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Transarterial chemoembolization combined with radiofrequency ablation for solitary large hepatocellular carcinoma ranging from 5 to 7 cm: an 8-year prospective study

  • Hepatobiliary
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Abstract

Purpose

This prospective study was performed to investigate long-term (8-year) survival in patients with solitary large hepatocellular carcinoma (HCC) ranging from 5 to 7 cm who underwent transarterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) and identify factors that significantly affected outcomes.

Methods

Forty-eight patients with large HCC (36 men, 12 women; mean age, 57.0 ± 11.2 [range, 37–82] years) without fever or signs of infection were enrolled. All patients were treated with TACE + RFA. Overall survival (OS) and disease-free survival (DFS) were calculated using the Kaplan–Meier method. Prognostic factors were assessed using the Cox hazards regression method.

Results

The median OS duration was 47.0 months, and the 1-, 3-, 5-, and 8-year OS rates were 73%, 57%, 53%, and 27%, respectively. The median DFS duration was 9.05 (3.99–12.01) months, and the 1-, 3-, and 5-year DFS rates were 35%, 9%, and 0%, respectively. Cox hazards regression analysis revealed that the Child–Pugh class, platelet count, lymphocyte-to-monocyte ratio (LMR), and DFS were independent predictive factors of OS (p = 0.000, 0.003, 0.020, and 0.000, respectively). The LMR and platelet-to-lymphocyte ratio (PLR) were independent predictive factors of recurrence (p = 0.046 and 0.016, respectively).

Conclusion

TACE + RFA may be a safe and effective treatment for selected solitary large HCC ranging from 5 to 7 cm. Measurement of the LMR (> 4) and PLR (≤ 100) in peripheral blood before the intervention might help to identify which patients with solitary large HCC are suitable for TACE + RFA.

Registration number: ChiCTR-TRC-12002768 (https://www.chictr.org.cn).

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Abbreviations

HCC:

Hepatocellular carcinoma

CLIP:

Cancer of the liver Italian program

CT:

Computed tomography

TACE:

Transarterial chemoembolization

RFA:

Radiofrequency ablation

ECOG:

Eastern cooperative oncology group

CR:

Complete response

BCLC:

Barcelona clinic liver cancer group

OS:

Overall survival

DFS:

Disease-free survival

PLR:

Platelet-to-lymphocyte ratio

LMR:

Lymphocyte-to-monocyte ratio

AFP:

Alpha fetoprotein

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Acknowledgements

We thank Angela Morben, DVM, ELS, from Liwen Bianji, Edanz Editing China (www.liwenbianji.cn/ac), for editing the English text of a draft of this manuscript.

Funding

This clinical research projects supported by Beijing municipal science& Technology Commission (Number: Z171100001017063). At the same time, the work was supported by 2019 Project of Clinical Cooperation capacity Building of traditional Chinese and Western Medicine for Major difficult Diseases.

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Author notes

  1. Jiang Long and Huaguang Wang have contributed equally to this work.

Authors and Affiliations

  1. Department of Oncology Minimally Invasive Interventional Radiology, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China

    Jiang Long, Peng Zhao, Shou-peng Sheng,  Qin-sheng Shi & Jia-sheng Zheng

  2. Department of Pharmaceutical Affairs, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China

    Huaguang Wang

  3. Department of Academic Division, The Second Affiliated Hospital, MuDanJiang Medical College, MuDanJiang, 157009, China

    Mei Long

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  1. Jiang Long
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Correspondence to Jia-sheng Zheng.

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Long, J., Wang, H., Zhao, P. et al. Transarterial chemoembolization combined with radiofrequency ablation for solitary large hepatocellular carcinoma ranging from 5 to 7 cm: an 8-year prospective study. Abdom Radiol 45, 2736–2747 (2020). https://doi.org/10.1007/s00261-020-02612-5

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