Evidence map›Paper›PMID 30672806›Full record

ArticleAnnals of surgery2020

Liver Resection for Multiple Hepatocellular Carcinomas: A Japanese Nationwide Survey.

Yasuyuki Fukami, Yuji Kaneoka, Atsuyuki Maeda, Takashi Kumada, Junko Tanaka, Tomoyuki Akita, Shoji Kubo, Namiki Izumi, Masumi Kadoya, Michiie Sakamoto and 10 more

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Article in Annals of surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
55citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

55 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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  14. Spectrum of therapeutic options in hepatocellular carcinoma.Journal of exercise rehabilitation · 2025
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors.

Yasuyuki FukamiDepartment of Surgery, Ogaki Municipal Hospital, Gifu, Japan.
Yuji KaneokaDepartment of Surgery, Ogaki Municipal Hospital, Gifu, Japan.
Atsuyuki MaedaDepartment of Surgery, Ogaki Municipal Hospital, Gifu, Japan.
Takashi KumadaDepartment of Gastroenterology, Ogaki Municipal Hospital, Gifu, Japan.
Junko TanakaDepartment of Epidemiology, Infectious Disease Control, and Prevention, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan.
Tomoyuki AkitaDepartment of Epidemiology, Infectious Disease Control, and Prevention, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan.
Shoji KuboDepartment of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Namiki IzumiDepartment of Gastroenterology, Musashino Red Cross Hospital, Tokyo, Japan.
Masumi KadoyaDepartment of Radiology, Shinshu University School of Medicine, Matsumoto, Japan.
Michiie SakamotoDepartment of Pathology, Keio University School of Medicine, Tokyo, Japan.
Osamu NakashimaDepartment of Clinical Laboratory Medicine, Kurume University Hospital, Kurume, Japan.
Yutaka MatsuyamaDepartment of Biostatics, School of Public Health, University of Tokyo, Tokyo, Japan.
Takashi KokudoHepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Kiyoshi HasegawaHepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Tatsuya YamashitaAdvanced Preventive Medical Research Center, Kanazawa University, Kanazawa, Japan.
Kosuke KashiwabaraDepartment of Biostatistics, School of Public Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Tadatoshi TakayamaDepartment of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan.
Norihiro KokudoNational Center for Global Health and Medicine, Tokyo, Japan.
Masatoshi KudoDepartment of Gastroenterology and Hepatology, Kinki University School of Medicine, Osaka, Japan.
Liver Cancer Study Group of Japan

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe aim of the study was to evaluate the survival benefits of liver resection (LR) compared with transarterial chemoembolization (TACE) for patients with multiple hepatocellular carcinomas (HCCs).

backgroundDespite significant improvements in diagnostic imaging and the widespread application of screening programs, some patients with HCC continue to present with multiple tumors. The surgical indications for multiple HCCs remain controversial.

methodsAmong 77,268 patients with HCC reported in a Japanese nationwide survey, 27,164 patients had multiple HCCs. The exclusion criteria were Child-Pugh B/C, treatment other than LR and TACE, >3 tumors, and insufficient available data. Ultimately, 3246 patients (LR: n = 1944, TACE: n = 1302) were included. The survival benefit of LR for patients multiple HCCs was evaluated by using propensity score matching analysis.

resultsThe study group of 2178 patients (LR: n = 1089, TACE: n = 1089) seemed to be well matched. The overall survival rate in the LR group was 60.0% at 5 years, which was higher than that in the TACE group (41.6%, P < 0.001). Among patients with a tumor size of 30 mm or more, LR showed a survival benefit over TACE at 5 years (53.0% vs 32.7%, P < 0.001). The multivariate analysis indicated that age, serum albumin level, serum alpha-fetoprotein (AFP) level, macrovascular invasion, tumor size, and TACE were independent predictors of poor prognosis in multiple HCCs.

conclusionsLR could offer better long-term survival than TACE for patients with multiple HCCs (up to 3 tumors). If patients have good liver function (Child-Pugh A), LR is recommended, even for those with multiple HCCs with tumor sizes of 30 mm or more.

Indexed as

AgedCarcinoma, HepatocellularChemoembolization, TherapeuticFemaleHepatectomyHumansJapanLiver NeoplasmsMaleMiddle AgedPractice Patterns, Physicians'PrognosisPropensity ScoreProspective StudiesSurvival Rate

Identifiers

PMID30672806

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.