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

  • Hepatobiliary-Pancreas
  • Published:
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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

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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

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Acknowledgements

Nothing to declare.

Funding

This study has received funding from the National Natural Science Foundation of China (No.81770608) and the Kelin Outstanding Young Scientist of the First Affiliated Hospital of Sun Yat-sen University for Zhen-Wei Peng.

Author information

Author notes

  1. Zhenwei Peng and Mengchao Wei contributed equally to this work

Authors and Affiliations

  1. Department of Oncology, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, 510080, China

    Zhenwei Peng

  2. Clinical Trials Unit, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, 510080, China

    Zhenwei Peng, Jie Mei & Bin Li

  3. Department of Liver Surgery, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, 510080, China

    Mengchao Wei & Ming Kuang

  4. Division of Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, 510080, China

    Shuling Chen, Manxia Lin, Chunlin Jiang, Xiaoyan Xie & Ming Kuang

  5. Department of Interventional Oncology, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, 510080, China

    Yu Wang & Jiaping Li

Authors
  1. Zhenwei Peng
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  2. Mengchao Wei
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  7. Bin Li
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  8. Yu Wang
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  9. Jiaping Li
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  11. Ming Kuang
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Corresponding author

Correspondence to Ming Kuang.

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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

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Peng, Z., Wei, M., Chen, S. et al. Combined transcatheter arterial chemoembolization and radiofrequency ablation versus hepatectomy for recurrent hepatocellular carcinoma after initial surgery: a propensity score matching study. Eur Radiol 28, 3522–3531 (2018). https://doi.org/10.1007/s00330-017-5166-4

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  • DOI: https://doi.org/10.1007/s00330-017-5166-4

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