Abstract
Background and AimTransarterial chemoembolization (TACE) is the standard procedure for treating Barcelona clinic liver cancer (BCLC) stage B hepatocellular carcinoma (HCC). However, it is often carried out in the treatment of BCLC stage 0/A HCC for various reasons. This study aimed to elucidate the prognosis for BCLC stage 0/A HCC patients treated with TACE or with radiofrequency ablation (RFA).Materials and MethodsThe prognosis of 242 BCLC stage 0/A HCC patients within Milan criteria who underwent initially TACE or RFA were retrospectively analyzed using propensity score matching analysis.ResultsThe analyses of baseline patient characteristics revealed that the maximum tumor size and the proportion of BCLC stage A patients were significantly higher in patients treated with TACE than in those treated with RFA (P<0.001 and 0.047, respectively). After adjusting these factors using propensity score matching (1:3 matching), patients treated with TACE (n=32) and those treated with RFA (n=96) were further analyzed. The local recurrence rate was significantly higher in the TACE group than in the RFA group (P<0.001). However, the overall survival (OS) in HCC patients treated with TACE was comparable to that in HCC patients treated with RFA (1 year, 93.5 vs. 95.8%; 3 years, 75.4 vs. 85.8%; 5 years, 61.8 vs. 70.7%; P=0.196). Multivariate analyses followed by univariate analyses revealed that serum bilirubin level (P=0.032), serum albumin level (P=0.008), HBV-DNA (P=0.013), and tumor number (P=0.021) were independent predictors of OS.ConclusionTACE can substitute RFA at least in some patients with BCLC 0/A HCC.
Highlights
Hepatocellular carcinoma (HCC) is the sixth most common carcinoma worldwide and is the third leading cause of cancer-related mortality [1]
The analyses of baseline patient characteristics revealed that the maximum tumor size and the proportion of Barcelona clinic liver cancer (BCLC) stage A patients were significantly higher in patients treated with Transarterial chemoembolization (TACE) than in those treated with radiofrequency ablation (RFA) (P
After adjusting these factors using propensity score matching (1:3 matching), patients treated with TACE (n=32) and those treated with RFA (n=96) were further analyzed
Summary
Hepatocellular carcinoma (HCC) is the sixth most common carcinoma worldwide and is the third leading cause of cancer-related mortality [1]. The Barcelona Clinic Liver Cancer (BCLC) staging system classifies HCC into 0, A, B, C, and D based on the extent of tumor and Child-Pugh score, and the Eastern www.oncotarget.com. Transarterial chemoembolization (TACE) is considered as the standard treatment option for these tumors [8,9,10]. TACE is occasionally performed for BCLC stage 0/A HCC patients for various reasons in clinical practice, its significance remains unclear. Transarterial chemoembolization (TACE) is the standard procedure for treating Barcelona clinic liver cancer (BCLC) stage B hepatocellular carcinoma (HCC). It is often carried out in the treatment of BCLC stage 0/A HCC for various reasons. This study aimed to elucidate the prognosis for BCLC stage 0/A HCC patients treated with TACE or with radiofrequency ablation (RFA)
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