Comparison of prognosis between liver resection and transarterial chemoembolization in patients with Budd-Chiari syndrome complicating hepatocellular carcinoma
10.3760/cma.j.cn113855-20240406-00256
- VernacularTitle:布-加综合征并发肝细胞癌患者肝切除与经动脉化疗栓塞的预后比较
- Author:
Zedong WANG
1
;
Suxin LI
1
;
Luhao LI
1
;
Zhaochen LIU
1
;
Lin LI
1
;
Huahu GUO
1
;
Yang YANG
1
;
Shuaibo LING
1
;
Shengyan LIU
1
;
Xiaowei DANG
1
Author Information
1. 郑州大学第一附属医院肝胆胰外科 河南省卫生健康委员会普通外科（肝胆胰）疾病精准诊疗重点实验室 河南省肝胆胰疾病微创诊治工程研究中心 河南省布-加综合征诊疗中心，郑州 450052
- Publication Type:Journal Article
- Keywords:
Budd-Chiari syndrome;
Carcinoma, hepatocellular;
Liver resection;
Transarterial chemoembolization;
Prognosis
- From:
Chinese Journal of General Surgery
2025;40(5):360-365
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the prognostic differences between liver resection and transarterial chemoembolization (TACE) in patients with Budd-Chiari syndrome (BCS) complicated by hepatocellular carcinoma (HCC) and to identify independent risk factors affecting patient survival.Methods:The clinical and follow-up data of 103 patients with stage Ⅰa-Ⅲa BCS complicated by HCC treated at the First Affiliated Hospital of Zhengzhou University from Aug 2015 to Sep 2023 were retrospectively analyzed.Results:Patients were divided into two groups based on their initial treatment choices: the liver resection group ( n=20) and the TACE group ( n=83). Before propensity score matching(PSM), the median overall survival in the liver resection group was 42 months longer than in the TACE group (74 months vs. 32 months, P=0.002). After PSM, the median overall survival remained significantly longer in the liver resection group by 39 months (74 months vs. 35 months, P=0.032). In terms of disease-free survival, before PSM, the liver resection group was 30-month longer than the TACE group (42 months vs. 12 months, P=0.001). After PSM, the difference in median disease-free survival between the two groups was 23 months (35 months vs. 12 months, P=0.018). Multivariate Cox regression analysis identified treatment modality and maximum tumor diameter as independent risk factors for overall survival, while treatment modality was the only independent factor for disease-free survival. Conclusions:Liver resection significantly prolongs both overall survival and disease-free survival in resectable HCC in BCS patients compared to TACE. Treatment modality and tumor size are key prognostic factors influencing overall survival.
