Helmberger, Thomas; Dogan, Selin; Straub, Gundula; Schrader, Angelika; Jüngst, Christoph; Reiser, Maximilian F.; Waggershauser, Tobias; Jakobs, Tobias; Hoffmann, Ralf-Thorsten; Löhe, Florian; Graeb, Christian; Rau, Horst-Günter; Schauer, Rolf; Jauch, Karl-Walter; Caselmann, Wolfgang H.; Göke, Burkhard; Jüngst, Dieter
Liver resection or combined chemoembolization and radiofrequency ablation improve survival in patients with hepatocellular carcinoma.
In: Digestion, No. 2-3: pp. 104-112
Background/ Aims: To evaluate the long-term outcome of surgical and non-surgical local treatments of patients with hepatocellular carcinoma (HCC). Methods: We stratified a cohort of 278 HCC patients using six independent predictors of survival according to the Vienna survival model for HCC (VISUM- HCC). Results: Prior to therapy, 224 HCC patients presented with VISUM stage 1 (median survival 18 months) while 29 patients were classified as VISUM stage 2 (median survival 4 months) and 25 patients as VISUM stage 3 (median survival 3 months). A highly significant (p < 0.001) improved survival time was observed in VISUM stage 1 patients treated with liver resection ( n = 52; median survival 37 months) or chemoembolization (TACE) and subsequent radiofrequency ablation ( RFA) ( n = 44; median survival 45 months) as compared to patients receiving chemoembolization alone (n = 107; median survival 13 months) or patients treated by tamoxifen only (n = 21; median survival 6 months). Chemoembolization alone significantly (p <= 0.004) improved survival time in VISUM stage 1 - 2 patients but not (p = 0.341) in VISUM stage 3 patients in comparison to those treated by tamoxifen. Conclusion: Both liver resection or combined chemoembolization and RFA improve markedly the survival of patients with HCC.