Table 2.
Studies comparing liver resection with transarterial chemoembolisation for intermediate and advanced HCC.
| Study | Characteristics of the study | Characteristics of the patients and surgical procedures |
Outcomes and morbi/mortality |
||||||
|---|---|---|---|---|---|---|---|---|---|
| LR | TACE | p value | LR | TACE | p value | ||||
| Fukami et al. Ann Surg 2019156 |
Japan 2000–2007; Observational retrospective Study; Propensity matching1 |
Patients HBV Cirrhosis Portal hypertension 3 tumours HCC Tumour size ≥3 cm Vascular invasion |
1,944 22% 26% 67% 13% |
1,302 12% 36% 57% 7% |
<0.001 <0.001 <0.001 <0.001 |
Global 5-year OS With propensity score1 Complications (Grade 3–4) Hospital mortality |
52% 60% n.d. 0.57% |
42% 41.6% n.d. 0% |
<0.001 <0.001 n.d. n.s. |
| Yin et al. J Hepatol 2014149 |
China 2008–2010; Randomized controlled trial |
Patients HBV Cirrhosis Portal hypertension Multinodular HCC Tumour size Vascular invasion |
88 92% 78% n.d. 100% 9.5 cm 0% |
85 93% 87% n.d. 100% 10.4 cm 0% |
n.s. n.s. n.d. n.s. n.s. n.s. |
Global 5-year OS Complications (Grade 3–4) Hospital mortality |
52% 7% 1.1% |
18% 0% 0% |
<0.001 n.s. n.s. |
| Zhong et al. Ann Surg 2014151 |
China 2000–2007; Observational retrospective study; Propensity matching2 |
Patients HBV Cirrhosis Portal hypertension Multinodular HCC Tumour size Vascular invasion |
908 93% n.d. 19% n.d. 8 cm 27% |
351 90% n.d. 23% n.d. 10 cm 24% |
0.018 n.d. n.s. n.d. <0.001 n.s. |
Global 5-year OS With propensity score2 5-year OS for large tumour (≥10 cm) 5-year OS for ≥3 lesions Complications Hospital mortality |
39% 40% 34% 33% 27% 3.1% |
16% 18% 16% 6% 19% 2.8% |
<0.001 <0.001 <0.001 <0.001 <0.05 n.s. |
| Zhong et al. Plos One 2013150 |
China 2000–2007; Observational retrospective Study; Propensity matching3 |
Patients HBV Cirrhosis Portal hypertension Multinodular HCC Tumour size Vascular invasion |
257 94.6% n.d. 18% 23% 8.9 cm n.d. |
135 90.4% n.d. 22% 23% 8.8 cm n.d. |
n.s. n.s. n.s. n.s. n.d. |
Global 5-year OS With propensity score3 5-year OS for large tumour 5-year OS for multinodular form Complications Hospital mortality |
37% 62% 41% 24% 28% 3.1% |
14% 20% 18% 4% 18.5% 3.7% |
<0.001 <0.05 <0.001 <0.05 <0.05 n.s. |
| Hsu et al. Ann Surg Oncol 2012152 |
Taiwan 2002–2010; Observational retrospective study; Propensity matching4 |
Patients HBV Child-Pugh A Portal hypertension Multinodular HCC Tumour size ≥7 cm Vascular invasion |
268 66% 93% n.d. 40% 64% 67% |
455 50% 79% n.d. 60% 50% 39% |
<0.001 <0.001 n.d. <0.001 n.s. <0.001 |
Global 5-year OS With propensity score4 Complications Hospital mortality |
63% 68% n.d. 2.7% |
15% 22% n.d. 8.2% |
<0.001 <0.001 n.d. n.s. |
| Lin et al. World J Surg 2010153 |
Taiwan 2001–2007; Observational retrospective study |
Patients HBV Cirrhosis Multinodular HCC Tumour size Vascular invasion |
93 88% n.d. 47% 8 cm n.d. |
78 99% n.d. 72% 7.7 cm n.d. |
n.s. n.d. <0.05 n.s. n.d. |
3-year OS Complications Hospital mortality |
49% n.d. n.d. |
2% n.d. n.d. |
<0.001 n.d. n.d. |
AFP, alpha-fetoprotein; ALT, alanine aminotransferase; HCC, hepatocellular carcinoma; ICG-R15, hepatic clearance of indocyanine green 15 minutes after its intravenous administration; LR, liver resection; OS, overall survival; n.d., not determined; n.s., not significant; TACE, transarterial chemoembolisation.
Parameters included to generate propensity score: age, sex, hepatitis B and C, albumin, total bilirubin, ICG-R15, platelets count, prothrombin activity, alpha-fetoprotein, macrovascular invasion, number and tumour size.
Parameters included to generate propensity score: age, tumour size, hepatitis B, platelets count, alanine aminotransferase, and total bilirubin level.
Parameters included to generate propensity score: age, gender, tumour size, tumour number, serum bilirubin, ALT, albumin, and AFP.
Parameters included to generate propensity score: sex, hepatitis B, hepatitis C, alcoholism, tumour burden, severity of cirrhosis, performance status, diabetes mellitus, BCLC classification, and Cancer of the Liver Italian Program score.