Abstract
Objectives: Surgical decision making for patients with early hepatocellular carcinoma (HCC) and well-compensated cirrhosis remains controversial. The aim of the current study was to conduct a meta-analysis of published reports to compare survival outcomes after transplantation and resection, respectively, in patients with early HCC [i.e. HCC falling within the Milan Criteria (a solitary lesion measuring ≤5 cm or fewer than three lesions with a largest diameter of ≤3 cm, and absence of macroscopic vascular invasion or extrahepatic disease)] and well-compensated cirrhosis. Methods: A total of 990 abstracts were identified through a PubMed-based search. Ten articles comparing transplantation and resection in patients with early HCC were included in the meta-analysis. Meta-analysis was performed using stata 9.2 statistical software. Results: Outcomes were analysed for a total of 1763 patients with early HCC. The 5-year overall survival (OS) for all patients was 58% (transplantation: 63%; resection: 53%). Meta-analysis of all 10 studies revealed a survival advantage for transplantation [odds ratio (OR) 0.581, 95% confidence interval (CI) 0.359-0.939; P= 0.027]. Analysis of only those reports that utilized an 'intention-to-treat' strategy failed to demonstrate a survival advantage for either treatment approach (OR 0.600, 95% CI 0.291-1.237; P= 0.166). Conclusions: The current study demonstrates a favourable outcome in patients with early HCC treated by either transplantation or resection. Although transplantation was noted to have a survival advantage in some settings, resection continues to be a viable treatment approach.
Original language | English (US) |
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Pages (from-to) | 635-645 |
Number of pages | 11 |
Journal | HPB |
Volume | 14 |
Issue number | 9 |
DOIs | |
State | Published - Sep 2012 |
ASJC Scopus subject areas
- Hepatology
- Gastroenterology