Transplantation versus hepatectomy for HCC beyond the Milan criteria: A propensity score analysis.

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Transplantation versus hepatectomy for HCC beyond the Milan criteria: A propensity score analysis.

Int J Surg. 2017 May 18;:

Authors: Shen JY, Li C, Wen TF, Yan LN, Li B, Wang WT, Yang JY, Xu MQ, Wen J

Abstract
BACKGROUND: Increasing studies have suggested that surgical resection (SR) or liver transplantation (LT) could bring survival benefits for patients with hepacelluar carcinoma (HCC) beyond Milan criteria. This study compared the long-term survival of patients beyond the Milan criteria who received SR or LT.
MATERIAL AND METHODS: A total of 461 HCC patients were retrospectively collected. Analysis was performed using propensity score matching (PSM), the Kaplan-Meier method and the Cox proportional hazards model.
RESULTS: Prognosis was significantly better for the LT group than the SR group before (P<0.001) and after PSM(p=0.003). In subgroup analysis, for patients with lower AFP level, the 1-, 3-, and 5-year OS rates for the two groups were significantly different (86.7, 71.9, and 71.9 % for group LT vs. 75.8, 48.1, and 10.7 % for group SR, P=0.003). For patients with smaller tumor size, the 1-, 3-, and 5-year OS rates were 78.3, 66.7, and 66.7% for group LT, and 83.8, 42.6, and 18.6% for group SR, p=0.009). Transplantation was a favorable factor associated with prognosis before and after propensity score matching (HR 2.643).
CONCLUSION: Our propensity model suggested that LT provided significantly better long-term survival than SR for HCC beyond Milan criteria before and after PSM.

PMID: 28529191 [PubMed - as supplied by publisher]

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