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. 2020 Oct;146(10):2669-2680.
doi: 10.1007/s00432-020-03254-2. Epub 2020 May 25.

Transcatheter arterial chemoembolization alone or combined with ablation for recurrent intermediate-stage hepatocellular carcinoma: a propensity score matching study

Chenwei Wang  1   2 , Yadi Liao  1   2 , Jiliang Qiu  1   2 , Yichuan Yuan  1   2 , Yuanping Zhang  1   2 , Kai Li  1   2 , Ruhai Zou  1   3 , Yongjin Wang  1   2 , Dinglan Zuo  1 , Wei He  1   2 , Yun Zheng  1   2 , Binkui Li  4   5 , Yunfei Yuan  6   7
Affiliations

Transcatheter arterial chemoembolization alone or combined with ablation for recurrent intermediate-stage hepatocellular carcinoma: a propensity score matching study

Chenwei Wang et al. J Cancer Res Clin Oncol. 2020 Oct.

Abstract

Purpose: The recurrence after curative hepatectomy is common. Limited data have investigated the effect of transcatheter arterial chemoembolization (TACE) combined with ablation in treating recurrent intermediate-stage hepatocellular carcinoma (HCC) after hepatectomy. We aim to compare the efficacy of TACE combined with ablation versus TACE alone in treating recurrent intermediate-stage HCC after hepatectomy.

Methods: A total of 183 patients with recurrent intermediate-stage HCC after hepatectomy were enrolled at Sun Yat-sen University Cancer Centre, including 111 patients who underwent TACE alone and 72 patients who underwent TACE combined with ablation (TACE-Ablation). Overall survival (OS) and progression-free survival (PFS) were compared by the log-rank test. Propensity score matching (PSM) was used to reduce the confounding bias.

Results: Before PSM, the 5-year OS rates were 43.3% vs. 27.9% (P = 0.001), and the 5-year PFS rates were 21.7% vs. 13.0% (P < 0.001) for TACE-Ablation and TACE-alone groups, respectively. After PSM, TACE-Ablation still resulted in better 5-year OS (41.6% vs. 30.2%, P = 0.028) and 5-year PFS rate (21.3% vs. 15.8%, P = 0.024) than that of TACE alone. Patients in TACE-Ablation group exhibited similar major complication rates to TACE-alone group but higher minor complication rates both before and after PSM. Cox regression analysis identified TACE-alone modality as an independently unfavourable predictor for OS and PFS (both P < 0.05).

Conclusion: TACE combined with ablation is safe and superior to TACE alone in tumour control and prolonging overall survival in recurrent intermediate-stage HCC after hepatectomy.

Keywords: Recurrent intermediate-stage hepatocellular carcinoma; Survival; Transcatheter arterial chemoembolization; Transcatheter arterial chemoembolization combined with ablation.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Flowchart of the patient selection. HCC hepatocellular carcinoma. TACE transcatheter arterial chemoembolization
Fig. 2
Fig. 2
Overall survival (OS) and Progression-free survival (PFS) curves with risk tables for patients with intermediate-stage recurrent HCC after hepatectomy who underwent TACE or TACE combined with ablation. a OS curves before propensity score matching, b PFS curves before propensity score matching. TACE transcatheter arterial chemoembolization, CI confidence interval
Fig. 3
Fig. 3
Overall survival (OS) and Progression-free survival (PFS) curves with risk tables for patients with intermediate-stage recurrent HCC after hepatectomy who underwent TACE or TACE combined with ablation after propensity score matching. a OS curves after propensity score matching, b DFS curves after propensity score matching. TACE transcatheter arterial chemoembolization, CI confidence interval
See this image and copyright information in PMC

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