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CardioVascular and Interventional Radiology

, Volume 40, Issue 11, pp 1748–1755 | Cite as

Transarterial Chemoembolization Monotherapy Versus Combined Transarterial Chemoembolization–Microwave Ablation Therapy for Hepatocellular Carcinoma Tumors ≤5 cm: A Propensity Analysis at a Single Center

  • Qi-Feng Chen
  • Zhen-Yu Jia
  • Zheng-Qiang Yang
  • Wen-Long Fan
  • Hai-Bin Shi
Clinical Investigation

Abstract

Purpose

To compare effectiveness of transarterial chemoembolization (TACE) combined with microwave ablation (MWA; TACE–MWA) with TACE alone for treating hepatocellular carcinoma (HCC) tumors ≤5 cm.

Materials and Methods

We reviewed data of 244 patients treated for HCC by TACE–MWA or TACE from June 2014 to December 2015. Median follow-up period was 505 days (TACE–MWA group: 485 days; TACE group: 542 days). Patients were propensity score matched (1:2 ratio); outcomes of TACE–MWA and TACE groups were compared. Primary endpoints were tumor responses, including tumor necrosis rates after initial treatment, tumor responses at 6 months [per modified Response Evaluation Criteria in Solid Tumors (mRECIST)], and time to tumor progression (TTP). Secondary endpoints were overall survival (OS) and re-intervention times.

Results

After initial treatments, tumor necrosis rates were higher in the TACE–MWA group (n = 48; 92.1% [58/63]) than the TACE group (n = 96; 46.3% [56/121]; P < 0.001). At 6 months’ follow-up, the TACE–MWA group had better tumor responses (CR + PR + SD [per mRECIST]: TACE–MWA, 95.8%; TACE, 64.5%; P < 0.001). The TACE–MWA group had better TTP (P < 0.001), but did not significantly differ in OS (P = 0.317). TACE–MWA decreased re-TACE times from 1.90 to 0.52; and re-MWA times from 0.22 to 0.17. In subgroup analysis, TACE–MWA also showed better TTP in patients with tumors ≤3 cm (P < 0.001) and 3–5 cm (P = 0.004).

Conclusions

Compared with TACE, TACE–MWA leads to better responses for HCC tumors ≤5 cm.

Keywords

Hepatocellular carcinoma Transarterial chemoembolization Microwave ablation Propensity analysis ≤5 cm 

Notes

Compliance with Ethical Standards

Conflict of interest

On behalf of all of the authors, the corresponding author states that there are no conflicts of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2017

Authors and Affiliations

  • Qi-Feng Chen
    • 1
  • Zhen-Yu Jia
    • 1
  • Zheng-Qiang Yang
    • 1
  • Wen-Long Fan
    • 1
  • Hai-Bin Shi
    • 1
  1. 1.Department of Interventional RadiologyFirst Affiliated Hospital of Nanjing Medical UniversityNanjingChina

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