Comparison of Combined Transcatheter Arterial Chemoembolization and CT-guided Radiofrequency Ablation with Surgical Resection in Patients with Hepatocellular Carcinoma within the Up-to-seven Criteria: A Multicenter Case-matched Study

Mu, Luwen; Wu, Chun; Wu, Xiang-yuan; Xie, Qiankun; Li, Xishan; Lyu, Ning; Li, Shaolong; Deng, Haijing; Jiang, Zai-bo; Lin, Aihua; Zhao, Ming

doi:10.7150/jca.19964

Cited by 36 publications

(31 citation statements)

References 29 publications

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“…It indicated that DEB-TACE combined with RFA can achieve the same short-term effects as surgical treatment. In terms of liver damage, the results implied that the treatment of DEA-TACE combined with RFA had less damage to the liver than surgical treatment, which is similar to the results of the Pan et al[ 45 ]. In terms of complications, it indicated that patients treated with DEB-TACE combined with RFA showed better tolerance.…”

Section: Discussionsupporting

confidence: 84%

Drug-eluting beads transarterial chemoembolization sequentially combined with radiofrequency ablation in the treatment of untreated and recurrent hepatocellular carcinoma

Zhang¹,

Zhang²,

Fan³

et al. 2020

WJGS

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BACKGROUND Drug-eluting beads transarterial chemoem-bolization (DEB-TACE) has the advantages of slow and steady release, high local concentration, and low incidence of adverse drug reactions compared to the traditional TACE. DEB-TACE combined with sequentially ultrasound-guided radiofrequency ablation (RFA) therapy has strong anti-cancer effects and little side effects, but there are fewer related long-term studies until now. AIM To explore the outcome of DEB-TACE sequentially combined with RFA for patients with primary hepatocellular carcinoma (HCC). METHODS Seventy-six patients with primary HCC who underwent DEB-TACE sequentially combined with RFA were recruited. Forty patients with untreated HCC were included in Group A, and 36 patients with recurrent HCC were included in Group B. In addition, 40 patients with untreated HCC who were treated with hepatectomy were included in Group C. The serological examination, preoperative magnetic resonance imaging examination, and post-treatment computed tomography enhanced examination were performed for all patients. The efficacy was graded as complete remission (CR), partial remission (PR), stable disease and progressive disease at the 3 rd , 6 th , and 9 th . All patients were followed up for 3 years and their overall survival (OS), disease-free survival (DFS) were assessed. RESULTS The efficacy of Group A and Group C was similar ( P > 0.05), but the alanine aminotransferase, aspartate aminotransferase and total bilirubin of Group A were lower than those of Group C (all P < 0.05). The proportions of CR (32.5%), PR (37.5%) were slightly higher than Group A (CR: 27.5%, PR: 35%), but the difference was not statistically significant ( χ 2 = 0.701, P = 0.873). No operational-related deaths occurred in Group A and Group C. The OS (97.5%, 84.7%, and 66.1%) and the DFS (75.0%, 51.7%, and 35.4%) of Group A at the 1 st , 2 nd , and 3 rd year after treatment were similar with those of Group C (OS: 90.0%, 79.7%, and 63.8%; DFS: 80.0%, 59.7%, and 48.6%; P > 0.05). The OS rates in Group A and Group B (90%, 82.3%, and 66.4%) were similar ( P > 0.05). The DFS rates in Group B (50%, 31.6%, and 17.2%) were lower than that of Group A ( P = 0.013). CONCLUSION The efficacy of DEA-TACE combined with RFA for untreated HCC is similar with hepatectomy. Patients with recurrent HCC could get a longer survival time through the combined treatment.

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Section: Discussionsupporting

confidence: 84%

Drug-eluting beads transarterial chemoembolization sequentially combined with radiofrequency ablation in the treatment of untreated and recurrent hepatocellular carcinoma

Zhang¹,

Zhang²,

Fan³

et al. 2020

WJGS

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“…The OS in the TR group was significantly prolonged compared to that in the HT group. Pan et al 10 compared surgical resection with the combination of TACE with RFA for HCC. The median OS and the 1-, 3-, and 5-year survival rates were 61.0 months and 94.4%, 83.6%, and 49.5%, respectively, in the resection group and 55.0 months and 95.6%, 80.8%, and 40.6%, respectively, in the combination group.…”

Section: Discussionmentioning

confidence: 99%

“… 9 There are only few reports, with a small number of patients, which focus on the comparison between TACE with RFA and hepatectomy for HCC beyond the Milan criteria. 10 – 12 So, we retrospectively analyzed clinical data of TACE combined with RFA and hepatectomy in newly diagnosed HCC patients, comparing the efficacies of the two treatment methods and analyzing the prognostic factors.…”

Section: Introductionmentioning

confidence: 99%

Transarterial chemoembolization with radiofrequency ablation versus hepatectomy in hepatocellular carcinoma beyond the Milan criteria: a retrospective study

