Transarterial Chemoembolization Monotherapy Versus Combined Transarterial Chemoembolization-Microwave Ablation Therapy for Hepatocellular Carcinoma Tumors ≤5 cm: A Propensity Analysis at a Single Center.
Cardiovasc Intervent Radiol
; 40(11): 1748-1755, 2017 Nov.
Article
em En
| MEDLINE
| ID: mdl-28681222
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 ANDMETHODS:
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 (12 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.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Quimioembolização Terapêutica
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Carcinoma Hepatocelular
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Técnicas de Ablação
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Neoplasias Hepáticas
Tipo de estudo:
Observational_studies
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Prognostic_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article