Comparison of survival, safety, and efficacy after transarterial chemoembolization and radioembolization of Barcelona Clinic Liver Cancer stage B-C hepatocellular cancer patients.

Abstract

This study aimed to compare the overall survival (OS) times, long-term complications, and recurrence rates of chemoembolization and radioembolization for Barcelona Clinic Liver Cancer (BCLC) stage B-C hepatocellular cancer patients. This retrospective study included 80 BCLC stage B-C hepatocellular cancer patients who received chemoembolization (group 1) or radioembolization (group 2). The OS times, long-term complications, and disease recurrence rates of the two groups were compared. The prognostic role of sex, age, presence of underlying chronic liver disease, BCLC stage, dimension and number of liver lesions, tumor load, and presence of extrahepatic disease were also analyzed for each group. Each group included 40 (67 men, 13 women, mean age: 41.9±21.9 years) patients. During the follow-up period, 22 patients died in group 2 and 30 patients died in group 1. The overall mean survival of the entire patient group was calculated to be 37.31±3.94 months [95% confidence interval (CI), 30.46-44.1 months], with 30.63±3.68 months (95% CI, 23.42-37.84 months) for group 1 and 39.24±4.62 months (95% CI, 30.18-48.29 months) for group 2 (P=0.014). The 1- and 2-year survival rates were 72 versus 74% and 47 versus 59% for groups 2 and 1, respectively. There was no significant difference between the chronic complication (P=0.32) and disease recurrence (P=0.65) rates of the groups. Whereas the dimension of the largest lesion was the most significant predictor (P=0.01) in group 2, female sex (P=0.008), dimension of the largest lesion (P=0.03), and BCLC stage (P=0.01) were significant in group 1. Although chemoembolization and radioembolization for BCLC Stage B-C patients have similar levels of safety and efficacy, they differ in OS. In this retrospective study, patients undergoing radioembolization had a longer survival rate.