Comparative effectiveness of nonsurgical therapies for localized hepatocellular carcinoma: Analysis of the National Cancer Database.

425Background: Data guiding selection of optimal nonsurgical therapies for management of localized hepatocellular carcinoma (HCC) are lacking. Because there are limited prospective comparative data for these treatment modalities, we aimed to compare the effectiveness of chemotherapy (systemic or arterial directed) versus radiofrequency ablation (RFA) versus radioembolization (RE) in nonsurgically managed patients with stage I and II HCC using the National Cancer Database. Methods: We identified patients who received chemotherapy, RFA or RE for nonsurgically managed Stage I (T1N0M0) and II (T2N0M0) HCC between 2008 and 2013. Patients excluded included those who received upfront lobectomy or resection or extended lobectomy or hepatectomy or transplant, and if they had Ishak fibrosis score of 5-6 or total bilirubin > 3 mg/dl or international normalized ratio (INR) of > 3. Overall survival (OS) was compared between treatment groups using propensity score matched (1:1:1) and weighted analyses. We also verified...