Chemoembolization Combined with Radiofrequency Ablation for Medium-Sized Hepatocellular Carcinoma: A Propensity-Score Analysis

Chu, Hee Ho; Kim, Jin Hyoung; Yoon, Haesung; Ko, Heung‐Kyu; Gwon, Dong Il; Kim, Pyo Nyun; Sung, Kyu‐Bo; Ko, Gi‐Young; Kim, So Yeon

doi:10.1016/j.jvir.2019.06.006

Cited by 41 publications

(29 citation statements)

References 37 publications

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“…After the initial CT or MR imaging scan, subsequent follow-up contrast-enhanced CT or MR imaging scans were repeated every 2-3 months during the first 2 years or until recurrence of HCC, and thereafter every 3-6 months until recurrence of HCC. When tumor growth or a residual new tumor was found, an additional local therapy consisting of TACE, radiofrequency ablation, or stereotactic body radiation therapy was initiated (9). Some patients underwent surgical resection or liver transplantation during the follow-up period after the initial or repeated TACE.…”

Section: Data Collection and Image Analysismentioning

confidence: 99%

“…The improved surveillance of patients kjronline.org generally curative treatments such as surgical resection, liver transplantation, and radiofrequency ablation (3)(4)(5). The lack of liver donors is a major limitation for liver transplantation (6), thereby making surgical resection and radiofrequency ablation the most feasible treatment options against small (≤ 3 cm) HCC (7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

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Imaging Predictors of Survival in Patients with Single Small Hepatocellular Carcinoma Treated with Transarterial Chemoembolization

Park

Kim

et al. 2021

Korean J Radiol

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Objective: Clinical outcomes of patients who undergo transarterial chemoembolization (TACE) for single small hepatocellular carcinoma (HCC) are not consistent, and may differ based on certain imaging findings. This retrospective study was aimed at determining the efficacy of pre-TACE CT or MR imaging findings in predicting survival outcomes in patients with small HCC upon being treated with TACE. Besides, the study proposed to build a risk prediction model for these patients. Materials and Methods: Altogether, 750 patients with functionally good hepatic reserve who received TACE as the first-line treatment for single small HCC between 2004 and 2014 were included in the study. These patients were randomly assigned into training (n = 525) and validation (n = 225) sets. Results: According to the results of a multivariable Cox analysis, three pre-TACE imaging findings (tumor margin, tumor location, enhancement pattern) and two clinical factors (age, serum albumin level) were selected and scored to create predictive models for overall, local tumor progression (LTP)-free, and progression-free survival in the training set. The median overall survival time in the validation set were 137.5 months, 76.1 months, and 44.0 months for low-, intermediate-, and high-risk groups, respectively (p < 0.001). Time-dependent receiver operating characteristic curves of the predictive models for overall, LTP-free, and progression-free survival applied to the validation cohort showed acceptable areas under the curve values (0.734, 0.802, and 0.775 for overall survival; 0.738, 0.789, and 0.791 for LTP-free survival; and 0.671, 0.733, and 0.694 for progression-free survival at 3, 5, and 10 years, respectively). Conclusion: Pre-TACE CT or MR imaging findings could predict survival outcomes in patients with small HCC upon treatment with TACE. Our predictive models including three imaging predictors could be helpful in prognostication, identification, and selection of suitable candidates for TACE in patients with single small HCC.

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Section: Data Collection and Image Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Imaging Predictors of Survival in Patients with Single Small Hepatocellular Carcinoma Treated with Transarterial Chemoembolization

Park

Kim

et al. 2021

Korean J Radiol

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“…Additionally, SBRT appears to be a viable treatment option for HCC, especially at LT centers with significant experience in performing SBRT, typically in those who have failed or are too decompensated for other LRTs. Finally, if the initial decision in this patient is to pursue TACE, there is emerging evidence from several Asian centers that combination therapy with TACE followed by RFA in BCLC A and B patients with HCC larger than 3 cm is generally safe and leads to superior overall and progression‐free survival compared with TACE alone . Chu et al showed improved outcomes in patients undergoing combination TACE‐RFA for a single 3.1‐5 cm HCC compared with either modality alone.…”

Section: Case 2 Part Bmentioning

confidence: 99%

Hepatocellular Carcinoma—How to Determine Therapeutic Options

Mehta

2020

Hepatol Commun

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Deciding on specific treatment strategies involves not only tumor stage, performance status, and severity of underlying liver disease, but additional factors such as biomarkers, organ availability, and radiographic tumor response to treatment. In this review, we present hepatocellular carcinoma (HCC) cases to highlight how to determine therapeutic options for HCC in specific scenarios, including resection versus liver transplant, choice of initial local regional treatment, tumor downstaging, and systemic therapies for advanced HCC.

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“…Recent studies have shown that RFA combined with TACE can have a synergistic effect on HCCs [ 17 , 18 ]. Meta-analyses showed that TACE in combination with RFA significantly improved local tumor control and overall survival rates compared with TACE or RFA alone for patients with HCC larger than 3 cm [ 17 – 19 ].…”

Section: Introductionmentioning

confidence: 99%

Radiofrequency Ablation (RFA) Combined with Transcatheter Arterial Chemoembolization (TACE) for Patients with Medium-to-Large Hepatocellular Carcinoma: A Retrospective Analysis of Long-Term Outcome

Liu

Xiao

et al. 2020

Med Sci Monit

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Chemoembolization Combined with Radiofrequency Ablation for Medium-Sized Hepatocellular Carcinoma: A Propensity-Score Analysis

Cited by 41 publications

References 37 publications

Imaging Predictors of Survival in Patients with Single Small Hepatocellular Carcinoma Treated with Transarterial Chemoembolization

Imaging Predictors of Survival in Patients with Single Small Hepatocellular Carcinoma Treated with Transarterial Chemoembolization

Hepatocellular Carcinoma—How to Determine Therapeutic Options

Radiofrequency Ablation (RFA) Combined with Transcatheter Arterial Chemoembolization (TACE) for Patients with Medium-to-Large Hepatocellular Carcinoma: A Retrospective Analysis of Long-Term Outcome

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