03:00 PM Abstract No. 208 Conventional versus Drug-eluting bead transarterial chemoembolization for nodular hepatocellular carcinoma in a superselective fashion using cone-beam CT: analysis of a five-year outcome

Abstract

To compare the clinical outcomes of conventional transarterial chemoembolization (cTACE) and drug-eluting bead (DEB-TACE) used in a superselective fashion using cone-beam computed tomography (CBCT) for nodular hepatocellular carcinoma (HCC). A total of 198 consecutive patients with nodular HCC (tumor number ≤ 5) who were initially treated with cTACE (n=125) or DEB-TACE (n=57) were retrospectively included. The primary endpoint was progression-free survival (PFS). Secondary endpoints included time-to-local progression (TTLP), time-to-progression (TTP), overall survival (OS), and safety. During the follow-up of median 62 months (range, 1–87 months), 122 patients developed tumor progression and 54 patients died. The PFS was significantly longer in the cTACE group than in the DEB-TACE group (hazard ratio [HR], 0.658; 95% confidence interval [CI], 0.445–0.973; log-rank P=0.031). Median PFS was 18 months in the cTACE group and 7 months in the DEB-TACE group. In multivariable analysis, cTACE showed significantly lower risk of tumor progression or death (adjusted HR, 0.624; 95% CI, 0.418–0.931; P=0.021). Moreover, both TTLP (median, 34 months vs 11 months; log-rank P < 0.001) and TTP (median, 18 months vs 7 months; log-rank P=0.025) were significantly longer in the cTACE group than in the DEB-TACE group. OS was not statistically different between cTACE and DEB-TACE groups (5-year OS: 74.5% vs 70.0%; log-rank P=0.299). Post embolization syndrome occurred more frequently in the cTACE group (odds ratio, 2.44; P=0.006). cTACE showed significantly longer PFS and TTP than DEB-TACE, although it failed to increase OS. DEB-TACE showed fewer cases of postembolization syndrome.