TY - JOUR
T1 - Clinical prognosis of surgical resection versus transarterial chemoembolization for single large hepatocellular carcinoma (≥5 cm)
T2 - A propensity score matching analysis
AU - Hsieh, Pei Min
AU - Hsiao, Pojen
AU - Chen, Yaw Sen
AU - Yeh, Jen Hao
AU - Hung, Chao Ming
AU - Lin, Hung Yu
AU - Ma, Ching Hou
AU - Tang, Tao Qian
AU - Huang, Yu Wei
AU - Cheng, Pin Nan
AU - Hsieh, Kun Chou
AU - Hu, Kuang Chun
AU - Bair, Ming Jong
AU - Lin, Chih Wen
N1 - Funding Information:
E‐Da Hospital, Grant/Award Numbers: EDPJ103040, EDPJ104019, EDAHP104047, EDCHP105003, EDAHP106054, EDAHP107041, EDAHP108036, EDAHP108037, EDAHP108038, EDPJ109025, EDAHP109044, EDAHP109057, EDPJ109072, EDDHM109001, EDAHP110035, EDAHP110036, EDAHP110037, EDAHP110040, EDPN110061, EDAHP111004, EDAHP111008, EDAHP111013, EDAHP111025, EDAHS111040, and EDPJ111075; Liver Disease Prevention and Treatment Research Foundation; National Cheng Kung University, Grant/Award Number: NCKUEDA10803, NCKUEDA10916; National Health Research Institutes, Grant/Award Number: NHRI‐109BCCO‐MF202016‐03; National Science and Technology Council, Grant/Award Number: 110‐2314‐B‐214‐004‐MY1, 111‐2314‐B‐214‐008‐MY1 Funding information
Funding Information:
We would like to thank The National Biobank Consortium of Taiwan and its cooperative institutions for providing the biological specimen and related clinical data (All are deidentified) for our research. “National Biobank Consortium of Taiwan” is supported by grants from Ministry of Health and Welfare and National Health Research Institutes, Taiwan. The funders had a role in study design, decision to publish and preparation of the manuscript. No additional external funding was received for this study.
Publisher Copyright:
© 2023 The Authors. The Kaohsiung Journal of Medical Sciences published by John Wiley & Sons Australia, Ltd on behalf of Kaohsiung Medical University.
PY - 2023/3
Y1 - 2023/3
N2 - Favorable prognostic factors and therapeutic strategies are important for patients with single large hepatocellular carcinoma (HCC). This retrospective study aimed to investigate the prognostic factors in patients with single large (≥5 cm) HCC with Child-Pugh (CP) class A patients and to recommend therapeutic strategies. Overall, 298 HCC patients with single and large (≥5 cm) tumors with CP class A, but without distant metastasis and macrovascular invasion were included, and their clinicopathological data, overall survival (OS), and progression-free survival (PFS) were recorded. OS and PFS was analyzed by the Kaplan–Meier method and Cox regression analysis. Propensity score matching (PSM) analysis was performed. The 298 HCC patients were 79.2% male and median age of 64 years. For the initial treatment, surgical resection (SR) and transarterial chemoembolization (TACE) was 50.8% and 49.2%, respectively. The OS and PFS were significantly higher in patients receiving SR than those receiving TACE before and after PSM. Furthermore, in multivariate analysis, cirrhosis (Hazard ratio [HR]: 2.04; 95% confidence interval [CI]: 1.35–3.03, p < 0.001, CP class A5/6 [HR: 4.01; 95% CI: 2.43–6.66, p < 0.001], and initial treatment [SR vs. TACE HR = 3.23; 95% CI: 2.13–5.01, p < 0.001]) remained significantly associated with mortality. Moreover, in multivariate analysis, CP class A5/6 (HR: 3.23; 95% CI: 1.89–5.88, p < 0.001), and initial treatment (Resection vs. TACE; HR = 4.17; 95% CI: 1.64–8.33, p = 0.039) remained significantly associated with recurrence. In conclusion, SR was associated with significantly higher OS and PFS rates than TACE before and after PSM for single large HCC patients.
AB - Favorable prognostic factors and therapeutic strategies are important for patients with single large hepatocellular carcinoma (HCC). This retrospective study aimed to investigate the prognostic factors in patients with single large (≥5 cm) HCC with Child-Pugh (CP) class A patients and to recommend therapeutic strategies. Overall, 298 HCC patients with single and large (≥5 cm) tumors with CP class A, but without distant metastasis and macrovascular invasion were included, and their clinicopathological data, overall survival (OS), and progression-free survival (PFS) were recorded. OS and PFS was analyzed by the Kaplan–Meier method and Cox regression analysis. Propensity score matching (PSM) analysis was performed. The 298 HCC patients were 79.2% male and median age of 64 years. For the initial treatment, surgical resection (SR) and transarterial chemoembolization (TACE) was 50.8% and 49.2%, respectively. The OS and PFS were significantly higher in patients receiving SR than those receiving TACE before and after PSM. Furthermore, in multivariate analysis, cirrhosis (Hazard ratio [HR]: 2.04; 95% confidence interval [CI]: 1.35–3.03, p < 0.001, CP class A5/6 [HR: 4.01; 95% CI: 2.43–6.66, p < 0.001], and initial treatment [SR vs. TACE HR = 3.23; 95% CI: 2.13–5.01, p < 0.001]) remained significantly associated with mortality. Moreover, in multivariate analysis, CP class A5/6 (HR: 3.23; 95% CI: 1.89–5.88, p < 0.001), and initial treatment (Resection vs. TACE; HR = 4.17; 95% CI: 1.64–8.33, p = 0.039) remained significantly associated with recurrence. In conclusion, SR was associated with significantly higher OS and PFS rates than TACE before and after PSM for single large HCC patients.
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U2 - 10.1002/kjm2.12640
DO - 10.1002/kjm2.12640
M3 - Article
C2 - 36625289
AN - SCOPUS:85146184602
SN - 1607-551X
VL - 39
SP - 302
EP - 310
JO - Kaohsiung Journal of Medical Sciences
JF - Kaohsiung Journal of Medical Sciences
IS - 3
ER -