Yuan

Ping

et al. 2018

CMAR

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PurposeTo compare the efficacies of transarterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) with hepatectomy. Prognostic factors for the patient groups were analyzed.Patients and methodsData of 314 newly diagnosed cases of hepatocellular carcinoma beyond the Milan criteria were studied from January 2012 to December 2013 in our hospital. Forty-four patients were excluded owing to loss to follow-up (27 cases) or missing imaging data (17 cases); finally, 270 patients were included. All patients underwent TACE combined with RFA (TR group, 136 patients) or hepatectomy (HT group, 134 patients). Efficacy evaluation and prognostic factor analysis of the groups were conducted. Overall survival (OS) rate, progression-free survival (PFS) rate, and major complications were recorded.ResultsThe 1-, 2-, 3-, and 5-year OS rates and median survival times were 98.5%, 83.1%, 66.2%, 37.1%, and 46 months, respectively, for the TR group and 89.6%, 69.4%, 53.7%, 30.3%, and 38 months, respectively, for the HT group. There were significant statistical differences in survival rate and median survival time between the groups. Median PFS was 21 months for the TR group and 8 months for the HT group. Difference between groups was statistically significant. Multivariate analysis showed treatment method, tumor diameter and number, Child–Pugh classification, antiviral therapy, and alpha-fetoprotein levels were the independent factors affecting OS rates. Treatment mode and tumor diameter and number were the independent factors affecting PFS.ConclusionTACE with RFA is superior to hepatectomy in hepatocellular carcinoma treatment beyond the Milan criteria.

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“…Hepatocellular carcinoma (HCC) is still one of the most common tumors in the world and the second most common cause of cancer death [1,2]. Although ultrasound and serum alpha-fetoprotein (AFP) levels monitor high-risk populations for early detection of HCC, most patients are diagnosed as advanced stages [3][4][5]. Moreover, some cirrhosis patients with insufficient liver reserves may not be suitable for hepatectomy [6,7].…”

Section: Introductionmentioning

confidence: 99%

Improved Clinical Outcome Using Transarterial Chemoembolization Combined with Radiofrequency Ablation for Patients in Barcelona Clinic Liver Cancer Stage A or B Hepatocellular Carcinoma Regardless of Tumor Size: Results of a Single-center Retrospective Case Control Study

Ren

Cao

et al. 2019

Preprint

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Background To determine the safety and efficacy of transarterial chemoembolization (TACE) combined with radiofrequency ablation (hereafter, TACE-RFA) in treating Barcelona Clinic Liver Cancer (BCLC) Stage A or B (hereafter, BCLC A/B) hepatocellular carcinoma (HCC) patients, and to explore the range of tumor sizes suitable for combination therapy. Methods This retrospective study assessed the consecutive medical records of HCC patients with BCLC A/B who received TACE-RFA or TACE from September 2009 to September 2018. Progression-free survival (PFS), overall survival (OS), therapeutic response, and complications were compared between the two groups. Results Among 2447 patients who received TACE-RFA or TACE, 399 eligible patients were enrolled in our study, including 128 patients in the TACE-RFA group and 271 patients in the TACE group. Compared with the TACE group, the PFS and OS rates of 1,3,5,8 years in the TACE-RFA group were significantly better, with higher objective tumor regression rate and better disease control rate. RFA treatment did not increase the risk of death in patients with HCC, and both liver subcapsular hematoma and bile duct injury were improved by symptomatic treatment.. Serum α-fetoprotein level and treatment method were important independent prognostic factors for OS, whereas albumin, hepatitis B and treatment method were important independent prognostic factors for PFS. Subgroup analysis showed that patients in the TACE-RFA group always showed better OS and PFS. Conclusions TACE-RFA had an advantage over TACE alone in prolonging PFS and improving OS in HCC patients with BCLC A/B, and can benefit patients regardless of tumor size.

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Comparison of Combined Transcatheter Arterial Chemoembolization and CT-guided Radiofrequency Ablation with Surgical Resection in Patients with Hepatocellular Carcinoma within the Up-to-seven Criteria: A Multicenter Case-matched Study

Cited by 36 publications

References 29 publications

Drug-eluting beads transarterial chemoembolization sequentially combined with radiofrequency ablation in the treatment of untreated and recurrent hepatocellular carcinoma

Drug-eluting beads transarterial chemoembolization sequentially combined with radiofrequency ablation in the treatment of untreated and recurrent hepatocellular carcinoma

Transarterial chemoembolization with radiofrequency ablation versus hepatectomy in hepatocellular carcinoma beyond the Milan criteria: a retrospective study

Improved Clinical Outcome Using Transarterial Chemoembolization Combined with Radiofrequency Ablation for Patients in Barcelona Clinic Liver Cancer Stage A or B Hepatocellular Carcinoma Regardless of Tumor Size: Results of a Single-center Retrospective Case Control Study

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