Abstract:
BACKGROUND:Recurrent hepatocellular carcinoma (rHCC) patients with microvascular invasive (MVI) positive at first resection usually had poorly differentiated tumors and worse survivals. The optimal treatment for this population remains to be elucidated. METHODS:We retrospectively analyzed 319 rHCC patients with MVI-positive at first resection from June, 2009 to June, 2017. Survival and costs between curative treatments [re-resection (RR) and radiofrequency ablation (RFA)] and transarterial chemoembolization (TACE) were compared. Subgroup comparisons were made in patients in Barcelona Clinic Liver Cancer (BCLC) stage 0-A and BCLC stage B-C, respectively. A one-to-one propensity score matching (PSM) was used to diminish bias. RESULTS:In BCLC stage 0-A, 98 received RR/RFA, and 49 received TACE. The median overall survival (OS) of RR/RFA group was not reached, while the OS of TACE group was 26.3 months (P=0.001). After matching, the OS of the RR/RFA group was longer than that of the TACE group (39.5 vs. 26.3 months, P=0.045). In BCLC stage B-C, 137 patients received TACE, 11 received RR and 24 received RFA. The median OS was 29.8 months, 17.9 months and 11.1 months for RR, RFA and TACE group, respectively. No significant difference was found between RR and TACE (P=0.237) or RFA and TACE (P=0.484) after matching. Costs of the TACE group was significantly lower than that of the RR group but similar to that of the RFA group. CONCLUSION:RR/RFA provided better survival outcomes for rHCC patients with MVI-positive at first resection in selected BCLC stage 0-A. In selected BCLC stage B-C, TACE shared a similar efficacy with RR and RFA but a lower cost than RR.
journal_name
Am J Transl Resjournal_title
American journal of translational researchauthors
Xiao H,Chen ZB,Jin HL,Li B,Xu LX,Guo Y,Chen SL,Li HP,Peng ZW,Shen JXsubject
Has Abstractpub_date
2019-03-15 00:00:00pages
1864-1875issue
3issn
1943-8141journal_volume
11pub_type
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journal_title:American journal of translational research
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journal_title:American journal of translational research
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journal_title:American journal of translational research
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journal_title:American journal of translational research
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journal_title:American journal of translational research
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journal_title:American journal of translational research
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journal_title:American journal of translational research
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journal_title:American journal of translational research
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journal_title:American journal of translational research
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journal_title:American journal of translational research
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journal_title:American journal of translational research
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journal_title:American journal of translational research
pub_type: 杂志文章
doi:
更新日期:2020-10-15 00:00:00
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journal_title:American journal of translational research
pub_type: 杂志文章
doi:
更新日期:2019-06-15 00:00:00
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journal_title:American journal of translational research
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更新日期:2016-02-15 00:00:00
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journal_title:American journal of translational research
pub_type: 杂志文章
doi:
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journal_title:American journal of translational research
pub_type: 杂志文章
doi:
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journal_title:American journal of translational research
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doi:
更新日期:2020-10-15 00:00:00
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journal_title:American journal of translational research
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doi:
更新日期:2019-10-15 00:00:00
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journal_title:American journal of translational research
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doi:
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journal_title:American journal of translational research
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journal_title:American journal of translational research
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journal_title:American journal of translational research
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journal_title:American journal of translational research
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journal_title:American journal of translational research
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更新日期:2017-12-15 00:00:00
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journal_title:American journal of translational research
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更新日期:2017-04-15 00:00:00
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journal_title:American journal of translational research
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更新日期:2020-08-15 00:00:00
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journal_title:American journal of translational research
pub_type: 杂志文章,已发布勘误
doi:
更新日期:2018-12-15 00:00:00
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journal_title:American journal of translational research
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journal_title:American journal of translational research
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