Abstract
PurposeTo investigate the effectiveness and safety of transarterial chemoembolization (TACE) combined with sorafenib and thermal ablation in patients with huge hepatocellular carcinoma (HCC).Materials and MethodsThis retrospective study examined 50 patients with huge unresectable HCC treated from January 2009 to December 2015. Among them, 28 cases received TACE-sorafenib treatment (TACE-sorafenib group), and 22 cases received TACE-sorafenib plus thermal ablation treatment (TACE-sorafenib-thermal ablation group). The Overall survival (OS), progression-free survival (PFS), and adverse events (AEs) were compared.ResultsThe median follow-up was 13.5 months (ranges 4.2 to 96.7 months). The median OS was significantly longer in the TACE-sorafenib-thermal ablation group than that in the TACE-sorafenib group (20.8 vs. 10.4 months, P=0.003). The median PFS of the ablation and no ablation groups were 4.3 vs. 7.1 months (P=0.546). The treatment modality was an independent predictor of OS (P=0.004). There were no notable drug-related high grade adverse events or permanent adverse sequelae.ConclusionTACE-sorafenib-thermal ablation provided extended OS to patients with huge unresectable HCC and could be a better choice than TACE-sorafenib.
Highlights
Hepatocellular carcinoma (HCC) is the second most common cause of cancer-related mortality in China (Jemal et al, 2011)
The inclusion criteria were: (1) diagnosis of HCC confirmed by liver biopsy or clinically according to the American Association for the Study of Liver Diseases (AASLD) criteria (Llovet et al, 2008); (2) original tumor ≥10 cm in diameter, and satellite foci ≤2 cm; (3) All target lesions that could be measured according to the modified Response Evaluation Criteria in Solid Tumors Group guidelines (Lencioni and Llovet, 2010); (4) 18–80 years of age; and (5) underwent transarterial chemoembolization (TACE) with sorafenib or TACE, sorafenib, and thermal ablation treatment
22 patients with huge HCCs were treated with TACEsorafenib and TACE-sorafenib-thermal ablation therapy, respectively
Summary
Hepatocellular carcinoma (HCC) is the second most common cause of cancer-related mortality in China (Jemal et al, 2011). Huge unresectable HCC (i.e., >10 cm in its larger axis) is encountered in a considerable portion of patients at diagnosis. Huge HCCs have specific features that need to be taken into account for successful management. HBV-related liver cirrhosis is the predominant underlying cause of HCC in China (Chen et al, 2016). Huge HCCs always show an incomplete capsule and are prone to invade local vasculature, increasing the risk of tumor thrombus and metastasis (Xue et al, 2015). Huge HCCs have an increased risk of rupture, which may accelerate their local spread and deterioration of liver function (Poon et al, 2002). Adequate management of huge HCCs is a challenge
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