Combination transarterial chemoembolization and radiofrequency ablation therapy for early hepatocellular carcinoma.
- Author:
Myeong Jun SONG
1
;
Si Hyun BAE
;
June Sung LEE
;
Sung Won LEE
;
Do Seon SONG
;
Chan Ran YOU
;
Jong Young CHOI
;
Seung Kew YOON
Author Information
- Publication Type:Comparative Study ; Original Article ; Research Support, Non-U.S. Gov't
- Keywords: Radiofrequency ablation; Transarterial chemoembolization; Recurrence; Overall survival
- MeSH: Adult; Aged; Aged, 80 and over; Carcinoma, Hepatocellular/mortality/pathology/*therapy; *Catheter Ablation/adverse effects/mortality; *Chemoembolization, Therapeutic/adverse effects/mortality; Chemotherapy, Adjuvant; Disease-Free Survival; Female; Humans; Kaplan-Meier Estimate; Liver Neoplasms/mortality/pathology/*therapy; Male; Middle Aged; *Neoadjuvant Therapy/adverse effects/mortality; Neoplasm Recurrence, Local; Neoplasm Staging; Patient Selection; Proportional Hazards Models; Republic of Korea; Retrospective Studies; Risk Factors; Time Factors; Treatment Outcome; Tumor Burden; Young Adult
- From:The Korean Journal of Internal Medicine 2016;31(2):242-252
- CountryRepublic of Korea
- Language:English
- 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 < or = 5.0 cm or up to three HCCs < or = 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.
