According to current guidelines of hepatocellular carcinoma (HCC) treatment, multiple HCCs are usually not suitable for surgical
resection. However, surgical resection is still possible for patients with multiple HCCs. The role of hepatic resection vs
transarterial chemoembolization (TACE) for multiple HCCs should be further clarified.
Methods We retrospectively enrolled 1065 patients with multiple HCCs. Among them, 294 received surgical resection, 367 received transarterial
chemoembolization (TACE), and 404 received chemotherapy or supportive care. Three staging systems (TNM, CLIP, and BCLC) were
used for comparison of stage-specific survival between different treatment modalities.
Results The median survival of multiple HCC patients who received surgical resection was 37.9 months, while it was 17.3 months in
TACE group, and 2.8 months in supportive group (P < .001). The 1-year, 3-year, 5-year survival rates for surgical group were 77.4%, 51.9%, and 36.6%, respectively. Kaplan-Meier
survival analysis demonstrated that patients who received surgical resections had the best survival, followed by TACE and
supportive care. For patients of the same stage, surgical resection yields better results than TACE. Surgery could offer better
survival than TACE for patients either within or beyond Milan’s criteria.
Conclusions Our results indicate that if patients have preserved liver functions, hepatic resection is helpful, even for patients with
multiple HCCs. |
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