Abstract |
The optimal treatment ( liver transplantation [LT] vs surgical resection [SR]) for early-stage hepatocellular carcinoma (HCC) remains controversial.A total of 209 SR patients and 129 LT patients were identified at our institution. After eliminating 27 patients with Child-Pugh C, the data from 209 SR patients and 102 LT patients were analyzed using a propensity score matching (PSM) model. Forty-six pairs were generated. A subgroup analysis was conducted based on the alpha-fetoprotein (AFP) level or platelet count (PLT). A survival analysis was performed using the Kaplan-Meier method.Gender, satellite lesions, and the treatment method were predictors of HCC recurrence. The Ishak score and treatment methods were associated with long-term survival after surgery. Before PSM, LT patients had a better prognosis than those treated by SR. Among HCC patients with childhood A/B cirrhosis, after PSM, SR achieved similar overall survival outcomes compared with LT. LT and SR resulted in comparable long-term survival for patients with or without thrombocytopenia. Patients with an AFP ≥ 400 ng/mL might achieve more survival benefits from LT.Our propensity score model provided evidence that, compared with transplantation, surgical resection could result in comparable long-term survival for resectable early-stage HCC patients, except for the AFP ≥ 400 ng/mL HCC subgroup. Surgical resection might not be a contraindication for early-stage HCC patients with thrombocytopenia due to their similar prognosis after transplantation.
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Authors | Jun-Yi Shen, Chuan Li, Tian-Fu Wen, Lv-Nan Yan, Bo Li, Wen-Tao Wang, Jia-Yin Yang, Ming-Qing Xu, Tholakkara Nazar Highness |
Journal | Medicine
(Medicine (Baltimore))
Vol. 95
Issue 52
Pg. e5756
(Dec 2016)
ISSN: 1536-5964 [Electronic] United States |
PMID | 28033289
(Publication Type: Journal Article)
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Chemical References |
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Topics |
- Adult
- Carcinoma, Hepatocellular
(blood, pathology, surgery)
- Disease-Free Survival
- Female
- Hepatectomy
- Humans
- Kaplan-Meier Estimate
- Liver Neoplasms
(blood, pathology, surgery)
- Liver Transplantation
- Male
- Middle Aged
- Neoplasm Staging
- Platelet Count
- Propensity Score
- Survival Rate
- alpha-Fetoproteins
(metabolism)
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