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

Abstract

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.

Pyogenic liver abscess in non‐liver cancer patients and liver cancer patients treated with TACE: Etiological characteristics, treatment, and outcome analysis

“…TACE can improve survival in liver cancer patients by combining targeted chemotherapy with ischemic necrosis caused by arterial embolization [22]. However, PLA is a serious postoperative complication, which deserves our attention.…”

Evaluation of 3D-CEUS in the Recurrence of Liver Cancer after Radiofrequency Ablation

“…e classification and diagnosis system of liver diseases based on contrastenhanced ultrasound (CEUS) imaging achieves the classification of liver diseases [23]. Some scholars have applied 2D-CEUS in the follow-up of liver cancer after surgery [24], while further development of 3D-CEUS makes imaging examination enter a new stage of microcirculation system diagnosis. is examination method can significantly enhance the echo signal of blood, which facilitates dynamic display of the blood perfusion of liver lesions.…”

Transarterial Chemoembolization and Unresectable Hepatocellular Carcinoma: A Narrative Review

“…A retrospective study conducted for nine years with a sample population of 2247 patients with HCC, BCLC stage A or B of varying sizes showed that there was overall survival and progression-free survival in patients at one, three, five, and eight years when TACE was combined with RFA than TACE alone, thereby concluding that the combination was effective regardless of the size (Table 4 ) [ 31 ]. TACE is the recommended treatment approach for intermediate stage (BCLC-B) HCC, which comprises large asymptomatic or numerous tumors with no invasion of vascular channels or extrahepatic metastasis; the intermediate stage is further classified based on tumor burden (Table 1 ) [ 24 , 26 ].…”