J Cancer 2017; 8(17):3506-3513. doi:10.7150/jca.19964
Comparison of Combined Transcatheter Arterial Chemoembolization and CT-guided Radiofrequency Ablation with Surgical Resection in Patients with Hepatocellular Carcinoma within the Up-to-seven Criteria: A Multicenter Case-matched Study
1. Department of Vascular Interventional Radiology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China;
2. Division of Minimally Invasive Interventional Therapy, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China;
3. Department of Interventional Radiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China;
4. School of Public Health, Sun Yat-sen University, Guangzhou, China.
* Tao Pan and Lu-Wen Mu are co-first authors of this study and they contributed equally to this work.
Pan T, Mu LW, Wu C, Wu Xq, Xie QK, Li XS, Lyu N, Li Sl, Deng Hj, Jiang Zb, Lin Ah, Zhao M. Comparison of Combined Transcatheter Arterial Chemoembolization and CT-guided Radiofrequency Ablation with Surgical Resection in Patients with Hepatocellular Carcinoma within the Up-to-seven Criteria: A Multicenter Case-matched Study. J Cancer 2017; 8(17):3506-3513. doi:10.7150/jca.19964. Available from http://www.jcancer.org/v08p3506.htm
Background & Aims: We compared the efficacy of transcatheter arterial chemoembolization (TACE) in combination with CT-guided radiofrequency ablation (RFA) with that of surgical resection (SR) in patients with hepatocellular carcinoma (HCC) within the up-to-seven criteria.
Methods: From January 2004 to December 2014, 420 multicenter consecutive patients with HCC who conformed to the up-to-seven criteria and initially received either TACE plus CT-guided RFA (TACE-RFA) or SR were enrolled. A matched cohort composed of 206 patients was selected after adjustment with propensity score matching. The overall survival (OS) of each patient was calculated with the Kaplan-Meier method and compared by the log-rank test.
Results: The median OS and 1-, 3-, and 5-year survival rates were 56.0 months, 96.1%, 76.7% and 41.3% in the TACE-RFA group and 58.0 months, 96.1%, 86.4% and 46.2% in the SR group, respectively. There was no significant difference in OS between the two groups (P = 0.138). For patients with HCC beyond the Milan criteria, TACE-RFA provided a longer median OS than SR (52.0 vs 45.0 months, P = 0.023).
Conclusions: Treatment by TACE-RFA conferred an OS rate comparable with that of SR in patients within the up-to-seven criteria. For patients with HCC between the Milan and the up-to-seven criteria, TACE-RFA might be superior to SR for survival prolongation.
Keywords: Transarterial chemoembolization, Radiofrequency ablation, Surgical resection, Hepatocellular carcinoma, Up-to-seven criteria.