ISSN: 1837-9664Journal of Cancer
Global reach, higher impact
J Cancer 2017; 8(17):3506-3513. doi:10.7150/jca.19964 This issue Cite
Research Paper
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.
Abstract
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.
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