Trial Information

A Prospective Randomized Trial of Surgical Resection Versus Percutaneous Local Ablative Therapy for Hepatocellular Carcinoma Complicating Clinically Significant Portal Hypertension Within the Milan Criteria

HCC is a major health problem worldwide, with an estimated incidence ranging between 500,000
and 1,000,000 new cases annually. It is the fifth most common cancer in the world and the
third most common cause of cancer-related death,especially in East-Asia countries.SR remains
the first therapeutic option for a cure but is suitable only for 9%—27% of patients.The
presence of significant background cirrhosis often precludes liver resection for HCC.Even
though these HCC patients undergo SR，the incidence of posthepatectomy liver failure(PHLF)
and death would be high，especially to HCC patients complicating CSPH，whose corresponding
risk of PHLF and persistent PHLF were 59.02%and 14.75%respectively in our past study. It is
extremely urgent to search a safe and effective means in this subgroup of HCC
patients.PLAT, a recently developed local ablative technique, has attracted the greatest
interest and popularity because of its effectiveness and safety,with a 3-year survival rate
of 62-77%,a low treatment complication rate of 8-9% and a low treatment mortality rate of
0-0.5%.However, there is still debate on whether PLAT or SR is the most suitable therapy for
HCC.To our knowledge,there have been no study on the therapy of HCC complicating CSPH.