J Cancer 2018; 9(21):4000-4008. doi:10.7150/jca.24250
The efficacy and safety of long- versus short-interval transarterial chemoembolization in unresectable hepatocellular carcinoma
1. State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, China
2. Department of Hepatobiliary Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
3. Department of Ultrasound, Sun Yat-Sen University Cancer Center, Guangzhou, China
* These authors contributed equally to this work.
Yang ZW, He W, Zheng Y, Zou RH, Liu WW, Zhang YP, Wang CW, Wang YJ, Yuan YC, Li BK, Yuan YF. The efficacy and safety of long- versus short-interval transarterial chemoembolization in unresectable hepatocellular carcinoma. J Cancer 2018; 9(21):4000-4008. doi:10.7150/jca.24250. Available from http://www.jcancer.org/v09p4000.htm
Background: To compare the efficacy and safety of long- versus short-interval of transarterial chemoembolization (TACE) in unresectable hepatocellular carcinoma (HCC) patients.
Methods: This retrospective analysis enrolled 574 patients with unresectable HCC who underwent at least two sessions of TACE between January 2007 and December 2014. The patients were divided into a short-interval group (SIG) and a long-interval group (LIG) based on the median TACE interval of the first two sessions. Propensity score matching (PSM) identified 476 patients for a comparison of overall survival (OS) and safety.
Results: Before matching, the LIG had a longer OS than the SIG (Median: 12.1 vs. 8.7 months; P = 0.003). After matching, median OS in the SIG and LIG were 9.1 and 14.2 months (P < 0.001). The 1-, 2-, and 3-year survival rates were 37.5%, 17.1%, and 9.9% for SIG and 50.1%, 19.3%, and 11.6% for LIG, respectively. The TACE interval was an independent prognostic factor for OS. The LIG had a longer OS than the SIG in Barcelona Clinic liver cancer (BCLC) stage C patients (Median: 10.2 vs. 5.8 months; P < 0.001), but not in BCLC-A or B. The postoperative adverse rates were similar in matched SIG and LIG patients (29.4% vs. 33.6%, P = 0.324).
Conclusions: A long interval between the first two sessions of TACE resulted in a better OS than a short interval in patients with unresectable BCLC C-stage HCC.
Keywords: unresectable hepatocellular carcinoma, transarterial chemoembolization, interval