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Liver Resection Improves the Survival of Patients with Multiple Hepatocellular Carcinomas

  • Hepatobiliary and Pancreatic Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

According to current guidelines of hepatocellular carcinoma (HCC) treatment, multiple HCCs are usually not suitable for surgical resection. However, surgical resection is still possible for patients with multiple HCCs. The role of hepatic resection vs transarterial chemoembolization (TACE) for multiple HCCs should be further clarified.

Methods

We retrospectively enrolled 1065 patients with multiple HCCs. Among them, 294 received surgical resection, 367 received transarterial chemoembolization (TACE), and 404 received chemotherapy or supportive care. Three staging systems (TNM, CLIP, and BCLC) were used for comparison of stage-specific survival between different treatment modalities.

Results

The median survival of multiple HCC patients who received surgical resection was 37.9 months, while it was 17.3 months in TACE group, and 2.8 months in supportive group (P < .001). The 1-year, 3-year, 5-year survival rates for surgical group were 77.4%, 51.9%, and 36.6%, respectively. Kaplan-Meier survival analysis demonstrated that patients who received surgical resections had the best survival, followed by TACE and supportive care. For patients of the same stage, surgical resection yields better results than TACE. Surgery could offer better survival than TACE for patients either within or beyond Milan’s criteria.

Conclusions

Our results indicate that if patients have preserved liver functions, hepatic resection is helpful, even for patients with multiple HCCs.

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Acknowledgments

This study was financially supported by the Liver Disease Prevention & Treatment Research Foundation, Taiwan. We are indebted to our colleagues at the Cancer Registry, Office of Medical Record, NTUH, for their excellent work in the cancer registry system and to the physicians for their care of the patients. We also appreciate Ms. Yu-Jen Lin’s help for the statistical analyses.

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Authors and Affiliations

  1. Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

    Ming-Chih Ho MD, PhD & Po-Huang Lee MD, PhD

  2. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

    Guan-Tarn Huang MD, PhD, Ding-Shinn Chen MD, Jin-Chuan Sheu MD, PhD & Chien-Hung Chen MD, PhD

  3. Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

    Yuk-Ming Tsang MD

  4. Graduate Institute of Clinical Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

    Ding-Shinn Chen MD

  5. Hepatitis Research Center, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

    Ding-Shinn Chen MD

Authors
  1. Ming-Chih Ho MD, PhD
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  2. Guan-Tarn Huang MD, PhD
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  3. Yuk-Ming Tsang MD
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  4. Po-Huang Lee MD, PhD
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  5. Ding-Shinn Chen MD
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  6. Jin-Chuan Sheu MD, PhD
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  7. Chien-Hung Chen MD, PhD
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Corresponding author

Correspondence to Chien-Hung Chen MD, PhD.

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Ho, MC., Huang, GT., Tsang, YM. et al. Liver Resection Improves the Survival of Patients with Multiple Hepatocellular Carcinomas. Ann Surg Oncol 16, 848–855 (2009). https://doi.org/10.1245/s10434-008-0282-7

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  • DOI: https://doi.org/10.1245/s10434-008-0282-7

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