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題名 Comparison of surgical resection and transarterial chemoembolization for patients with intermediate stage hepatocellular carcinoma 作者 林志陵
Lin, Chih-Lin
Lin, Che-Kuang
Lin, Tsung-Jung
Lee, Hsi-Chang
Chen, Kuan-Yang
Liao, Li-Ying
Ting, Chin-Tsung
Wang, Chung-Kwe貢獻者 心理系 關鍵詞 Intermediate-stage hepatocellular carcinoma; Surgical resection; Transcatheter arterial chemoembolization; Alpha-fetoprotein; Cirrhosis 日期 2016-06 上傳時間 23-Nov-2017 16:55:24 (UTC+8) 摘要 Objective :Current guidelines recommend transarterial chemoembolization (TACE) as the standard treatment for patients with intermediate stage hepatocellular carcinoma (HCC). However, choosing the optimal treatments for patients with intermediate stage HCC still remains challenging for clinicians. The purpose of our study was to compare the long-term survival of intermediate stage HCC patients treated with surgical resection or TACE. Methods : We obtained the baseline characteristics of 210 intermediate stage HCC patients that were recruited for this study. Survival analysis was performed by Kaplan–Meier method and a comparison was made by log-rank test. Factors associated with survival rate were analyzed by Cox`s regression. Results : There were 164 men and 46 women in the study group, with a mean age of 63 ± 11 years (range, 31–92 years). Among them, 67 patients (31.9%) received surgical resection and 143 patients (68.1%) received TACE. Patients receiving surgical resection had a significantly larger mean of maximum tumor size (6.8 ± 2.8 vs. 5.8 ± 3.2 cm, P = 0.016), higher ratio of solitary tumor (68.7% vs. 17.5%, P < 0.001), and Child-Pugh class A (97% vs. 85%, P = 0.009) than those with TACE. Patients receiving surgical resection had a significantly higher 1, 3, and 5 year survival rate compared with those treated with TACE (87.4%, 62.8% and 57.3% vs. 58.1%, 29.9% and 16.6%, P < 0.001). Multivariate analysis revealed that AFP level >400 ng/ml [hazard ratio (HR):2.141, 95% CI: 1.091–4.203, P = 0.027], Child B cirrhosis (HR: 4.726, 95% CI: 1.021–21.884, P = 0.047), and TACE (HR:3.391, 95% CI: 1.625–7.076, P = 0.001) were independent risk factors associated with poor prognosis. Conclusions : Our results indicated that surgical resection provided superior survival benefit than TACE to patients with intermediate-stage HCC. This is in part attributable to advances in liver surgery which make the resection of intermediate-stage HCC possible. Surgical resection should be considered first for patients with preserved liver function. 關聯 Journal of Cancer Research and Practice, Volume 3, Issue 2, Pages 34-38 資料類型 article DOI https://doi.org/10.1016/j.jcrpr.2015.03.001 dc.contributor 心理系 zh_TW dc.creator (作者) 林志陵 zh_TW dc.creator (作者) Lin, Chih-Lin en_US dc.creator (作者) Lin, Che-Kuang en_US dc.creator (作者) Lin, Tsung-Jung en_US dc.creator (作者) Lee, Hsi-Chang en_US dc.creator (作者) Chen, Kuan-Yang en_US dc.creator (作者) Liao, Li-Ying en_US dc.creator (作者) Ting, Chin-Tsung en_US dc.creator (作者) Wang, Chung-Kwe en_US dc.date (日期) 2016-06 dc.date.accessioned 23-Nov-2017 16:55:24 (UTC+8) - dc.date.available 23-Nov-2017 16:55:24 (UTC+8) - dc.date.issued (上傳時間) 23-Nov-2017 16:55:24 (UTC+8) - dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/114858 - dc.description.abstract (摘要) Objective :Current guidelines recommend transarterial chemoembolization (TACE) as the standard treatment for patients with intermediate stage hepatocellular carcinoma (HCC). However, choosing the optimal treatments for patients with intermediate stage HCC still remains challenging for clinicians. The purpose of our study was to compare the long-term survival of intermediate stage HCC patients treated with surgical resection or TACE. Methods : We obtained the baseline characteristics of 210 intermediate stage HCC patients that were recruited for this study. Survival analysis was performed by Kaplan–Meier method and a comparison was made by log-rank test. Factors associated with survival rate were analyzed by Cox`s regression. Results : There were 164 men and 46 women in the study group, with a mean age of 63 ± 11 years (range, 31–92 years). Among them, 67 patients (31.9%) received surgical resection and 143 patients (68.1%) received TACE. Patients receiving surgical resection had a significantly larger mean of maximum tumor size (6.8 ± 2.8 vs. 5.8 ± 3.2 cm, P = 0.016), higher ratio of solitary tumor (68.7% vs. 17.5%, P < 0.001), and Child-Pugh class A (97% vs. 85%, P = 0.009) than those with TACE. Patients receiving surgical resection had a significantly higher 1, 3, and 5 year survival rate compared with those treated with TACE (87.4%, 62.8% and 57.3% vs. 58.1%, 29.9% and 16.6%, P < 0.001). Multivariate analysis revealed that AFP level >400 ng/ml [hazard ratio (HR):2.141, 95% CI: 1.091–4.203, P = 0.027], Child B cirrhosis (HR: 4.726, 95% CI: 1.021–21.884, P = 0.047), and TACE (HR:3.391, 95% CI: 1.625–7.076, P = 0.001) were independent risk factors associated with poor prognosis. Conclusions : Our results indicated that surgical resection provided superior survival benefit than TACE to patients with intermediate-stage HCC. This is in part attributable to advances in liver surgery which make the resection of intermediate-stage HCC possible. Surgical resection should be considered first for patients with preserved liver function. en_US dc.format.extent 421914 bytes - dc.format.mimetype application/pdf - dc.relation (關聯) Journal of Cancer Research and Practice, Volume 3, Issue 2, Pages 34-38 en_US dc.subject (關鍵詞) Intermediate-stage hepatocellular carcinoma; Surgical resection; Transcatheter arterial chemoembolization; Alpha-fetoprotein; Cirrhosis en_US dc.title (題名) Comparison of surgical resection and transarterial chemoembolization for patients with intermediate stage hepatocellular carcinoma en_US dc.type (資料類型) article dc.identifier.doi (DOI) 10.1016/j.jcrpr.2015.03.001 dc.doi.uri (DOI) https://doi.org/10.1016/j.jcrpr.2015.03.001
