Combination transarterial chemoembolization and radiofrequency ablation therapy for early hepatocellular carcinoma

Abstract

Background/Aims:We compared the recurrence of hepatocellular carcinoma (HCC) and the survival of patients who received radiofrequency ablation (RFA) after transarterial chemoembolization (TACE) with patients treated with TACE or RFA alone.Methods:This study included 201 patients with HCC, who were consecutively enrolled at Seoul St. Mary’s Hospital between December 2004 and February 2010. Inclusion criteria were a single HCC ≤ 5.0 cm or up to three HCCs ≤ 3.0 cm. We used a propensity score model to compare HCC patients (n = 87) who received RFA after TACE (TACE + RFA) with those who received TACE (n = 71) or RFA alone (n = 43).Results:The median follow-up period was 33.3 months (range, 6.8 to 80.9). The TACE + RFA group showed significantly lower local recurrence than the RFA or TACE groups (hazard ratio [HR], 0.309; 95% confidence interval [CI], 0.130 to 0.736; p = 0.008; and HR, 0.352; 95% CI, 0.158 to 0.787; p = 0.011, respectively). The overall survival was significantly better in the TACE + RFA group compared to the RFA group (HR, 0.422; 95% CI, 0.185 to 0.964; p = 0.041). However, the survival benefit was not different between the TACE + RFA and TACE groups (p = 0.124). Subgroup analysis showed that among patients with a tumor size < 3 cm, the TACE + RFA group had significantly better long-term survival than those in the TACE or RFA groups (p = 0.017, p = 0.004, respectively).Conclusions:TACE + RFA combination treatment showed favorable local recurrence and better overall survival rates in early-stage HCC patients. Patients with tumors < 3 cm are likely to benefit more from TACE + RFA combination treatment. Additional studies are needed for the selection of suitable HCC patients for TACE + RFA treatment.

Combined transarterial chemoembolization and microwave ablation versus transarterial chemoembolization in BCLC stage B hepatocellular carcinoma

“…The propensity score model was determined by previous studies (8,11), the independent variables used in the matching included gender, age, alpha-fetoprotein (AFP) level, Child-Pugh score, alanine aminotransferase (ALT), tumor size and tumor number. Propensity score matching was performed using optimal matching method at the ratio of 1:2 (9).…”

WITHDRAWN: Simultaneous transarterial chemoembolization combined with radiofrequency ablation for treatment of large hepatocellular carcinoma: 3 years follow-up

“…However, TACE alone results in incomplete tumor necrosis. Although the therapeutic efficacy of RFA of small HCC (i.e., < 3 cm) could be comparable to surgical operation [6,7], RFA has shown poor local tumor control when the tumor size exceeds 3 cm [8,9]. Therefore, the combination of TACE with radiofrequency ablation (RFA) may enhance efficacy against large HCC and prolong survival time in patients.…”

Prognostic factors and therapeutic effects of different treatment modalities for colorectal cancer liver metastases

“…Therefore, we believe that TACE treatment is relatively limited for CLM patients with potential surgical resection and is more suitable for the local treatment of tumors in unresectable patients. Nevertheless, some studies have shown that with a tumor diameter less than 3 cm, the long-term survival rate of patients treated with combined ablation is significantly better than that of patients treated with monotherapy, and the treatment effect is significantly improved compared with monotherapy[ 47 , 48 ].…”