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Therapeutic efficacy of transcatheter arterial chemoembolization as compared with hepatic resection in hepatocellular carcinoma patients with compensated liver function in a hepatitis B virus-endemic area: a prospective cohort study

Cited 89 time in Web of Science Cited 90 time in Scopus
Authors
Lee, Hyo-Suk; Kim, Kang Mo; Yoon, Jung-Hwan; Lee, Tae-Rim; Suh, Kyung Suk; Lee, Kuhn Uk; Chung, Jin Wook; Park, Jae Hyung; Kim, Chung Yong
Issue Date
2002
Publisher
American Society of Clinical Oncology
Citation
J Clin Oncol 20:4459-4465
Keywords
Carcinoma,Hepatocellular/complications/pathology/*physiopathology/surgery/*therapyCatheters, Indwelling*Chemoembolization, Therapeutic/methodsCohort StudiesContrast Media*HepatectomyHepatic ArteryHepatitis B/*complications/*epidemiology/physiopathologyInfusions, Intra-ArterialIodized Oil/diagnostic useKorea/epidemiologyLiver Neoplasms/complications/pathology/*physiopathology/surgery/*therapyNeoplasm StagingProspective StudiesSurvival AnalysisTomography, X-Ray Computed/methodsTreatment Outcome
Abstract
PURPOSE: Identifying a special subgroup of hepatocellular carcinoma (HCC) patients who may benefit from transcatheter arterial chemoembolization (TACE) when compared with the standard treatment of hepatic resection (HR) warrants research in Asian countries. PATIENTS AND METHODS: From January 1993 to December 1994, 182 patients with operable HCC (Child-Pugh class A and International Union Against Cancer [UICC] stage T1-3N0M0) were enrolled. After initial TACE and lipiodol computed tomography, 91 received HR and 91, who refused the operation, received repeated sessions of TACE. After stratification according to the tumor stage (UICC and Cancer of the Liver Italian Program [CLIP]) and lipiodol retention pattern, the survival rates of the two treatment groups were compared. The median follow-up period was 83 months. RESULTS: As of December 31, 2000, 48 patients who underwent HR and 68 patients who underwent TACE had died. In a subgroup analysis according to tumor stage, the HR group survival rate was significantly higher than the TACE group in both UICC T1-2N0M0 (P =.0058) and CLIP 0 (P =.0027) subgroups. However, there was no significant difference in either UICC T3N0M0 (P =.7512) or CLIP 1-2 (P =.5366) subgroups. Even in patients with UICC T1-2N0M0 HCC, when lipiodol was compactly retained, the survival rate of the HR group was comparable to that of the TACE group (P =.0596). CONCLUSION: TACE proved to be as effective as HR in the subpopulations with UICC T3N0M0 or CLIP 1-2 HCC and adequate liver function, and even with UICC T1-2N0M0 HCC when lipiodol was compactly retained in the tumor. In such cases, the choice of treatment modality between TACE and HR may be left to the patient's preference.
ISSN
0732-183X (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12431969

http://hdl.handle.net/10371/11306
DOI
https://doi.org/10.1200/JCO.2002.02.013
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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