Clinical effect of transcatheter arterial chemoembolization combined with microwave ablation versus repeat resection in treatment of recurrent hepatocellular carcinoma
10.3969/j.issn.1001-5256.2022.09.020
- VernacularTitle:经肝动脉化疗栓塞术联合微波消融与重复肝切除术治疗复发性肝细胞癌的效果比较
- Author:
Jun LING
1
;
Wenwu WAN
1
,
2
;
Zheng ZENG
1
,
2
;
Huihua YAO
3
;
Ou JIANG
1
;
Bing DING
1
Author Information
1. The Second People's Hospital of Neijiang, Neijiang, Sichuan 641000, China
2. School of Clinical Medicine, Southwest Medical University, Luzhou, Sichuan 646000, China
3. Department of Hepatobiliary Surgery, Chengdu First People's Hospital, Chengdu 610000, China
- Publication Type:Original Articles_Liver Neoplasms
- Keywords:
Carcinoma, Hepatocellular;
Chemoembolization, Therapeutic;
Ablation Techniques;
Hepatectomy
- From:
Journal of Clinical Hepatology
2022;38(9):2053-2060
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical effect of transcatheter arterial chemoembolization (TACE) combined with microwave ablation (MWA) (TACE-MWA) versus repeat resection (RR) in the treatment of recurrent hepatocellular carcinoma (RHCC). Methods A total of 178 patients with RHCC who were admitted to The Second People's Hospital of Neijiang from June 2015 to September 2020 were enrolled, and according to the treatment modality, they were divided into RR group with 64 patients and TACE-MWA group with 114 patients. Baseline demographic data, liver function, and tumor conditions before treatment were recorded, and the patients were followed up to October 2021 to compare postoperative overall survival (OS) time and recurrence-free survival (RFS) time between the two groups. Subgroup analysis based on recurrence pattern (recurrence time and tumor size) was performed, and the influencing factors for prognosis were analyzed. The independent samples t -test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data; the Kaplan-Meier method was used for postoperative survival rate, the Log-rank test was used for survival difference analysis, and a multivariate Cox regression analysis was used to investigate independent risk factors for survival. Results The multivariate analysis showed that tumor diameter, alpha-fetoprotein (AFP) level, alanine aminotransferase, albumin, and time to recurrence were independent prognostic factors for OS (all P < 0.05), and AFP level and time to recurrence were independent prognostic factors for RFS (both P < 0.05). For RHCC with late recurrence (> 2 years), there were significant differences between the two groups in median OS (54.0 months vs 36.0 months, χ 2 =6.171, P =0.013) and median RFS (28.0 months vs 21.0 months, χ 2 = 5.211, P =0.022). For RHCC with a tumor diameter of ≤5 cm, there was a significant difference in median OS between the two groups (33.0 months vs 27.0 months, χ 2 =6.447, P =0.011). Conclusion RR has a similar clinical effect to TACE-MWA in RHCC with early recurrence or a tumor diameter of > 5 cm, but RR should be the first choice for RHCC with late recurrence or a tumor diameter of ≤5 cm.
