Resection Versus Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma With Solitary Huge Tumor

Resection Versus Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma With Solitary Huge Tumor: a Randomized Controlled Trial

This clinical trial aims to compare hepatectomy with Transarterial Chemoembolization (TACE) for Hepatic Cellular Cancer With Solitary Huge Tumor (≥5cm). All patients will be divided into two group.One group will receive hepatic resection, while an another equivalent group patients will be treated with Transarterial Chemoembolization.

Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver.For Barcelona Clinic Liver Cancer (BCLC) stage B patients，especially those with Solitary Huge Tumor (≥5cm) ，the better therapy between hepatic resection and transarterial chemoembolization remains controversial despite extensive studies。 From now on, we prospectively collected patients with solitary huge HCC who received hepatectomy or TACE. Of the 200 patients，100 patients were surgically treated and the others underwent TACE。After the treatment, patients received routine follow-up with physical examination, serum α-fetoprotein (AFP) level and ultrasonography at 3-month intervals for the first year and then every 6 months.The end of follow-up was determined as either the time of last follow-up (July 2019) or death. The overall survival，including 1, 2 and 3-year overall survival rates，will be analyse. All data are collected prospectively.

Inclusion Criteria:

• Clinical diagnosis of Hepatic cellular Carcinoma.
• Patients with Solitary Huge Tumor (≥5cm）of Hepatic cellular Carcinoma (HCC) detected by Serum Alpha Fetoprotein (AFP) and CT or MRI.
• Patients without Hepatic vein or bile duct invasion and extrahepatic metastasis.
• Patients without surgical contraindication.
• Patients with Child A or B liver function and indocyanine green retention rate at 15min (ICGR15) < 10% before treatment.
• Laboratory examination: haemoglobin (Hb)>100g/L, white blood cell (WBC) > 3000/mL, blood platelet counts (PLT) > 8×10*10/L before treatment.
• Patients without severe esophagogastric varices before treatment.
• Patients with HBV，HBV DNA≤100, 000 copy/mL.
• All of the patients has written consent for this research.

Exclusion Criteria:

• Patients with multiple tumors or vascular or bile duct invasion or extrahepatic metastasis.
• Patients with surgical contraindication.
• Patients with Child C grade liver function before treatment.
• Patients with other malignancy.
• .Patients treated with hepatic resection or TACE before this treatment.
• Patients with severe esophagogastric varices or refractory ascites or coagulation dysfunction before treatment.