Transarterial Chemoembolization Monotherapy Versus Combined Transarterial Chemoembolization–Microwave Ablation Therapy for Hepatocellular Carcinoma Tumors ≤5 cm: A Propensity Analysis at a Single Center

Chen, Qifeng; Jia, Zhenyuan; Yang, Zhaohui; Fan, Wenlong; Shi, Haibin

doi:10.1007/s00270-017-1736-8

Cited by 50 publications

(45 citation statements)

References 22 publications

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“…ALB, Albumin; AST, Aspartate aminotransferase; ALT, Alanine aminotransferase; TBIL, Total bilirubin feasibility of TACE combined with MWA [21,22]. A retrospective study of 244 HCC patients highlighted that the tumor response (CR + PR + SD) rates at 6 months was 92.1% in the TACE-MWA group compared with 46.3% noted in the conventional TACE (P < 0.001), and they concluded that patients with HCC tumors equal to or smaller than 5 cm in diameter (≤5 cm) exhibited a better response to combined treatment than that noted for TACE alone [23]. Additionally, the 1-, 3and 5-year OS rates were significantly higher in the combination therapy group than those in the TACE alone group (p < 0.001) [24].…”

Section: Discussionmentioning

confidence: 99%

Transcatheter arterial chemoembolization combined with simultaneous DynaCT-guided microwave ablation in the treatment of small hepatocellular carcinoma

Jiao

Han

et al. 2020

Cancer Imaging

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Purpose: To evaluate the method and effectiveness of transcatheter arterial chemoembolization (TACE) combined with simultaneous DynaCT-guided Microwave ablation (MWA) for the treatment of small hepatocellular carcinoma (SHCC). Materials and methods: From June 2015 to May 2017, a total of 28 consecutive patients with SHCC received single treatment of TACE and 23 subjects received a combination treatment of TACE with simultaneous DynaCTguided MWA. Following 1 month of treatment, the tumor response was assessed using the mRECIST criteria and the outcomes were analyzed including intervention-associated complications, changes in liver function, imaging response, and progression-free survival (PFS). Results: The technical success rate was 100%. The rates of CR (65%) in the combined TACE and MWA group were higher than those of the TACE group (46%). The rate of common adverse events, such as liver abscess, spontaneous bacterial peritonitis and liver dysfunction, in the combined TACE and MWA group (56%) was comparable to the corresponding rate of the TACE group (P > 0.411). The median and mean PFS of the TACE group were significantly lower than those of the combined TACE and MWA group (19.00 months vs. 29.00 months, 21.076 months vs. 24.693 months, p = 0.019, log-rank test). Conclusion: Stereotactic DynaCT-guided MWA is a safe and effective method for the treatment of SHCC, which usually provides an effective tumor puncture path, notably for lesions that cannot be detected following TACE. Overall, the data suggested that this treatment method could improve the clinical outcome of patients with SHCC.

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Section: Discussionmentioning

confidence: 99%

Transcatheter arterial chemoembolization combined with simultaneous DynaCT-guided microwave ablation in the treatment of small hepatocellular carcinoma

Jiao

Han

et al. 2020

Cancer Imaging

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“…The propensity score model was determined by previous studies (8,11), the independent variables used in the matching included gender, age, alpha-fetoprotein (AFP) level, Child-Pugh score, alanine aminotransferase (ALT), tumor size and tumor number. Propensity score matching was performed using optimal matching method at the ratio of 1:2 (9).…”

Section: Discussionmentioning

confidence: 99%

“…Previously, two retrospective studies demonstrated the superior treatment effectiveness of the TACE-MWA combination therapy compared with the TACE monotherapy for specific HCC patients (7,8). However, their studies did not specify the BCLC stage and included HCC patients at BCLC stages A, B, and C. Our study focused mainly on BCLC stage B patients with tumor size ≤7 cm and tumor number ≤5.…”

Section: Discussionmentioning

confidence: 99%

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Combined transarterial chemoembolization and microwave ablation versus transarterial chemoembolization in BCLC stage B hepatocellular carcinoma

Zhang¹,

Shen

Zhao

et al. 2018

Diagn Interv Radiol

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“…Meanwhile, TACE, despite of being recommended for intermediatestage HCC in the guidelines, has also been a valid option for patient ineligible for curative treatment with early-stage HCC in clinical practice. 25,26 However, there is a paucity of study comparing therapeutic effectiveness between MWA and TACE for HCC in early-stage. Hence, to present more clinical reference of the treatment allocation for early-stage HCC, we conducted this retrospective study.…”

Section: Discussionmentioning

confidence: 99%

<p>Comparison of Microwave Ablation and Transarterial Chemoembolization for Single-Nodule Hepatocellular Carcinoma Smaller Than 5cm: A Propensity Score Matching Analysis</p>

Cui¹,

Wang²,

Ma³

et al. 2019

CMAR

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These authors contributed equally to this workPurpose: To compare overall survival (OS) and progression-free survival (PFS) between microwave ablation (MWA) and transarterial chemoembolization (TACE) for solitary hepatocellular carcinoma (HCC) smaller than 5 cm. Methods: Patients with solitary HCC smaller than 5cm who initially underwent MWA or TACE were identified in Chinese PLA General Hospital from June 2010 to October 2015. Propensity score matching (PSM) was performed with a 1:1 matching protocol. OS and PFS were compared by using the log-rank test. After matching, subgroup analysis based on tumor size (≤3cm/3.1-5cm) was also conducted. Prognostic factors for OS and PFS were assessed with Cox proportional hazard regression model. Results: A total of 202 patients (MWA, n=120; TACE, n=82) were identified. After matching, 116 patients were included (58 patients for each treatment group). MWA provided significantly better OS and PFS than TACE for both the entire cohort (OS, P<0.001; PFS, P<0.001) and the matched cohort (OS, P=0.015; PFS, P<0.001). Subgroup analysis showed that among patients with tumor of 3cm or less, the MWA group had significantly better OS (P=0.027) and PFS (P=0.008) than the TACE group. Multivariate Cox regression analysis showed TACE was associated with worse OS (hazard ratio, 2.385; 95% CI: 1.427, 3.985; P=0.001) and PFS (hazard ratio, 2.567; 95% CI: 1.820, 3.622; P<0.001). Conclusion: MWA outperformed TACE for solitary HCC smaller than 5cm in OS and PFS. For single tumors less than 5cm, especially those smaller ones (≤3cm), priority should be given to MWA when making treatment options between MWA and TACE. Precis' StatementThis paper reported the comparative results in therapeutic effectiveness between MWA and TACE for solitary HCC smaller than 5cm.

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Transarterial Chemoembolization Monotherapy Versus Combined Transarterial Chemoembolization–Microwave Ablation Therapy for Hepatocellular Carcinoma Tumors ≤5 cm: A Propensity Analysis at a Single Center

Abstract: Compared with TACE, TACE-MWA leads to better responses for HCC tumors ≤5 cm.

Cited by 50 publications

References 22 publications

Transcatheter arterial chemoembolization combined with simultaneous DynaCT-guided microwave ablation in the treatment of small hepatocellular carcinoma

Transcatheter arterial chemoembolization combined with simultaneous DynaCT-guided microwave ablation in the treatment of small hepatocellular carcinoma

Combined transarterial chemoembolization and microwave ablation versus transarterial chemoembolization in BCLC stage B hepatocellular carcinoma

<p>Comparison of Microwave Ablation and Transarterial Chemoembolization for Single-Nodule Hepatocellular Carcinoma Smaller Than 5cm: A Propensity Score Matching Analysis</p>

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