Transarterial Chemoembolization versus Radiofrequency Ablation for Recurrent Hepatocellular Carcinoma after Resection within Barcelona Clinic Liver Cancer Stage 0/A: A Retrospective Comparative Study

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• 作者：Rongxin Chen ; MD ; PhD^a ; ^b ; Yuhong Gan ; MD^a ; ^b ; Ninglin Ge ; MD ; PhD^a ; ^b ; Yi Chen ; MD ; PhD^a ; ^b ; Yan Wang ; MD^a ; ^b ; Boheng Zhang ; MD ; PhD^a ; ^b ; Yanhong Wang ; MD ; PhD^a ; ^b ; Shenglong Ye ; MD ; PhD^a ; ^b ; Zhenggang Ren ; MD ; PhD^a ; ^b ; ^{ren.zhenggang@zs-hospital.sh.cn}
• 关键词：AFP ; α-fetoprotein ; BCLC ; Barcelona Clinic Liver Cancer ; HCC ; hepatocellular carcinoma ; OS ; overall survival ; RECIST ; Response Evaluation Criteria In Solid Tumors
• 刊名：Journal of Vascular and Interventional Radiology
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：27
• 期：12
• 页码：1829-1836
• 全文大小：645 K
• 卷排序：27

文摘

To compare outcomes of transarterial chemoembolization with radiofrequency (RF) ablation in treatment of recurrent hepatocellular carcinoma (HCC) after resection within Barcelona Clinic Liver Cancer (BCLC) stage 0/A.Materials and MethodsFrom January 2007 to December 2011, 110 consecutive patients with recurrent HCC meeting BCLC stage 0/A criteria underwent transarterial chemoembolization (n = 78; mean tumor size, 1.9 cm ± 1.0) or RF ablation (n = 32; mean tumor size, 1.9 cm ± 0.6) as initial treatment. The primary outcome was overall survival (OS). Kaplan-Meier method was used to construct survival curves, which were compared by log-rank test. Prognostic factors for OS were analyzed using univariate and multivariate Cox proportional hazard models.ResultsNo significant differences between baseline clinical characteristics of the 2 treatment groups were identified. The 1-, 3-, and 5-year OS rates were 89.7%, 61.0%, and 36.6% for the transarterial chemoembolization group and 90.1%, 72.8%, and 60.0% for the RF ablation group. There was no significant difference in OS rates between the groups (P = .159). Subgroup analysis indicated that RF ablation achieved better survival than transarterial chemoembolization among patients ≤ 55 years old and patients with BCLC stage 0 (P = .036 and P = .045). Multivariate analysis revealed that serum albumin (≤ 35 g/L) (hazard ratio = 2.797; 95% confidence interval, 1.366–2.726; P = .005) and α-fetoprotein (> 400 ng/mL) (HR = 2.336; 95% CI, 1.210–4.508; P = .011) levels before treatment were 2 significant risk factors for poor prognosis.ConclusionsTransarterial chemoembolization might provide a similar OS as RF ablation in patients with recurrent BCLC stage A HCC. However, RF ablation could provide better OS in patients with recurrent BCLC stage 0 HCC.