Comparison of long-term survival of patients with solitary large hepatocellular carcinoma of BCLC stage A after liver resection or transarterial chemoembolization: a propensity score analysis

The aim of this study was to compare the long-term outcome of patients with a solitary large (> 5 cm) hepatocellular carcinoma (HCC) in Barcelona Clinic Liver Cancer (BCLC) stage A who received liver resection (LR) or transarterial chemoembolization (TACE). Our study examined 128 patients treated...

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Published in:PloS one 2014-12, Vol.9 (12), p.e115834-e115834
Main Authors: Zhu, Shao-Liang, Ke, Yang, Peng, Yu-Chong, Ma, Liang, Li, Hang, Li, Le-Qun, Zhong, Jian-Hong
Format: Article
Language:English
Subjects:
Adult
Biopsy
Cancer therapies
Carcinoma, Hepatocellular - pathology
Carcinoma, Hepatocellular - surgery
Carcinoma, Hepatocellular - therapy
Care and treatment
Chemoembolization
Chemoembolization, Therapeutic
Female
Hepatectomy
Hepatocellular carcinoma
Hepatology
Humans
Kaplan-Meier Estimate
Liver
Liver - pathology
Liver - surgery
Liver cancer
Liver Neoplasms - pathology
Liver Neoplasms - surgery
Liver Neoplasms - therapy
Male
Matching
Medical imaging
Medical prognosis
Medicine and Health Sciences
Middle Aged
Mortality
Multivariate Analysis
Patient outcomes
Patients
Prognosis
Propensity Score
Research and Analysis Methods
Studies
Surgery
Survival
Tomography
Treatment Outcome
Veins & arteries
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cited_by cdi_FETCH-LOGICAL-c692t-7701449ca79030edca1c0546bd16dad08a52d6fb310bd5ec5eb0a258c66749263
cites cdi_FETCH-LOGICAL-c692t-7701449ca79030edca1c0546bd16dad08a52d6fb310bd5ec5eb0a258c66749263
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container_issue 12
container_start_page e115834
container_title PloS one
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creator Zhu, Shao-Liang
Ke, Yang
Peng, Yu-Chong
Ma, Liang
Li, Hang
Li, Le-Qun
Zhong, Jian-Hong
description The aim of this study was to compare the long-term outcome of patients with a solitary large (> 5 cm) hepatocellular carcinoma (HCC) in Barcelona Clinic Liver Cancer (BCLC) stage A who received liver resection (LR) or transarterial chemoembolization (TACE). Our study examined 128 patients treated by LR and 90 treated by TACE. To reduce bias in patient selection, we conducted propensity score analysis in the present study and 54 pairs of patients after propensity score matching were generated, their long-term survival was compared using the Kaplan-Meier method. Independent predictors of survival were identified by multivariate analysis. Long-term survival was significantly better for the LR group by log-rank test (P < 0.001). In multivariate analysis, tumor size, serum ALT level and TACE independently predicted survival. Despite similar baseline characteristics after propensity score matching, LR group still had significantly better survival (1 year, 68.5 vs. 55.0%; 3 years, 47.6 vs. 21.2%; 5 years, 41.3 vs. 18.5%; P = 0.007) than TACE group. The LR and TACE groups had comparable 30- and 90-day post-treatment mortality. Multivariate analysis showed that serum ALT level, serum AFP level and TACE independently predicted survival by multivariate analysis after propensity score matching. Our propensity-score-matched study suggested that LR provided significantly better long-term survival than TACE for a solitary large HCC of the BCLC stage A, regardless of tumor size.
doi_str_mv 10.1371/journal.pone.0115834
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5 cm) hepatocellular carcinoma (HCC) in Barcelona Clinic Liver Cancer (BCLC) stage A who received liver resection (LR) or transarterial chemoembolization (TACE). Our study examined 128 patients treated by LR and 90 treated by TACE. To reduce bias in patient selection, we conducted propensity score analysis in the present study and 54 pairs of patients after propensity score matching were generated, their long-term survival was compared using the Kaplan-Meier method. Independent predictors of survival were identified by multivariate analysis. Long-term survival was significantly better for the LR group by log-rank test (P &lt; 0.001). In multivariate analysis, tumor size, serum ALT level and TACE independently predicted survival. Despite similar baseline characteristics after propensity score matching, LR group still had significantly better survival (1 year, 68.5 vs. 55.0%; 3 years, 47.6 vs. 21.2%; 5 years, 41.3 vs. 18.5%; P = 0.007) than TACE group. The LR and TACE groups had comparable 30- and 90-day post-treatment mortality. Multivariate analysis showed that serum ALT level, serum AFP level and TACE independently predicted survival by multivariate analysis after propensity score matching. Our propensity-score-matched study suggested that LR provided significantly better long-term survival than TACE for a solitary large HCC of the BCLC stage A, regardless of tumor size.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>25541684</pmid><doi>10.1371/journal.pone.0115834</doi><oa>free_for_read</oa></addata></record>
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1932-6203
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subjects Adult
Biopsy
Cancer therapies
Carcinoma, Hepatocellular - pathology
Carcinoma, Hepatocellular - surgery
Carcinoma, Hepatocellular - therapy
Care and treatment
Chemoembolization
Chemoembolization, Therapeutic
Female
Hepatectomy
Hepatocellular carcinoma
Hepatology
Humans
Kaplan-Meier Estimate
Liver
Liver - pathology
Liver - surgery
Liver cancer
Liver Neoplasms - pathology
Liver Neoplasms - surgery
Liver Neoplasms - therapy
Male
Matching
Medical imaging
Medical prognosis
Medicine and Health Sciences
Middle Aged
Mortality
Multivariate Analysis
Patient outcomes
Patients
Prognosis
Propensity Score
Research and Analysis Methods
Studies
Surgery
Survival
Tomography
Treatment Outcome
Veins & arteries
title Comparison of long-term survival of patients with solitary large hepatocellular carcinoma of BCLC stage A after liver resection or transarterial chemoembolization: a propensity score analysis
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-27T19%3A18%3A13IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Comparison%20of%20long-term%20survival%20of%20patients%20with%20solitary%20large%20hepatocellular%20carcinoma%20of%20BCLC%20stage%20A%20after%20liver%20resection%20or%20transarterial%20chemoembolization:%20a%20propensity%20score%20analysis&rft.jtitle=PloS%20one&rft.au=Zhu,%20Shao-Liang&rft.date=2014-12-26&rft.volume=9&rft.issue=12&rft.spage=e115834&rft.epage=e115834&rft.pages=e115834-e115834&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0115834&rft_dat=%3Cgale_plos_%3EA417793371%3C/gale_plos_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c692t-7701449ca79030edca1c0546bd16dad08a52d6fb310bd5ec5eb0a258c66749263%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1640559835&rft_id=info:pmid/25541684&rft_galeid=A417793371&rfr_iscdi=true