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

Yuan, Hang; Ping, Cao; Li, Hailiang; Hu, Hongtao; Guo, Cheng; Zhao, Yan; Yao, Quan-Jun; Geng, Xianguo

doi:10.2147/cmar.s182914

Cited by 8 publications

(8 citation statements)

References 26 publications

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“…A retrospective study of HCC patients by Yuan et al [ 20 ] showed that the number of tumors was an independent factor affecting the overall survival of patients, which was consistent with the relevant literature [ 21 ]. Our results also showed that the high-risk group had more tumors than the low-risk group because the number of tumors can predict the degree of intrahepatic spread of HCC.…”

Section: Discussionsupporting

confidence: 77%

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

Zhu

Ren

et al. 2022

Med Sci Monit

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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.

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Section: Discussionsupporting

confidence: 77%

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

Zhu

Ren

et al. 2022

Med Sci Monit

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“…Yuan et al's study comparing surgical resection and TACE combined with RFA in patients beyond Milan criteria also showed that tumor diameter >7 cm was an independent risk factor for OS and PFS. 34 In addition, this study found that higher NLR was an independent risk factor for OS and PFS. In HCC patients, previous studies demonstrated the prognostic value of NLR in multiple treatment modalities, including TACE, ablation, targeted, and immunotherapy.…”

Section: Discussionmentioning

confidence: 61%

“…This conclusion was consistent with our study. Subsequently, Yuan et al 34 published a study in 2018 comparing the efficacy of TACE plus RFA and liver resection in patients with liver cancer beyond Milan criteria. The 1-, 2-, 3-, and 5-year OS rates and median survival time in the TACE combined with the RFA group were 98.5%, 83.1%, 66.2%, and 37.1% and 46 months, and 89.6%, 69.4%, 53.7%, 30.3%, and 38 months in the surgical resection group, respectively (P = 0.017).…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Efficacy and Safety of Transarterial Chemoembolization Plus Microwave Ablation versus Surgical Resection in Patients with Solitary Large Hepatocellular Carcinoma: A Propensity Score-Matched Analysis

Chen¹,

Chen²,

Duan³

et al. 2022

JHC

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Background:The liver resection for solitary large hepatocellular carcinoma (SLHCC) remains controversial due to the high risk of complications and recurrence after resection. This study aimed to compare the efficacy and safety of transcatheter arterial chemoembolization (TACE) plus microwave ablation (MWA) with resection for SLHCC. Methods: We retrospectively analyzed a total of 148 patients who were treated with either TACE-MWA (n = 94) or resection (n = 54) for SLHCC (≥5 cm). A matched cohort composed of 86 patients was included after propensity score matching (PSM). The primary endpoint was overall survival (OS), and the secondary endpoints were progression-free survival (PFS) and safety. Results: The TACE-MWA group was older with higher ALT and AST (all P < 0.05). After PSM, the 1-, 3-, and 5-year OS were 100%, 80.3%, and 51.0% in the TACE-MWA group, and 88.3%, 66.7%, and 39.4% in the liver resection group, respectively. The 1-, 3-, and 5-year PFS were 76.7%, 48.8%, and 19.6% in the TACE-MWA group, and 72%, 40.2%, and 22.6% in the liver resection group, respectively. There was no significant difference in OS and PFS between the two groups (all P > 0.05). For SLHCC patients with tumor size ≥7cm, TACE-MWA showed favorable OS than liver resection. The TACE-MWA group exhibited a lower rate of major complications and shorter hospital stay than the resection group. Conclusion: TACE-MWA showed comparable efficacy to liver resection in patients with SLHCC, but better safety and shorter hospital stay. TACE-MWA might provide a longer OS than liver resection for SLHCC patients with tumor size ≥7cm.

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“…These figures can't be considered better than our study when the numbers of advanced and terminal stages related to our patients are considered. For HCC patients subjected to sorafenib treatment the median OS was 10.0 and the median TTP was 4.1 months [ 13 ]. Regardless of the treatment means, the 1-, 2- and 3-year survival rates of advanced HCC reported by some authors were 29%, 16%, and 8%, with median OS less than 6 months [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Long-term outcome of novel combined surgical-injection treatment (COSIT) for large hepatocellular carcinoma: Stage 2A IDEAL prospective case series

Elsanousi

Mohamed

Salim

et al. 2021

Annals of Medicine and Surgery

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Background Large hepatocellular carcinoma (HCC) treatment options have obvious limitations. Our trial comprises ipsilateral hepatic artery ligation and extrahepatic collaterals division (HALED, reinforced by percutaneous tumor injection controlling residual HCC arterial supply. We aimed to evaluate the long term safety and feasibility of the Combined Surgical and Injection of alcohol Treatment (COSIT) as a novel therapy for the large HCC. Material and methods Candidates' clinical data of the of this case series were prospectively and sequentially reported in accordance with stage 2a development IDEAL (Idea, Development, Exploration, Assessment and Long-term monitoring) recommendations. It included adult patients with HCC (diameter >5 cm) subjected to COSIT coming to our center during a five years' trial evaluating the long term outcome measures. Study ID (NCT03138044 ClinicalTrials.gov ). Results Patients were 21, their mean age (±standard deviation) was 61·9 (±9·3) years. Eleven (52.4%) patients had tumors diameter >10 cm. 17 (80.9%) patients were advanced BCLC stage. Six modifications were made in this injection phase till it came to a stability. The mean alcohol volume was 72.0 mls. The mean follow-up duration was 16 months. The median overall survival duration was 14 months. The one, three and five years' survival was 71.4%, 23.8% and 4.8%, respectively. Grade 3/4 and 4 Common Toxicity Criteria for Adverse Effects (v4.03) were encountered in 10 (47.6%) and one (4.8%) patients, respectively. Conclusion This preliminary findings of COSIT can be a promising alternative treatment for patients having large HCC. Consequently, a multicenter stage 2b Exploration IDEAL trial is suggested.

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

Cited by 8 publications

References 26 publications

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

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

Comparison of the Efficacy and Safety of Transarterial Chemoembolization Plus Microwave Ablation versus Surgical Resection in Patients with Solitary Large Hepatocellular Carcinoma: A Propensity Score-Matched Analysis

Long-term outcome of novel combined surgical-injection treatment (COSIT) for large hepatocellular carcinoma: Stage 2A IDEAL prospective case series

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