| The effectiveness of locoregional therapies versus supportive care in maintaining survival within the Milan criteria in patients with hepatocellular carcinoma. | |
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MedLine Citation:
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PMID: 20656222 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To compare survival after treatment with either locoregional therapy (LRT) or supportive care in patients with hepatocellular carcinoma (HCC) within the Milan criteria. MATERIALS AND METHODS: Patients with HCC who were classified within the Milan criteria (solitary HCC <or= 5 cm or <or= 3 tumors with none greater than 3 cm in largest diameter, and no macrovascular invasion) and underwent transcatheter therapy or radiofrequency ablation (RF ablation) between 1998 and 2008 were retrospectively studied. Patients with tumor burden within the Milan criteria who received the best supportive care only were used as the control group. Survival within the Milan criteria was compared between those who underwent LRT and patients who underwent supportive care. RESULTS: Of 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). CONCLUSIONS: LRT 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. |
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Authors:
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Renumathy Dhanasekaran; Vinit Khanna; David A Kooby; James R Spivey; Samir Parekh; Stuart J Knechtle; John D Carew; John S Kauh; Hyun S Kim |
Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of vascular and interventional radiology : JVIR Volume: 21 ISSN: 1535-7732 ISO Abbreviation: J Vasc Interv Radiol Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-26 Completed Date: 2010-11-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9203369 Medline TA: J Vasc Interv Radiol Country: United States |
Other Details:
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Languages: eng Pagination: 1197-204; quiz 204 Citation Subset: IM |
Copyright Information:
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Copyright (c) 2010 SIR. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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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. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Carcinoma, Hepatocellular / mortality, pathology, therapy* Catheter Ablation* / adverse effects, mortality Chemoembolization, Therapeutic* / adverse effects, mortality Chi-Square Distribution Female Georgia Humans Kaplan-Meiers Estimate Liver Neoplasms / mortality, pathology, therapy* Liver Transplantation Male Middle Aged Neoplasm Staging Palliative Care* Proportional Hazards Models Retrospective Studies Risk Assessment Risk Factors Time Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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