Detailed Abstract
[Poster Presentation 13 - Liver (Liver Disease/Surgery)]
[LV PP 13-S5] Survival Comparison of Patients with BCLC Stage B Hepatocellular Carcinoma Initially Treated by Surgical Resection And TACE: a Nationwide Multicenter Study
Yung Kil KIM 1, Hyeyoung KIM 1, Sang Ho BAE 1, Hae Il JUNG 1
1 Department of Surgery, Soon Chun Hyang University Cheonan Hospital, REPUBLIC OF KOREA
Background : Although the recent evidence supporting the survival benefit of surgical resection is increasing, transarterial chemoembolization (TACE) is still recommended as the main standard treatment for Barcelona Clinic Liver Cancer B hepatocellular carcinoma (BCLC-B HCC). This study aims to compare the survival benefit of surgical resection and TACE.
Methods : The nationwide multicenter database of the Korean Liver Cancer Association was reviewed. Patients with BCLC-B HCC who underwent liver resection (LR) or TACE as a first treatment after initial diagnosis between 2008 and 2018 were selected randomly. Survival outcomes of propensity score matched groups (1:1) were compared.
Results : Among 1,596 randomly selected patients with BCLC-B HCC, 217 underwent LR as a first treatment while 978 underwent TACE. After propensity score matching, the two groups were well balanced (n=200, each). HCC-specific median survival in the LR group was better than in the TACE group (56.5 versus 33.0 months, p<0.001). The 1-, 2-, 3-, and 5-year HCC-specific survival in the LR group were 89.6%, 79.9%, 71.7%, and 62.6%, and 84.3%, 63.4%, 45.8%, and 30.1% in the TACE group, respectively (p<0.001). In multivariate analysis, PIVKA-II ≥100mAU/mL (hazard ratio (HR), 2.64; 95% confidence interval (CI, 1.76 to 3.94; p <0.001), TACE (HR, 2.28; 95% CI, 1.64 to 3.18; p<0.001), preoperative ascites (HR, 1.87; 95% CI, 1.14 to 3.05; p=0.013), and tumor number ≥4 (HR, 1.56; 95% CI, 1.09 to 2.24; p=0.016) were independent predictors for worse HCC-specific survival.
Conclusions : Surgical resection provide a significant survival benefit compared with TACE for potentially resectable the BCLC-B HCC.
Methods : The nationwide multicenter database of the Korean Liver Cancer Association was reviewed. Patients with BCLC-B HCC who underwent liver resection (LR) or TACE as a first treatment after initial diagnosis between 2008 and 2018 were selected randomly. Survival outcomes of propensity score matched groups (1:1) were compared.
Results : Among 1,596 randomly selected patients with BCLC-B HCC, 217 underwent LR as a first treatment while 978 underwent TACE. After propensity score matching, the two groups were well balanced (n=200, each). HCC-specific median survival in the LR group was better than in the TACE group (56.5 versus 33.0 months, p<0.001). The 1-, 2-, 3-, and 5-year HCC-specific survival in the LR group were 89.6%, 79.9%, 71.7%, and 62.6%, and 84.3%, 63.4%, 45.8%, and 30.1% in the TACE group, respectively (p<0.001). In multivariate analysis, PIVKA-II ≥100mAU/mL (hazard ratio (HR), 2.64; 95% confidence interval (CI, 1.76 to 3.94; p <0.001), TACE (HR, 2.28; 95% CI, 1.64 to 3.18; p<0.001), preoperative ascites (HR, 1.87; 95% CI, 1.14 to 3.05; p=0.013), and tumor number ≥4 (HR, 1.56; 95% CI, 1.09 to 2.24; p=0.016) were independent predictors for worse HCC-specific survival.
Conclusions : Surgical resection provide a significant survival benefit compared with TACE for potentially resectable the BCLC-B HCC.
SESSION
Poster Presentation 13
Zone G 3/22/2024 2:50 PM - 3:40 PM