Surgical resection versus transarterial chemoembolization for BCLC stage C hepatocellular carcinoma

Abstract

SR provides significantly better long-term survival than TACE in patients with BCLC stage C HCC, and should be an integral part in the management of advanced HCC. Multidisciplinary approaches for these patients and further amendment to the BCLC classification scheme are required.

Hepatic resection compared to chemoembolization in intermediate‐ to advanced‐stage hepatocellular carcinoma: A meta‐analysis of high‐quality studies

“…Among the remaining 27 studies, eight studies were reported from three identical institutions and shared overlapping periods and populations. Therefore, we chose the more recent and comprehensive data sets . Additionally, four studies were excluded after quality assessment (modified MINORS score <12).…”

“…The details and reasons for exclusion requiring consensus between the authors are described in http://onlinelibrary.wiley.com/doi/10.1002/hep.29883/suppinfo. Finally, 18 studies reporting PH versus TACE in BCLC stage B or stage C patients were included in the systematic review and meta‐analysis.…”

“…Eighteen trials (one RCT, five PSM NRCTs, and 12 NRCTs) consisting of 20 data sets and a total of 5,986 patients were included in the meta‐analysis. The RCT was a single‐center trial conducted in China .…”

“…A further 17 NRCTs were performed in Spain (one NRCT), Korea (two NRCTs), China (three PSM NRCTs, seven NRCTs), Taiwan (one PSM NRCT, two NRCTs), and Japan (one PSM NRCT). Nine studies with 3,457 patients included BCLC stage B patients, and another nine trials (11 data sets) with 3,051 patients enrolled BCLC stage C patients. All trials were published between 2010 and 2017.…”

Incorporation of alpha-fetoprotein(AFP) into subclassification of BCLC C stage hepatocellular carcinoma according to a 5-year survival analysis based on the SEER database

“…Patients with A0 in stage C, defined as C1, are suggested to receive resection, leaving patients with moderate to severe cirrhosis. Liu et al study demonstrated a better overall survival of surgical resection than transarterial chemoembolization (TACE) in HCC patients with BCLC stage C [26]. LT is the optimal treatment even for small, otherwise resectable HCC.…”