Curative Analysis of Patients with Hepatocellular Carcinoma Using Transcatheter Arterial Chemoembolization Combined with Radiofrequency Ablation

Abstract

Background Transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) can improve the survival of patients with hepatocellular carcinoma (HCC). The purpose was to explore the characteristics of high-risk and low-risk groups of HCC patients receiving combination therapy using a decision tree model. Material/Methods This retrospective cohort study investigated HCC patients treated with a combination of TACE and RFA at our hospital from 2012 to 2018. Decision tree analysis was used to study the 1-year prognosis of patients, and patients were divided into high-risk and low-risk groups. Results We included a total of 142 patients with HCC, 21.83% female and 78.17% male, with the median age of 60 years old. The median follow-up was 13.5 months; 39.44% of patients had progressive disease or death (high-risk group) and 60.56% of patients did not have progressive disease or survival (low-risk group). The area under the curve (AUC) of the decision tree model was 0.846. There were significant differences in sex ( P =0.003), age ( P =0.038), tumor number ( P =0.043), number of RFAs in the first treatment cycle ( P <0.001), alanine transaminase (ALT) ( P <0.001), and aspartate transaminase (AST) ( P =0.041) between the high-risk and the low-risk groups. Risk of progressive disease or death in the high-risk group was 12.232 times higher than in the low-risk group. Conclusions To improve individual survival, clinicians should pay attention to the identification of high-risk HCC patients receiving combination therapy, especially those with less frequent use of RFA during the first treatment and higher ALT and AST levels.

Transarterial chemoembolization for advanced hepatocellular carcinoma without macrovascular invasion or extrahepatic metastasis: analysis of factors prognostic of clinical outcomes

“…Several recent studies, however, have suggested that patients with symptomatic HCC without MVI or EHS should not be regarded as having advanced-stage disease. Furthermore, patients with advanced HCC without MVI or EHS in a real-world setting have frequently been treated with locoregional therapy, such as transarterial chemoembolization (TACE) (6)(7)(8)(9)(10). The efficacy of TACE, however, has been insufficiently defined, and factors associated with prognosis in patients treated with TACE remain unclear.…”