Liver resection for hepatocellular carcinoma larger than 10 cm: A multi-institution long-term observational study

作     者：Chao-Wei Lee Ming-Chin Yu Chih-Chi Wang Wei-Chen Lee Hsin-I Tsai Feng-Che Kuan Chun-Wei Chen Yi-Chung Hsieh Hsing-Yu Chen 

作者机构：Division of General SurgeryDepartment of SurgeryLinkou Chang Gung Memorial HospitalGuishan 333TaoyuanTaiwan College of MedicineChang Gung UniversityGuishan 333TaoyuanTaiwan Graduate Institute of Clinical Medical SciencesChang Gung UniversityGuishan 333TaoyuanTaiwan Department of SurgeryNew Taipei Municipal Tu-Cheng Hospital(Built and Operated by Chang Gung Medical Foundation)Tu-Cheng 236017New Taipei CityTaiwan Division of General SurgeryDepartment of SurgeryKaohsiung Chang Gung Memorial HospitalKaohsiung 833Taiwan Division of General SurgeryDepartment of SurgeryChiayi Chang Gung Memorial HospitalChiayi 613Taiwan Department of AnesthesiologyLinkou Chang Gung Memorial HospitalGuishan 333TaoyuanTaiwan Department of Hematology and OncologyChiayi Chang Gung Memorial HospitalChiayi 613Taiwan Department of Gastroenterology and HepatologyLinkou Chang Gung Memorial HospitalGuishan 333TaoyuanTaiwan Division of Chinese Internal MedicineCenter for Traditional Chinese MedicineTaoyuan Chang Gung Memorial HospitalGuishan 33378TaoyuanTaiwan School of Traditional Chinese MedicineCollege of MedicineChang Gung UniversityGuishan 333TaoyuanTaiwan 

出 版 物：《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志（英文版）（电子版）)

年 卷 期：2021年第13卷第5期

页      面：476-492页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：Chang Gung Memorial Hospital No.CMRPG3J1691 

主　　题：Hepatocellular carcinoma 10 cm Liver resection Transarterial chemoembolization Chang Gung Research Database 

摘      要：BACKGROUND The treatment of hepatocellular carcinoma(HCC)≥10 cm remains a *** To consolidate the role of surgical resection for HCC larger than 10 *** Eligible HCC patients were identified from the Chang Gung Research Database,the largest multi-institution database,which collected medical records of all patients from Chang Gung Memorial *** surgical outcome of HCC≥10 cm(L-HCC)was compared to that of HCC10 cm(S-HCC)(model 1).The survival of L-HCC after either liver resection or transarterial chemoembolization(TACE)was also analyzed(model 2).The long-term risks of all-cause mortality and recurrence were assessed to consolidate the role of surgery for *** From January 2004 to July 2015,a total of 32403 HCC patients were identified from the Chang Gung Research *** 3985 patients who received liver resection,3559(89.3%)had S-HCC,and 426 had *** L-HCC patients had a worse disease-free survival(0.27 for L-HCC vs 0.40 for S-HCC)and overall survival(0.18 for L-HCC vs 0.45 for S-HCC)than the S-HCC after liver resection(both P0.001).However,the surgical and long-term outcome of resected L-HCC had improved dramatically in the recent *** adjusting for covariates,surgery could provide a better outcome for L-HCC than TACE(adjusted hazard ratio of all-cause mortality:0.46,95%confidence interval:0.38-0.56 for surgery).Subgroup analysis stratified by different stages showed similar trend of survival benefit among L-HCC patients receiving *** Our study demonstrated an improving surgical outcome for HCC larger than 10 *** selected conditions,surgery is better than TACE in terms of disease control and survival and should be *** to inferior survival,a subclassification within T1 stage should be *** studies are mandatory to confirm our findings.