Short-and long-term efficacy of transarterial chemoembolization versus liver resection in treatment of patients with Barcelona stage B multiple hepatocellular carcinoma

Objective To investigate the short-and long-term efficacy of transarterial chemoembolization (TACE) versus liver resection in the treatment of patients with Barcelona Clinic Liver Cancer (BCLC) stage B multiple hepatocellular carcinoma (HCC) .Methods A retrospective analysis was performed for the clinical data of 80 patients with BCLC stage B multiple HCC who were treated from June 2010 to June 2011, and among these patients, 49 underwent liver resection (LR group) and 31 underwent TACE (TACE group) .The postoperative complications, changes in liver function parameters, survival time, and 1-, 3-, and 5-year survival rates were compared between the two groups.The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups.The Kaplan-Meier curve was used for survival analysis, The log-rank test was used for conparison between two groups.Results At 1 week after surgery, the LR group and the TACE group had significant increases in total bilirubin, alanine aminotransferase (ALT) , and aspartate aminotransferase (AST) (LR group:t=3.181, 2.181, and 2.955, P=0.002, 0.032, and 0.004;TACE group:t=3.109, 3.965, and 4.519, P=0.003, P<0.001, and P<0.001) , and after surgery, the LR group had significantly lower levels of AST and ALT than the TACE group (t=2.094 and 2.111, P=0.040 and 0.038) .Compared with the TACE group, the LR group had significantly higher 1-, 3-, and 5-year survival rates (75.51%/51.02%/40.82% vs 61.29%/22.58%/9.68%, all P<0.05) and significantly longer median survival time (36.3 months vs 26.5 months, P<0.05) .The LR group had a significantly lower recurrence rate than the TACE group (30.61% vs 67.74%, χ2=10.576, P=0.001) .Conclusion Liver resection has a better effect in the treatment of patients with BCLC stage B multiple HCC than TACE and can improve overall survival and prolong survival time.