Superselective transarterial chemoembolization vs hepatic resection for resectable early-stage hepatocellular carcinoma in patients with Child-Pugh class a liver function

Locoregional Transarterial Therapies for Hepatocellular Carcinoma: Transarterial Chemoembolization and Radioembolization

“…BCLC stage B patients treated with 90Y-RE have reached a median survival ranging between 16.4 and 18 months [83,85,86], comparable with the median survival achieved by TACE in this stage (15.6-18.2 months) [31][32][33][34]36]. These findings are confirmed by retrospective analyses of different stages of HCC treated with TACE or 90Y-RE at the same institution in which nearly equivalent survivals between these treatments were found [35,[93][94][95].…”

“…This survival is in between the wide range of median survival from 16.8 to 45.4 months reported with TACE/transarterial embolization (TAE) in large series of BCLC-A patients, as previously described [31][32][33][34][35][36]63]. Median TTP in this early stage has been described as long as 25.1 months (95% CI: 8-27 months), i.e., longer than the one observed with TACE in a retrospective, well-balanced comparative study between both techniques (TACE and 90Y-RE) [35], and this may provide a rationale for its use as a bridge to liver transplantation in an attempt to avoid dropping from the waiting list [90].…”

“…Survival ranges widely in different series from 53 to 90% at 1 year, from 11 to 67% at 2 years, and from 8 to 26% at 5 years, reflecting the heterogeneous population treated [23][24][25][26][27][28][29][30][31]. According to the BCLC classification (table 1), reported survival ranges from 16 to 45 months in BCLC-A stage, from 15.6 to 18.2 months in BCLC-B stage, and between 6.8 and 13.6 in BCLC-C patients [31][32][33][34][35][36]. It has to be stressed that similar to other treatments, prognosis after chemoembolization largely depends on liver function [27,29,30,[37][38][39], tumor burden before treatment [23,29,30,40], presence of portal vein invasion [17,23,24,40,41], and response to treatment [16,34].…”

Small Single-Nodule Hepatocellular Carcinoma: Comparison of Transarterial Chemoembolization, Radiofrequency Ablation, and Hepatic Resection by Using Inverse Probability Weighting

“…In addition, our results showed that most of the patients initially treated with TACE achieved a complete response, which was one of the independent prognostic factors of survival. treatment modality (overall P , .001), total bilirubin (hazard ratio, (15) and propensity score matching (16) were used; they demonstrated that TACE provided overall survival similar to HR even after adjustment for baseline variables (15) and to RFA when populations were matched by using propensity score (16). A probable explanation for this is that the survival differences observed in our population before weighting might be determined by the degree of baseline liver dysfunction, on which the treatment selection was based, rather than by the specific treatment modality itself.…”

“…In comparison, there is a paucity of long-term data comparing TACE with HR or RFA for the treatment of small HCC (13,14). In the past few years, authors of some retrospective cohort studies (15,16) reported the efficacy of TACE compared with that of HR and with RFA in early-stage HCC. Because HR, RFA, and TACE are the major treatment modalities for small (3 cm) single-nodule HCC, there is a considerable need for an evaluation of the therapeutic efficacy of the three treatments in a single cohort of patients.…”