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Long-Term Outcomes of Transarterial Chemoembolization Combined with Radiofrequency Ablation Versus Transarterial Chemoembolization Alone for Recurrent Hepatocellular Carcinoma After Surgical Resection

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Abstract

Background

There is lack of data for identifying optimal local therapy for the management of recurrent hepatocellular carcinoma (HCC) after hepatic resection.

Aims

A retrospective study was performed to compare the effectiveness of transarterial chemoembolization (TACE) plus radiofrequency ablation (RFA) with that of TACE alone for recurrent HCC.

Methods

From 2007 to 2013, patients with recurrent HCC ≤ 5 cm were treated with either TACE plus RFA (n = 96) or TACE (n = 63). Inverse probability of treatment weighting was used to make allowances for imbalances in treatment assignment. The disease-free survival (DFS) and overall survival (OS) were retrospectively analyzed.

Results

The TACE group had lower pretreatment Child–Pugh class (P = 0.025) and shorter pretreatment interval of recurrence (P = 0.028). The 1-, 3-, and 5-year DFS rates for the TACE-RFA group were 55.1%, 22.5%, and 9.7%, respectively, and 41.1%, 9.9%, and 4.9%, respectively, for the TACE group. The OS rates at 1, 3, and 5 years were 82.3%, 42.7%, and 16.5%, respectively, in the TACE-RFA group, and 75.9%, 30.7%, and 11.3%, respectively, in the TACE group. Cirrhosis was significantly associated with disease progression (hazard ratio [HR] 1.53; 95% CI 1.09–2.14; P = 0.014).

Conclusions

In patients with recurrent HCC ≤ 5 cm, TACE-RFA shows better DFS than TACE alone as a first-line local therapy.

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Acknowledgments

The authors thank all the colleagues who contributed toward this work.

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Author notes

  1. Qingfeng Song and Weizheng Ren have equally contributed to the work.

Authors and Affiliations

  1. Department of Medical Research, Affiliated Tumor Hospital of Guangxi Medical University, No. 22 Shuangyong Rd, Nanning, China

    Qingfeng Song, Meiqi Zhao, Lisha Mao, Shichai Jiang & Ying Cui

  2. Department of Hepatobiliary Surgery, The First Medical Center, Chinese PLA General Hospital, Chinese PLA Medical School, Beijing, China

    Weizheng Ren

  3. Department of Interventional Radiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China

    Liwei Fan & Chang Zhao

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  1. Qingfeng Song
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  2. Weizheng Ren
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Correspondence to Ying Cui.

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Song, Q., Ren, W., Fan, L. et al. Long-Term Outcomes of Transarterial Chemoembolization Combined with Radiofrequency Ablation Versus Transarterial Chemoembolization Alone for Recurrent Hepatocellular Carcinoma After Surgical Resection. Dig Dis Sci 65, 1266–1275 (2020). https://doi.org/10.1007/s10620-019-05733-0

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  • DOI: https://doi.org/10.1007/s10620-019-05733-0

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