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Hepatology International

, Volume 12, Issue 5, pp 417–428 | Cite as

Liver resection versus transarterial chemoembolization for the initial treatment of Barcelona Clinic Liver Cancer stage B hepatocellular carcinoma

  • Biao YangEmail author
  • Bo Zheng
  • MaoNan Yang
  • Zhu Zeng
  • FangYun Yang
  • Ji Pu
  • ChunLin Li
  • ZhengYin LiaoEmail author
Review Article
  • 309 Downloads

Abstract

Aims

Current evidence supporting the efficacy of transarterial chemoembolization (TACE) in Barcelona Clinic Liver Cancer (BCLC)-B hepatocellular carcinoma (HCC) is controversial. The aim of this systematic review was to compare the benefits of liver resection (LR) versus TACE in BCLC-B HCC.

Methods

We conducted a comprehensive literature review of the EMBASE, PubMed, Google Scholar, and Chinese Biomedical Literature databases for retrospective or prospective studies evaluating the efficacy of LR and TACE for the treatment of BCLC-B HCC.

Results

Eleven studies incorporating 3366 patients were included in this analysis. 1-year (RR 0.52 95% CI 0.43–0.63, p < 0.001; I2 = 59%, p = 0.006), 3-year (RR 0.63 95% CI 0.59–0.67, p < 0.001; I2 = 16%, p = 0.29), and 5-year (RR 0.69 95% CI 0.63–0.75, p < 0.001; I2 = 56%, p = 0.021) OS were significantly improved in BCLC-B HCC patients that underwent LR compared to those that underwent TACE. Child–Pugh A liver disease (B vs. A) (HR 1.45 95% CI 1.17–1.79, p < 0.001; I2 = 0%, p = 0.49) and AFP levels (> 400 vs. ≤ 400 ng/ml) (HR 1.36 95% CI 1.09–1.71, p = 0.007; I2 = 90%, p = 0.001) were associated with improved OS.

Conclusion

Liver resection had significant survival benefits over TACE in selected BCLC-B HCC patients in comparison to TACE. However, LR was associated with a significantly increased incidence of treatment-related mortality and infection compared to TACE.

Keywords

Hepatocellular carcinoma Transarterial chemoembolization BCLC Resection Intermediate stage 

Notes

Acknowledgements

This study was sponsored by the Science and Technology Department of Sichuan Province of China (2017SZ0014) to LZY.

Compliance with ethical standards

Conflict of interest

Biao Yang, Bo Zheng, MaoNan Yang, Zhu Zeng, FangYun Yang, Ji Pu, ChunLin Li, ZhengYin Liao declare that there are no competing interests.

Ethics approval and consent to participate

This cohort study was approved by the Local Ethics Committee of West China Hospital, Sichuan University.

Supplementary material

12072_2018_9888_MOESM1_ESM.docx (7 mb)
Supplementary material 1 (DOCX 7148 kb)

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Copyright information

© Asian Pacific Association for the Study of the Liver 2018

Authors and Affiliations

  1. 1.Department of Abdominal Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China HospitalWest China Medical School, Sichuan UniversityChengduPeople’s Republic of China
  2. 2.Department of Interventional RadiologyHigh-Tech HospitalZigongPeople’s Republic of China
  3. 3.Department of OncologyLeShan Tradition Medicine HospitalLeshanPeople’s Republic of China

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