• Renumathy Dhanasekaran, Vinit Khanna, David A Kooby, James R Spivey, Samir Parekh, Stuart J Knechtle, John D Carew, John S Kauh, and Hyun S Kim.
• Division of Interventional Radiology and Image-guided Medicine, Department of Radiology, Emory University School of Medicine, 1364 Clifton Road NE, Suite AG-05, Atlanta, GA 30322, USA.
• J Vasc Interv Radiol. 2010 Aug 1;21(8):1197-204; quiz 204.

PurposeTo compare survival after treatment with either locoregional therapy (LRT) or supportive care in patients with hepatocellular carcinoma (HCC) within the Milan criteria.Materials And MethodsPatients with HCC who were classified within the Milan criteria (solitary HCC ResultsOf 162 patients studied, 110 patients (67.9%) underwent LRT, and 52 patients (32.1%) received supportive care alone. Median survival within the Milan criteria for patients who did and did not receive LRT were 644 days (95% confidence interval [CI], 193-1094) and 162 days (95% CI, 73-250) respectively (P < .001). In patients who received LRT, Child Pugh class was prognostic for survival within the Milan criteria on multivariate analysis (P = .002, hazard ratio 5.16 [2.69-9.89]). The long-term survival for patients who did not undergo transplant was 502 days (95% CI, 91-912) in patients who received LRT and 151 days (95% CI, 59-242) in patients who were treated with supportive care (P < .001).ConclusionsLRT is more effective than supportive care in prolonging survival within the Milan criteria in patients with HCC. The long-term survival in patients not undergoing transplant was significantly longer for patients who received LRT than for patients who were treated with supportive care.Copyright (c) 2010 SIR. Published by Elsevier Inc. All rights reserved.

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