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  4. Surgical resection significantly promotes the overall survival of patients with hepatocellular carcinoma: a propensity score matching analysis
 
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Surgical resection significantly promotes the overall survival of patients with hepatocellular carcinoma: a propensity score matching analysis

Journal
BMC Gastroenterology
Journal Volume
21
Journal Issue
1
Date Issued
2021
Author(s)
Chen Y.-S.
Hsieh P.-M.
Lin H.-Y.
Hung C.-M.
Lo G.-H.
Hsu Y.-C.
Lu I.-C.
CHIH-YUAN LEE  
Wu T.-C.
Yeh J.-H.
Hsiao P.
Li Y.-C.
Wang Y.-C.
Hsieh K.-C.
Lin C.-W.
DOI
10.1186/s12876-021-01807-4
URI
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85105779959&doi=10.1186%2fs12876-021-01807-4&partnerID=40&md5=1f76cfdee0df764890d804c75ccb6d4f
https://scholars.lib.ntu.edu.tw/handle/123456789/591820
Abstract
Background: The benefits of surgical resection (SR) for various Barcelona Clinic Liver Cancer (BCLC) stages of hepatocellular carcinoma (HCC) remain unclear. We investigated the risk factors of overall survival (OS) and survival benefits of SR over nonsurgical treatments in patients with HCC of various BCLC stages. Methods: Overall, 2316 HCC patients were included, and their clinicopathological data and OS were recorded. OS was analyzed by the Kaplan-Meier method and Cox regression analysis. Propensity score matching (PSM) analysis was performed. Results: In total, 66 (2.8%), 865 (37.4%), 575 (24.8%) and 870 (35.0%) patients had BCLC stage 0, A, B, and C disease, respectively. Furthermore, 1302 (56.2%) of all patients, and 37 (56.9%), 472 (54.6%), 313 (54.4%) and 480 (59.3%) of patients with BCLC stage 0, A, B, and C disease, respectively, died. The median follow-up duration time was 20 (range 0–96) months for the total cohort and was subdivided into 52 (8–96), 32 (1–96), 19 (0–84), and 12 (0–79) months for BCLC stages 0, A, B, and C cohorts, respectively. The risk factors for OS were (1) SR and cirrhosis; (2) SR, cirrhosis, and Child–Pugh (C–P) class; (3) SR, hepatitis B virus (HBV) infection, and C–P class; and (4) SR, HBV infection, and C–P class for the BCLC stage 0, A, B, and C cohorts, respectively. Compared to non-SR treatment, SR resulted in significantly higher survival rates in all cohorts. The 5-year OS rates for SR vs. non-SR were 44.0% versus 28.7%, 72.2% versus 42.6%, 42.6% versus 36.2, 44.6% versus 23.5%, and 41.4% versus 15.3% (all P values < 0.05) in the total and BCLC stage 0, A, B, and C cohorts, respectively. After PSM, SR resulted in significantly higher survival rates compared to non-SR treatment in various BCLC stages. Conclusions: SR conferred significant survival benefits to patients with HCC of various BCLC stages and should be considered a recommended treatment for select HCC patients, especially patients with BCLC stage B and C disease. ? 2021, The Author(s).
Subjects
Hepatitis B virus; Hepatocellular carcinoma; Overall survival; Prognosis; Surgical resection
SDGs

[SDGs]SDG3

Other Subjects
adult; age; alcohol consumption; Article; cancer prognosis; cancer staging; cancer surgery; Child Pugh score; cohort analysis; controlled study; female; follow up; hepatitis B; hepatitis C; human; liver cell carcinoma; liver cirrhosis; major clinical study; male; middle aged; mortality; overall survival; retrospective study; risk factor; sex; smoking; survival rate; tumor volume; liver cell carcinoma; liver resection; liver tumor; pathology; propensity score; treatment outcome; Carcinoma, Hepatocellular; Hepatectomy; Humans; Liver Neoplasms; Neoplasm Staging; Propensity Score; Retrospective Studies; Treatment Outcome
Publisher
BioMed Central Ltd
Type
journal article

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