Surgery Versus Transarterial Chemoembolization for Solitary Large Hepatocellular Carcinoma of BCLC Stage A

Jin, Young–Joo; Lee, Jin Woo; Choi, Younyoung; Chung, Hyun Jung; Kim, Young Soo; Lee, Kun-Young; Ahn, Seung-Ik; Shin, Woo Young; Cho, Soon Gu; Jeon, Yong Sun

doi:10.1007/s11605-013-2440-x

Cited by 41 publications

(39 citation statements)

References 22 publications

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“…However, many variables related to liver function and tumour characteristics have been identified in order to find the best candidates to hepatic resection into this group of patients. 2,3 BCLC stage B is a heterogeneous category. Hence, patients with Child-Pugh scores A/B and preserved PS with multiple tumours >3 cm, uninodular with theoretical unresectable criteria, and without extrahepatic spread or macrovascular invasion fit into this stage.…”

Section: Introductionmentioning

confidence: 99%

Optimizing the management of patients with BCLC stage-B hepatocellular carcinoma: Modern surgical resection as a feasible alternative to transarterial chemoemolization

Ciria

López‐Cillero

Gallardo

et al. 2015

European Journal of Surgical Oncology (EJSO)

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Section: Introductionmentioning

confidence: 99%

Optimizing the management of patients with BCLC stage-B hepatocellular carcinoma: Modern surgical resection as a feasible alternative to transarterial chemoemolization

Ciria

López‐Cillero

Gallardo

et al. 2015

European Journal of Surgical Oncology (EJSO)

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“…In general, for huge HCC with diameter [10 cm, treatment consists of surgical resection. However, this modality is not ideal because huge HCC are typically unresectable [4,5].…”

Section: Introductionmentioning

confidence: 99%

Transarterial chemoembolization for huge hepatocellular carcinoma with diameter over ten centimeters: a large cohort study

et al. 2015

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Patients with huge hepatocellular carcinoma >10 cm in diameter represent a special subgroup for treatment. To date, there are few data and little consensus on treatment strategies for huge hepatocellular carcinoma. In this study, we summarized the effects and safety of transarterial chemoembolization for huge hepatocellular carcinoma. A retrospective study was performed based on a large cohort of patients (n = 511) with huge hepatocellular carcinoma who underwent serial transarterial chemoembolization between January 2008 to December 2011 and were followed up until March 2013. We found median survival time was 6.5 months. On multivariate analysis, Child-Pugh class (A versus B) (p < 0.0001), alpha-fetoprotein (≤400 µg/L) (p = 0.002), Barcelona Clinic Liver Cancer stage (B versus C) (p = 0.013), and other treatments after transarterial chemoembolization such as surgical resection (p = 0.008), radiation (p = 0.018), and local radiofrequency ablation (p = 0.002) were factors significantly associated with better overall patient survival after chemoembolization. Twenty-nine percent of these patients showed a tumor response after serial transarterial chemoembolization. Severe complications were few (4.9%), including oncolytic syndrome (n = 3), tumor rupture (n = 3), gastrointestinal bleeding (n = 4), deep venous thrombosis (n = 3), acute cholecystitis (n = 4), femoral artery pseudoaneurysm (n = 1), acute pancreatitis (n = 1), and acute hepatic failure (n = 6). In conclusion, transarterial chemoembolization is a safe and effective treatment for selected patients with huge hepatocellular carcinoma and is recommended as a component of combination therapy. In addition, patients with good liver function and low alpha-fetoprotein levels may acquire greater survival benefits from transarterial chemoembolization.

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“…These long-term survivors are over 60 years old, have preserved hepatic function at the time of initial diagnosis, and have a major portal vein thrombosis without parasitic supply. In addition, published studies have also ignored the multinodular type of HCC [28][29][30][31] . Taking these observations into consideration allows the following improved understanding of the findings of published metaanalyses.…”

Section: New Questions and Ideasmentioning

confidence: 99%

Review of preoperative transarterial chemoembolization for resectable hepatocellular carcinoma

Gao

Bai

Jiang

et al. 2015

WJH

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Hepatocellular carcinoma (HCC) is one of the few cancers whose incidence has been continually increasing over recent years. Resection of HCC offers the only hope for cure. However, recurrences are common in patients who have undergone resection. In our opinion, the effectiveness with which transarterial chemoembolization (TACE) as a neoadjuvant therapy for resectable HCC prevents recurrence and prolongs survival has not been conclusively demonstrated. All published meta-analyses have consistently failed to demonstrate that preoperative TACE improves the prognosis of resectable HCC. We believe that these published articles have several limitations and have our own views about the results of meta-analyses. It is very important that the scientific community shed more light on the pathogenesis of HCC and relate this to choice of therapy. This review mainly concerns our understanding of preoperative TACE for resectable HCC and briefly addresses desirable directions for future studies. Core tip: Hepatocellular carcinoma (HCC) is the sixth most common neoplasm and third most frequent cause of cancer deaths. Resection of HCC offers the only hope for a cure, yet post-resection recurrence is common. The effectiveness of transarterial chemoembolization (TACE) as a neoadjuvant therapy for resectable HCC has not been conclusively demonstrated. All published meta-analyses have consistently failed to demonstrate its effectiveness. We believe these articles have several limitations and TACE is theoretically helpful in multinodular or infiltrative types of HCC.Gao ZH, Bai DS, Jiang GQ, Jin SJ. Review of preoperative transarterial chemoembolization for resectable hepatocellular carcinoma. World J Hepatol 2015; 7(1): 40-43 Available from:

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Surgery Versus Transarterial Chemoembolization for Solitary Large Hepatocellular Carcinoma of BCLC Stage A

Abstract: Surgery may be the more effective treatment modality than TACE for a solitary large HCC of the BCLC stage A, regardless of tumor size.

Cited by 41 publications

References 22 publications

Optimizing the management of patients with BCLC stage-B hepatocellular carcinoma: Modern surgical resection as a feasible alternative to transarterial chemoemolization

Optimizing the management of patients with BCLC stage-B hepatocellular carcinoma: Modern surgical resection as a feasible alternative to transarterial chemoemolization

Transarterial chemoembolization for huge hepatocellular carcinoma with diameter over ten centimeters: a large cohort study

Review of preoperative transarterial chemoembolization for resectable hepatocellular carcinoma

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