Guo Zhe, Zhong Jian-Hong, Jiang Jing-Hang, Zhang Jun, Xiang Bang-De, Li Le-Qun
Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, People's Republic of China.
Ann Surg Oncol. 2014 Sep;21(9):3069-76. doi: 10.1245/s10434-014-3704-8. Epub 2014 Apr 12.
It is unclear whether hepatic resection (HR) or transarterial chemoembolization (TACE) is associated with better outcomes for patients with hepatocellular carcinoma (HCC) in Barcelona Clinic Liver Cancer (BCLC) stage A. The present study compared survival for patients with BCLC stage A HCC treated by HR or TACE.
Our study examined 360 patients treated by HR and 221 treated by TACE. To reduce bias in patient selection, 152 pairs of propensity-score-matched patients were generated, and their long-term survival was compared using the Kaplan-Meier method. Independent predictors of survival were identified using the Cox proportional hazards model.
Among propensity-score-matched pairs of patients with Child-Pugh A liver function who were treated by HR or TACE, the 1-, 3-, and 5-year overall survival rates were 75.5, 44.8, and 30.2 % after HR and 64.5, 24.1, and 13.7 % after TACE (P < 0.001). Serum AST level, serum AFP level, tumor size, and TACE independently predicted survival in Cox regression analysis.
Our propensity-score-matched study confirmed that HR was associated with higher survival rates than was TACE in patients with BCLC stage A HCC.
对于巴塞罗那临床肝癌（BCLC）分期为A期的肝细胞癌（HCC）患者，肝切除术（HR）或经动脉化疗栓塞术（TACE）是否能带来更好的预后尚不清楚。本研究比较了接受HR或TACE治疗的BCLC A期HCC患者的生存率。
我们的研究纳入了360例接受HR治疗的患者和221例接受TACE治疗的患者。为减少患者选择偏倚，生成了152对倾向评分匹配的患者，并使用Kaplan-Meier方法比较他们的长期生存率。使用Cox比例风险模型确定生存的独立预测因素。
在倾向评分匹配的接受HR或TACE治疗的Child-Pugh A级肝功能患者中，HR治疗后1年、3年和5年总生存率分别为75.5%、44.8%和30.2%，TACE治疗后分别为64.5%、24.1%和13.7%（P<0.001）。在Cox回归分析中，血清AST水平、血清AFP水平、肿瘤大小和TACE是生存的独立预测因素。
我们的倾向评分匹配研究证实，对于BCLC A期HCC患者，HR的生存率高于TACE。
