Comparison of hepatic resection and transarterial chemoembolization for solitary hepatocellular carcinoma

Table 1 Baseline and tumor characteristics of the study patients

	Liver resection group	TACE group	P value
	218	281
Age (yr)	52.1 ± 12.5	52.0 ± 13.5	0.950
Sex (M/F)	162/56	210/71	0.915
Weight (kg)	67.6 ± 9.5	66.8 ± 9.4	0.358
Height (cm)	165.5 ± 8.7	164.9 ± 9.0	0.496
BMI (kg/m2)	23.6 ± 2.5	23.6 ± 2.4	0.870
Cirrhosis etiology (HBV/HCV/negative/other)	193/5/9/11	256/6/6/13	0.352
MELD score	5.4 ± 1.8	5.5 ± 1.7	0.607
Child score (A/B/C)	162/56/0	222/59/0	0.218
EOCG score (0/1/2)	161/29/28	211/39/31	0.697
PHT (yes/no)	182/36	244/37	0.668
Tumor diameter of the largest target (cm)	6.2 ± 2.3	7.6 ± 2.2	< 0.001
AFP level (ng/mL)	2388.5 ± 7916.0	2650.1 ± 8514.4	0.726
0-400 ng/mL	120	136
400-800 ng/mL	11	26
800-1200 ng/mL	15	13
≥ 1210 ng/mL	72	106
NLR ≥ 4 (yes/no)	109/109	160/121	0.123
Obvious arterial phase enhancement (yes/no)	175/43	222/59	0.727
Diagnostic method (enhanced CT/MRI/biopsy)	172/36/10	238/27/16	0.127

BMI: Body mass index; HBV: Hepatitis B virus; HCV: Hepatitis C virus; MELD: Model for end stage liver disease; TACE: Transarterial chemoembolization; LT: Liver transplantation; NLR: Neutrophil-lymphocyte ratio; CT: Computed tomography; MRI: Magnetic resonance imaging; M: Male; F: Female.

Table 2 Post-operative complications in the two patient groups n (%)

	Resection group	TACE group	P value
	218	281
Complications (Clavien-Dindo classification)	68 (31.2)	154 (54.8)	< 0.001
Grade I (without drugs, conservative treatment)	18 (8.3)	77 (27.4)
Grade II (simple medicine treatment)	12 (5.5)	56 (19.9)
Grade IIIa (therapeutic operation under local anesthesia)	7 (3.2)	5 (1.8)
Grade IIIb (operational treatment under general anesthesia)	5 (2.3)	2 (0.7)
Grade IVa (single organ function failure)	5 (2.3)	1 (0.4)
Grade IVb (multiple organ failure)	4 (1.8)	1 (0.4)
Grade V (In-hospital death)	4 (1.8)	2 (0.7)	0.254
Minor complications (I-II)	30 (13.8)	133 (43.3)	< 0.001
Major complications (III-V)	38 (17.4)	11 (3.9)	< 0.001
30-d mortality	5 (2.3)	3 (1.1)	0.280
90-d mortality	8 (3.7)	7 (2.5)	0.445

TACE: Transarterial chemoembolization.

Table 3 Univariate analyses show factors of overall survival

Variables	n	Overall survival rate
	499	P value
Age < 60 (yes/no)	341/158	0.041
Gender (M/F)	372/127	0.596
BMI ≥ 26 (yes/no)	72/427	0.268
Cause of liver diseases (HBV/HCV/no/others)	449/11/15/24	0.779
Child-Pugh Score (A/B)	384/115	0.897
ECOG score (0/1/2)	372/68/59	0.594
PHT (yes/no)	425/74	< 0.001
ALB ≥ 35 g/L (yes/no)	275/224	0.221
Platelets ≥ 100 × 109/L (yes/no)	177/322	0.923
HB ≥ 120 g/L (yes/no)	331/168	0.602
Creatinine ≥ 100 μmol/L (yes/no)	49/450	0.675
NLR ≥ 4 (yes/no)	269/230	< 0.001
AFP level (1-400/400-800/800-1200/ > 1200 ng/mL)	256/37/28/178	0.218
Tumor diameter > 6 cm (yes/no)	306/193	< 0.001
Obvious arterial phase enhancement (yes/no)	397/102	0.361
Diagnostic method (enhanced CT/MRI/biopsy)	410/63/26	0.587
Therapy (liver resection/TACE)	218/281	0.437

BMI: Body mass index; HBV: Hepatitis B virus; HCV: Hepatitis C virus; MELD: Model for end-stage liver disease; NLR: Neutrophil-lymphocyte ratio; AFP: Alpha-fetoprotein; TACE: Transarterial chemoembolization; ALB: Albumin; CT: Computed tomography; MRI: Magnetic resonance imaging; M: Male; F: Female.

Table 4 Multivariate analyses of factors that contributed to the overall survival rates

Variables	HR	95%CI	P value
Age < 60	1.129	0.981-1.282	0.121
PHT	1.228	0.908-1.556	0.262
NLR ≥ 4	1.431	0.992-1.781	0.128
Tumor diameter > 6 cm	1.328	1.002-1.783	0.048

NLR: Neutrophil-lymphocyte ratio.