Transarterial Chemoembolization Combined With Radiofrequency Ablation Versus Repeat Hepatectomy for Recurrent Hepatocellular Carcinoma After Curative Resection: A 10-Year Single-Center Comparative Study.

Xin Zheng,Kun Qian,Yanqiao Ren,Hanqing Hu

doi:10.3389/fonc.2021.713432

Abstract

BackgroundThe purpose of this study was to compare the efficacy and safety of transarterial chemoembolization (TACE) in combination with radiofrequency ablation (RFA) (TACE-RFA) and repeat hepatectomy in the treatment of recurrent hepatocellular carcinoma (HCC) after curative resection.MethodsThis retrospective study evaluated consecutive medical records of patients who received either TACE-RFA or repeat hepatectomy between January 2010 and May 2021. Overall survival (OS), progression-free survival (PFS), and complications were compared.ResultsOf the 2672 patients who received either TACE-RFA or repeat hepatectomy, 111 eligible patients were included in our study, 63 in the TACE-RFA group and 48 in the repeat hepatectomy group. The median OS was 38 months in the TACE-RFA group and 42 months in the repeat hepatectomy group, with no statistically difference between the two groups (P=0.45). Meanwhile, there was also no statistically significant difference in PFS between the two groups (P=0.634). Although both groups achieved similar outcomes, the rate of major complications was significantly higher in the repeat hepatectomy group (P=0.003).ConclusionsPatients with recurrent HCC in the TACE-RFA group and the repeat hepatectomy group had similar OS and PFS regardless of the patient’s tumor diameter, but the TACE-RFA group was safer and more minimally invasive.

Highlights

Hepatocellular carcinoma is the most frequent liver cancer, and liver cancer is the fifth most common cancer and the second most common cause of cancer-related death worldwide [1]
A total of 111 recurrent hepatocellular carcinoma (HCC) patients were enrolled in this study, 63 of whom received TACERFA and 48 of whom received repeat hepatectomy
The results of this study indicated that transarterial chemoembolization (TACE)-radiofrequency ablation (RFA) achieved similar local efficacy and survival outcomes in patients with recurrent HCC compared with repeat hepatectomy, with no significant difference in Overall survival (OS) and Progression-free survival (PFS) between the two groups

Summary

Introduction

Hepatocellular carcinoma is the most frequent liver cancer, and liver cancer is the fifth most common cancer and the second most common cause of cancer-related death worldwide [1]. Cirrhosis, tumors larger than 5 cm in diameter, positive histological margins, or portal vein invasion has been demonstrated to be potential risk factors for recurrence [6, 7]. This is a common clinical manifestation, there are still no clear global algorithms or guidelines on the management of recurrent HCC after hepatectomy, which remains a thorny issue that currently confounds clinicians and patients. The purpose of this study was to compare the efficacy and safety of transarterial chemoembolization (TACE) in combination with radiofrequency ablation (RFA) (TACE-RFA) and repeat hepatectomy in the treatment of recurrent hepatocellular carcinoma (HCC) after curative resection

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