Resectable Hepatocellular Carcinoma Beyond Milan Criteria Clinical Trial
Official title:
Hepatic Resection Versus Transarterial Chemoembolization as the Initial Treatment for Resectable Hepatocellular Carcinoma Beyond Milan Criteria
The purpose of this study is to compare the survival outcomes between hepatic resection and transarterial lipiodol chemoembolization (TACE) used as the initial treatment in patients with Resectable Hepatocellular Carcinoma Beyond Milan Criteria.
For patients with large/multiple, and resectable hepatocellular carcinomas (HCCs) without
macrovascular invasion or extrahepatic spread, the choice of treatment remains largely
controversial. For these patients, transarterial lipiodol chemoembolization (TACE) is
recommended as a palliative therapy.
On the other hand, many authors still believe that hepatic resection is the only potential
curative treatment in these patients because it is still feasible to remove all macroscopic
tumors safely at surgery. With advances in surgical techniques, more large/multiple HCCs are
now resectable, and long-term results have been reported that ranged from 30% to 58% at 5
years; even patients with large bilobar multiple HCC could reach a survival rate of more than
20% at 5 years after hepatic resection.
Until now, there have been only a few studies that compared the outcomes of hepatic resection
and TACE in the treatment of multiple HCCs, and these have reported controversial results.
Some studies showed that hepatic resection had survival benefi t over TACE, but other studies
showed the opposite result ( 11-15 ). Therefore, the investigators performed this prospective
study in consecutive patients with large/multiple, and resectable HCCs to compare the
outcomes in patients who underwent hepatic resection or TACE as the initial treatment.
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