Combined transcatheter arterial chemoembolization and radiofrequency ablation versus hepatectomy for recurrent hepatocellular carcinoma after initial surgery: a propensity score matching study

  • Zhenwei Peng
  • Mengchao Wei
  • Shuling Chen
  • Manxia Lin
  • Chunlin Jiang
  • Jie Mei
  • Bin Li
  • Yu Wang
  • Jiaping Li
  • Xiaoyan Xie
  • Ming Kuang
Hepatobiliary-Pancreas
  • 89 Downloads

Abstract

Objectives

To compare retrospectively the efficacy of transcatheter arterial chemoembolization (TACE) plus radiofrequency ablation (RFA) (TACE-RFA) with that of repeat hepatectomy in the treatment of initial recurrent hepatocellular carcinoma (HCC) after hepatectomy by propensity score matching (PSM).

Methods

From September 2006 to June 2015, 186 patients who underwent TACE-RFA (n=107) or repeat hepatectomy (n=79) for recurrent HCC ≤ 5.0 cm were included. The overall survival (OS) and disease-free survival (DFS) were compared. PSM was used to correct potential confounding factors between these two groups.

Results

1-, 3-, and 5-year OS rates after TACE-RFA and repeat hepatectomy were 84.6%, 66.9%, 49.1%, and 84.8%, 60.2%, 51.9%, respectively (p=.871). The corresponding DFS rates were 58.2%, 35.2%, 29.6% and 64.8%, 41.6%, 38.3% (p=.258). TACE-RFA has lower major complication rates (p=.009) and shorter hospital stay (p<.001). After PSM, 1-, 3-, 5- year OS rates after TACE-RFA (n=51) and repeat hepatectomy (n=51) were 84.3%, 60.4%, 46.4% and 84.3%, 64.5%, 49.8% (p=.951), the corresponding DFS rates were 54.9%, 35.0%, 30.6% and 58.7%, 35.8%, and 33.6% (p=.733). AFP and micro-vessel invasion of initial tumour were significant prognostic factors for OS and DFS, respectively.

Conclusions

TACE-RFA provides comparable OS and DFS to repeat hepatectomy, fewer major complications and shorter hospital stay.

Key Points

• TACE-RFA achieved similar OS and DFS with repeat hepatectomy for recurrent HCC

• Major complication rate was lower in the TACE-RFA group

• The hospital stay was shorter in the TACE-RFA group

• AFP was a predictor for OS, MVI was a predictor for DFS

• The treatment strategies were not significant prognostic factor for OS or DFS

Keywords

Carcinoma, Hepatocellular Hepatectomy Propensity Score Chemoembolization, Therapeutic Radio waves 

Abbreviations

AFP

Alpha fetoprotein

ALB

Albumin

CECT

Contrast-enhanced computed tomography

CEUS

Contrast enhanced ultrasound

DFS

Disease-free survival

HCC

Hepatocellular carcinoma

LTP

Local tumour progression

MVI

Micro-vessel invasion

OS

Overall survival

PSM

Propensity score matching

RFA

Radiofrequency ablation

TACE

Transarterial chemoembolization

Notes

Acknowledgements

Nothing to declare.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Ming Kuang.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper

Informed consent

Written informed consent was waived in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• observational

• performed at one institution

Supplementary material

330_2017_5166_MOESM1_ESM.docx (17 kb)
ESM 1 (DOCX 16 kb)

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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  • Zhenwei Peng
    • 1
    • 2
  • Mengchao Wei
    • 3
  • Shuling Chen
    • 4
  • Manxia Lin
    • 4
  • Chunlin Jiang
    • 4
  • Jie Mei
    • 2
  • Bin Li
    • 2
  • Yu Wang
    • 5
  • Jiaping Li
    • 5
  • Xiaoyan Xie
    • 4
  • Ming Kuang
    • 3
    • 4
  1. 1.Department of OncologyThe First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina
  2. 2.Clinical Trials UnitThe First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina
  3. 3.Department of Liver SurgeryThe First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina
  4. 4.Division of Interventional UltrasoundThe First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina
  5. 5.Department of Interventional OncologyThe First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina

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