Partial hepatectomy versus interventional treatment in patients with hepatitis B virus-related hepatocellular carcinoma and clinically significant portal hypertension: a randomized comparative clinical trial

作     者：Yichuan Yuan Hong Peng Wei He Yun Zheng Jiliang Qiu Bin Chen Ruhai Zou Chenwei Wang Wan Yee Lau Binkui Li Yunfei Yuan 

作者机构：State Key Laboratory of Oncology in South ChinaGuangdong Provincial Clinical Research Center for CancerSun Yat-sen University Cancer CenterGuangzhouGuangdongP.R.China Department of Liver SurgerySun Yat-sen University Cancer CenterGuangzhouGuangdongP.R.China The Center of Hepatocellular-pancreatobiliary SurgeryThe First Affiliated HospitalSun Yat-sen universityGuangzhouGuangdongP.R.China Department of UltrasoundSun Yat-sen University Cancer CenterGuangzhouGuangdongP.R.China Faculty of MedicineThe Chinese University of Hong KongHong KongSARP.R.China 

出 版 物：《Cancer Communications》 (癌症通讯（英文）)

年 卷 期：2024年第44卷第11期

页      面：1337-1349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：supported by the grants from the Sun Yat-Sen University Clinical Research 5010 Programme(2012010) the National Natural Science Foundation of China(82272887) 

主　　题：hepatocellular carcinoma portal hypertension partial hepatectomy interventional treatment 

摘      要：Background:The widely accepted view that portal hypertension(PHT)is a con-traindication to hepatectomy for patients with hepatocellular carcinoma(HCC)is being increasingly *** long-term survival outcomes and safety of partial hepatectomy versus interventional treatment using ablation with or without pre-ablation transarterial chemoembolization(TACE)in patients with HBV-related HCC within the Milan criteria and with clinically significant PHT were compared in this ***:This open-label randomized clinical trial was conducted on consecu-tive patients with clinically PHT and hepatitis B virus(HBV)-related HCC with tumors which were within the Milan *** patients were randomized 1:1 to receive either partial hepatectomy or interventional treatment between December 2012 and June *** primary endpoint was overall survival(OS);secondary endpoints included recurrence-free survival(RFS)and therapeutic ***:Each of the 2 groups had 80 *** 1-,3-and 5-year OS rates in the partial hepatectomy group and the interventional treatment group were 95.0%,86.2%,69.5%versus 93.8%,77.5%,64.9%,respectively(P=0.325).The corresponding RFS rates were 78.8%,55.0%,46.2%versus 71.3%,52.5%,45.0%,respectively(P=0.783).The partial hepatectomy group had a higher compli-cation rate compared to the interventional group(67.5%vs.20%,P0.05).Conclusions:This study shows that partial hepatectomy treatment did not meet prespecified significance for improved OS and RFS compared to interventional treatment for patients with HBV-related HCC within the Milan criteria and with clinically significant ***,partial hepatectomy is still a safe procedure and should be considered as a treatment option rather than a contraindication.