0%, if the probability of local recurrence following

initial complete ablation was <1.9%, if RFA could be performed for a recurrent HCC at least 70.2% of the time, if the median survival www.selleckchem.com/products/Adriamycin.html of patients with progressive HCC was >2.73 years, or if the R1 rate was >0.28% (Table 2). Other variables did not alter the preferred treatment option from HR. The analysis also demonstrated that group II was always superior to group III for overall survival and that group III was the preferred strategy over group I if the perioperative mortality rate was >3.8% or if the R1 rate was >4.2%. Two-way sensitivity analysis demonstrated that the overall survival of patients with a perioperative mortality rate of 1% for group I was the

same as that of patients with a local recurrence rate of 2.5% for group II, when other variables values remained constant at preset values (Fig. 3). The analysis also showed that a 3% increase in the local recurrence rate following RFA was equivalent to a 1% increase in the perioperative mortality rate following HR concerning the effect on overall survival. This finding was due to the fact that many of the local recurrent tumors could be successfully treated with repeated RFA. Tornado diagrams showed that the overall survival outcomes were most sensitive to the probability of remote intrahepatic recurrence or the repeatability of RFA for recurrent HCCs, which were not related to the initial treatment options Raf inhibitor (Supporting Fig. 2). In contrast, survival outcomes were less sensitive to variables related to initial treatment options such as perioperative mortality or local recurrence. The probability distributions of overall survival for the cohort in this study demonstrated that the expected overall survival for group I and group II were nearly identical, but were longer than that for group III (Fig. 4). The 95% confidence intervals were 7.18–7.96, see more 7.15–7.94, and 6.96–7.73 years for group I, group II, and group III, respectively. The 95% confidence intervals for the difference in overall

survival were −0.18–0.18 years between group I and II, 0.06–0.36 years between group I and III, and 0.13–0.30 years between group II and III. The difference between group I and II was insignificant (P = 0.309), but the difference between group I and III and between group II and III was statistically significant (P = 0.003 and P = 0.000, respectively) (Supporting Fig. 3). This apparent discrepancy occurred because the overall survival outcomes were more sensitive to variables not related to the initial treatment options. More importantly, this finding indicates that the preference for the treatment strategy between groups I/II and group III would not be affected by the uncertainties in the parameter estimations. Usually, RFA is inferior to HR in terms of local recurrence, which is known to be a significant adverse prognostic factor for survival.