IDDF2019-ABS-0070 Liver resection versus transarterial chemoembolization for the treatment of intermediate-stage hepatocellular carcinoma

Background The role of transarterial chemoembolization (TACE) as the standard therapy for intermediate-stage hepatocellular carcinoma (HCC) is being challenged by increasing studies supporting liver resection (LR), but evidence of survival benefits of LR is lacking. We aimed to compare the overall survival (OS) of LR with that of TACE for the treatment of intermediate-stage HCC in cirrhotic patients. Methods A Markov model, comparing LR with TACE over 15 years, was constructed based on data from 31 literatures. Additionally, external validation of the model was performed using a data set (n=1735; LR: 701; TACE: 1034) from a tertiary center with propensity score matching method. We conducted one-way and two-way sensitivity analyses, in addition to a Monte Carlo analysis with 10,000 patients allocated for each arm. Results The mean expected survival periods and survival percentages at 5 years were 77.8 months, 47.1% in LR group, and 48.6 months, 25.7% in TACE group, respectively. Sensitivity analyses demonstrated that initial LR was the more favorable treatment. The 95% CI for the difference in OS was 2.42–2.46 years between the two groups (P Conclusions LR may provide a survival benefit over TACE for cirrhotic patients with intermediate-stage HCC.