• J Y Lei, J J Zhong, L N Yan, J Q Zhu, W T Wang, Y Zeng, B Li, T F Wen, J Y Yang, and - Liver Surgery Group.
• Thyroid and Parathyroid Surgery Centre, West China Hospital of Sichuan University, Chengdu, China.
• Br J Surg. 2016 Jun 1; 103 (7): 881-90.

BackgroundLiver resection for intermediate (Barcelona Clinic Liver Cancer (BCLC) stage B) hepatocellular carcinoma (HCC) remains controversial. This study attempted to demonstrate the effectiveness of preresection transarterial chemoembolization (TACE) as a selection criterion for BCLC-B HCC.MethodsThe study included patients with BCLC-B HCC who underwent liver resection after TACE. The tumour response to TACE was evaluated according to the modified Response Evaluation Criteria in Solid Tumours (mRECIST). Patients with a complete or partial response comprised the responder group, whereas those with stable or progressive disease were classified as non-responders.ResultsA total of 242 patients were included. After between one and eight sessions of TACE, 141 patients were included in the responder group: 37 patients (15·3 per cent) who achieved a complete response and 104 who had a partial response. The cumulative 1-, 3- and 5-year overall survival rates were 97·2, 88·7 and 75·2 per cent respectively in the responder group, compared with 90·1, 67·3 and 53·5 per cent among 101 non-responders (P < 0·001). Tumour-free survival rates were also better among responders than non-responders (P < 0·001). In multivariable analysis, independent predictors of overall and tumour-free survival were response to TACE and microvascular invasion (all P < 0·001).ConclusionmRECIST may represent selection criterion for intermediate HCC for surgical treatment.© 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

46 keywords...

hide…