Comparison of Survival of Patients with BCLC Stage A Hepatocellular Carcinoma After Hepatic Resection or Transarterial Chemoembolization: A Propensity Score-Based Analysis |
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Authors: | Zhe Guo MD Jian-Hong Zhong MD Jing-Hang Jiang MD Jun Zhang MD Bang-De Xiang MD PhD Le-Qun Li MD PhD |
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Institution: | 1. Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China 2. Department of Ultrasound, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China
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Abstract: | Background It is unclear whether hepatic resection (HR) or transarterial chemoembolization (TACE) is associated with better outcomes for patients with hepatocellular carcinoma (HCC) in Barcelona Clinic Liver Cancer (BCLC) stage A. The present study compared survival for patients with BCLC stage A HCC treated by HR or TACE. Methods Our study examined 360 patients treated by HR and 221 treated by TACE. To reduce bias in patient selection, 152 pairs of propensity-score-matched patients were generated, and their long-term survival was compared using the Kaplan–Meier method. Independent predictors of survival were identified using the Cox proportional hazards model. Results Among propensity-score-matched pairs of patients with Child-Pugh A liver function who were treated by HR or TACE, the 1-, 3-, and 5-year overall survival rates were 75.5, 44.8, and 30.2 % after HR and 64.5, 24.1, and 13.7 % after TACE (P < 0.001). Serum AST level, serum AFP level, tumor size, and TACE independently predicted survival in Cox regression analysis. Conclusions Our propensity-score-matched study confirmed that HR was associated with higher survival rates than was TACE in patients with BCLC stage A HCC. |
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