| Background: Hepatocellular carcinoma(HCC)is the third most common cancer in the world and is the second major cause of cancer death.The main treatment of liver cancer are resection,radiofrequency ablation,liver transplantation,TACE,system drug therapy,best support therapy,etc.The treatment choice and related prognosis of hepatocellular carcinoma is closely related to the tumor stage and the degree of liver function.The BCLC staging system which has taken the tumor status and liver function into account,and for each period has suggested the corresponding treatment methods,is currently the most widely used clinical staging system.Patients among them,the BCLB B refers to those with the number of tumor nodules more than 3 or 2 ~ 3 tumor noduleswith any nodules greater than 3 cm,and no extrahepatic metastases or major vascular invasion,Child-Pugh,A-B,PS(performance status)score of 0.For such patients BCLC recommended TACE as the standard treatment,and the randomized controlled studies have shown that conventional TACE can prolong the patient’s survival.But with advances in surgical technique,care and perioperative treatment for patients with more specifications,liver function in patients with preoperative assessment more reasonable,surgical resection rate rising,and complication rates further decreasing.Now more than one study show that liver resection for "hepatocellular carcinoma"(BCLC B)have a better treatment result compared to TACE in terms of overall survival.Which ways should be selected to treat the patient with hepatocellular carcinoma(BCLC B)is controversial.This paper retrospectively analyzed the patients firstly diagnosed with hepatocellular carcinoma(BCLC B)between January 2008 and January 2014,and the rate of complications,mortality in 60 days and overall survival were compared.Materials and methods: To make retrospective analysis which is according to 43 patients firstly diagnosed with hepatocellular carcinoma(BCLC B)who came from the second hospital of Dalian medical university during 1.2008~1.2014.We divided these patients into 2 groups: group A: a total of 22 cases,liver resection.Group B: 21 cases,TACE.Compare two groups in the rate of complications and mortality in 60 days,the differences between the total survival rate and survival periods in order to explore the better treatment for patients firstly diagnosed with hepatocellular carcinoma(BCLC B).Results: the 43 cases were successfully completed surgery,no postoperative deaths.Two groups of patients in age,sex,viral hepatitis or not,cirrhosis of the liver or not,the AFP levels,tumor number,a single tumor diameter,degree of Child – Pugh,hypertension,diabetes,coronary heart disease have no significant difference(p > 0.05).No significant differences on postoperative complication rate between Liver resection and conventional TACE(18.18% vs 4.76%,p = 0.371),and the same result on mortality in 60 days between the two groups(4.55% vs 9.52%,p = 0.967).For survival analysis,the 1 year survival rate has no obvious difference(77.27% vs 61.90%,p = 0.273),but the difference in 2 years survival rate(59.09% vs 14.29%,p = 0.006),3 year survivalrate(27.27% vs 4.76%,p = 0.046)was statistically significant,also in overall survival(28 months vs 15 months,p = 0.04).The results above explain liver resection group have a longer survival period compared to TACE group.Conclusion: For treatment of intermediate-stage(BCLC B)hepatocellular carcinoma,the liver resection group had a better result in 2 years,3 years survival rate and even in overall survival rate compared to TACE group.According to the results of this research we suppose that it might be better to choose liver resection to deal with intermediate-stage(BCLC B)hepatocellular carcinoma firstly than TACE for a better suvival. |
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