Combination of individualized local control and target-specific agent to improve unresectable liver cancer managements: a matched case-control study
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Management of late-stage hepatocellular carcinoma is difficult. A direct comparison of clinical data is needed in order to demonstrate the survival benefits of different therapies. We directly compared various therapies in a retrospective matched case-control study. A total of 79 patients with unresectable tumors greater than 10 cm in size were included in the study between 2008 and 2012. Thirty-five patients were treated with transarterial chemoembolization for local control, 20 were treated with sorafenib systemic chemotherapy, and 24 received combination treatment. The total follow-up time after initial therapy was 4.5 years. Survival time after treatment was significantly longer in the combination therapy group (P < 0.0001). The median survival times for combination, local control, and systemic chemotherapy were 15 (12–21), 10 (9–13), and 3.5 (2.5–9.0) months (95 % confidence interval), respectively. The hazard ratios for local control and systemic chemotherapy were 1.985 and 5.102, respectively, with combination treatment as the reference. There was no observed difference in combination therapy from the side effects of the individual therapies. In conclusion, the limited availability of therapeutic options for late-stage liver cancer necessitates reliance on multidisciplinary personalized medicine approaches with target-specific medications to increase survival time. Combining individualized local control therapy and drugs that target specific disease markers provides more benefits to patients.
KeywordsMatched case-control Liver cancer Late-stage liver cancer Liver cancer managements Transarterial chemoembolization TACE Sorafenib Survival Target-specific treatment
We thank Dr. Zhi-Dong Jiang for critical review of the manuscript and suggestions; BioScience Writers, LLC, Houston, TX, for scientific editing services.
Authors’ contributions statement
JL, FZ, and SK devised the study conception and design. WW, HR, and SK did the data analysis. JL, FZ, JY, YZ, YW, WF, and YH provided study data for the analysis. JL, FZ, JY, WW, HR, and SK interpreted the data interpretation. JL, FZ, JY, YZ, YW, WF YH, WW, HR, and SK wrote the manuscript. All authors read the manuscript and contributed to the final version.
Grant support was provided by Natural Science Foundation of China (No. 81171441), the Scientific Research Foundation for the Returned Overseas Chinese Scholars, State Education Ministry (No. 20111139), Natural Science Foundation of Guangdong Province, China (No. S2012020010904), Guangdong Commercialization Research Funds (2012B091100458), and the Department of Radiology research funds at Baylor College of Medicine.
Conflicts of interest
All authors declare that they have no conflicts of interest.
Role of the funding source
The sponsors of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The corresponding authors had full access to all the data in the study and had final responsibility for the decision to submit for publication. The manufactures did not provide either devices or drugs for the study.
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