Surgery

The aim of this study is to compare the clinical outcomes following hepatic resection (HR) versus transarterial chemoembolization (TACE) for UICC (the Union for International Cancer Control) stage (7th) T3 HCC (hepatocellular carcinoma). From 2005 to 2013, 1179 patients who underwent HR or TACE were divided into two groups, HR (n=280) or TACE (n=899). The propensity model matched 244 patients in HR and TACE group, respectively, for further analyses. After matching, medium overall survival, 1, 3, and 5-year OS (overall survival) rates in TACE group were 11.8 months (95%CI, 9.9, 13.7), 49.6%, 16.5%, and 8.4%, respectively, whereas HR group were 17.8 months (95% CI, 14.8-20.8), 63.1%, 33.3%, and 26.4%, respectively; (P<0.01). Patients in HR group were more likely to developed pleural effusion. Multivariate analysis indicated that PT, tumor size, tumor numbers, UICC stage, and initial treatment were independent prognostic factors. This study revealed hepatic resection was safe and yielded a survival benefic compared with TACE in UICC stage T3 HCC patients. HR seemed to represent the optimal therapy strategy and should be recommended as a preferable treatment for the management of UICC stage T3 HCC.