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Should we routinely use DEBTACE for unresectable HCC? cTACE versus DEBTACE: a single-center survival analysis

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Abstract

Conventional trans-arterial chemoembolization (cTACE) for intermediate stage hepatocellular carcinoma (HCC) achieves a partial response in up to 72% of patients and improves median survival. Drug-eluting-beads-TACE (DEBTACE) improves treatment efficacy and tolerance as compared to cTACE. Our aim was to retrospectively evaluate our experience in the treatment of intermediate/advanced HCC with cTACE versus DEBTACE. Overall survival (OS) was the first endpoint. We retrospectively considered our department register data between 2006 and 2012. A total of 82 non-surgical patients, who underwent cTACE or DEBTACE, with a minimum of 12 months follow-up, met the inclusion criteria. Patients received a standard chemotherapy dose (50 mg). Radiological response was evaluated by CT after 30 days and re-treatment was considered. Statistical analysis was performed with SPSS software. 54 patients received cTACE and 28 DEBTACE. In the DEBTACE group the median survival times was 22.7 months (CI 11.6–33.8), while in the cTACE group it was 21.8 months (CI 15.7–27.9). The survival analysis at log-rank (p = 0.708) and Wilcoxon (p = 0.661) tests demonstrated no differences between DEBTACE and cTACE. The probability of death in function of time was significantly associated only to the Child–Pugh score. A Child A score was shown to be protective instead of Child B (OR 0.583; IC 95% = 0.344–0.987). DEBTACE for treating HCC is comparable to cTACE in terms of effectiveness, but seems to be better tolerated. Both treatments can be performed in case of tumor recurrence without substantial increase in procedural complications and risk of liver failure. We do confirm that there are no differences between the two techniques in terms of survival and that it is mainly affected by the reserved liver function proper of each patient.

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Authors and Affiliations

  1. IV Department Of Surgery, Regional Center for HPB Surgery, Ca’ Foncello Regional Hospital, 31100, Treviso, Italy

    M. Massani, T. Stecca, C. Ruffolo & N. Bassi

  2. IV Divisione Chirurgica, Ospedale Regionale, Piazza Ospedale 1, 31100, Treviso, Italy

    M. Massani

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  1. M. Massani
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  2. T. Stecca
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  3. C. Ruffolo
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Correspondence to M. Massani.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study and additional informed consent was obtained from all individual participants for whom identifying information is included in this article.

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Massani, M., Stecca, T., Ruffolo, C. et al. Should we routinely use DEBTACE for unresectable HCC? cTACE versus DEBTACE: a single-center survival analysis. Updates Surg 69, 67–73 (2017). https://doi.org/10.1007/s13304-017-0414-3

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