Abstract
Purpose To compare liver resection (LR) with single-step, balloon-occluded radiofrequency (RF) ablation plus drug-eluting embolics transarterial chemoembolization in cirrhotic patients with single hepatocellular carcinoma (HCC) ≥ 3 cm. Materials and Methods From 2010 to 2014, 25 patients with compensated cirrhosis and single HCC ≥ 3 cm (median size 4.5 cm; range, 3.0–6.8 cm) not suitable for LR or liver transplantation were treated with RF ablation plus transarterial chemoembolization in a prospective observational single-center pilot study; all patients had complete tumor necrosis after treatment. A retrospective control group included 29 patients (median HCC size 4.0 cm; range, 3.0–7.4 cm) who underwent LR. RF ablation plus transarterial chemoembolization group included more patients with severe portal hypertension (65.5% vs 35.0%, P =.017). Primary endpoints were overall survival (OS) and tumor recurrence (TR) rates. Results One death and 1 major complication (4%) were observed in LR group. No major complications were reported in RF ablation plus transarterial chemoembolization group (P =.463). OS rates at 1 and 3 years were 91.8% and 79.3% in LR group and 89.4% and 48.2% in RF ablation plus transarterial chemoembolization group (P = 0.117). TR rates at 1 and 3 years were 29.5% and 45.0% in LR group and 42.4% and 76.0% in RF ablation plus transarterial chemoembolization group (P =.034). Local tumor progression (LTP) rates at 3 years were significantly lower in LR group (21.8% vs 58.1%, P =.005). Similar results were found in patients with HCC ≤ 5 cm (TR rates 35.4% vs 75.1%, P =.016; LTP 16.0% vs 55.7%, P =.013). Conclusions LR achieved lower TR and LTP rates than RF ablation plus transarterial chemoembolization, but 3-years OS rates were not statistically different between the 2 groups. RF ablation plus transarterial chemoembolization is an effective treatment option in patients with compensated cirrhosis and solitary HCC ≥ 3 cm unsuitable for LR.
Lingua originale | Inglese |
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pagine (da-a) | 1512-1519 |
Numero di pagine | 8 |
Rivista | Journal of Vascular and Interventional Radiology |
Volume | 28 |
Numero di pubblicazione | 11 |
DOI | |
Stato di pubblicazione | Pubblicato - 2017 |
All Science Journal Classification (ASJC) codes
- Radiologia, Medicina Nucleare e Diagnostica per Immagini
- Cardiologia e Medicina Cardiovascolare
Keywords
- 80 and over
- Aged
- Carcinoma
- Catheter Ablation
- Chemoembolization
- Combined Modality Therapy
- Female
- Hepatocellular
- Humans
- Liver Cirrhosis
- Liver Neoplasms
- Male
- Middle Aged
- Pilot Projects
- Prospective Studies
- Radio Waves
- Retrospective Studies
- Survival Rate
- Therapeutic
- Treatment Outcome