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Role of curative treatment in patients with intermediate-stage hepatocellular carcinoma

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Abstract

Purpose

To retrospectively evaluate the role of curative treatment in patients with intermediate-stage hepatocellular carcinomas (HCCs), and to identify the subgroup having benefit from curative treatment.

Methods

From April 2000 to December 2014, 100 patients with intermediate-stage HCCs underwent either curative treatment (hepatectomy: n = 23, radiofrequency ablation (RFA); n = 29, both: n = 4) or transarterial chemoembolization (TACE): n = 44) as initial treatments for HCCs. Overall survival, influence of treatment allocation on prognosis, and factors affecting treatment allocation were evaluated.

Results

The 5-year survival rate was 59.2% [95% confidence interval (CI) 51.6–66.8%] in the curative group, and 25.1% (95% CI 11.5–38.7%) in the TACE group. Treatment allocation was the only significant prognostic factor (p = 0.014, hazard ratio: 0.382, 95% CI 0.177–0.821). The curative group consisted of more patients with Child-Pugh A (p = 0.0016) than the TACE group, a tumor number of 3 or fewer (p < 0.0001), a unilobar tumor location (p = 0.02), within 4 of 7 cm criterion (p = 0.001), and within up-to-7 criterion (p = 0.04). Child-Pugh A, within the 4 of 7 cm criterion, and a unilobar tumor location were significantly linked with treatment allocation in multivariate analysis.

Conclusions

Curative treatment can prolong survival in selected patients with intermediate-stage HCCs.

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Authors and Affiliations

  1. Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan

    Yuichi Sugino, Takashi Yamanaka, Masashi Fujimori, Atsuhiro Nakatsuka & Hajime Sakuma

  2. Department of Radiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan

    Koichiro Yamakado & Haruyuki Takaki

  3. Department of Gastroenterology and Hepatology, Mie University School of Medicine, Tsu, Mie, Japan

    Yoshiyuki Takei

  4. Department of Hepato-Biliary-Pancreas Transplant Surgery, Mie University School of Medicine, Tsu, Mie, Japan

    Shuji Isaji

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  1. Yuichi Sugino
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  2. Koichiro Yamakado
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Correspondence to Yuichi Sugino.

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Sugino, Y., Yamakado, K., Yamanaka, T. et al. Role of curative treatment in patients with intermediate-stage hepatocellular carcinoma. Jpn J Radiol 35, 254–261 (2017). https://doi.org/10.1007/s11604-017-0628-9

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  • DOI: https://doi.org/10.1007/s11604-017-0628-9

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