Abstract
Background: Transcatheter arterial chemoembolization (TACE) combined with ablation has been widely used for treating unresectable hepatocellular carcinoma (HCC). However, the technique with which TACE should be combined for it to be more effective remains unknown.Purpose: To retrospectively evaluate the efficacy and safety of TACE combined with microwave ablation (MWA) vs. TACE combined with cryoablation (CRA) in treating unresectable HCC.Materials and Methods: From January 2011 to December 2018, 108 patients diagnosed with unresectable HCC were divided into either the TACE-MWA group (n = 48) or TACE-CRA group (n = 60). Overall survival (OS) and time to progression (TTP) were compared between the two groups. To reduce potential bias, a propensity score matching (PSM) was performed. Complications were observed. Kaplan-Meier survival curves were constructed and compared using the log-rank test.Results : The baseline characteristics of the two groups were balanced. The median OS was 20.9 months (95% CI 14.3–27.6 months) in the TACE-MWA group and 13.0 months (95% CI 8.8–17.1 months) in the TACE-CRA group (P = 0.096). The median TTP was 8.8 months (95% CI 4.3–13.4 months) in the TACE-MWA group and 9.3 months (95% CI 7.1–11.5 months) in the TACE-CRA group (P = 0.675). After PSM, 48 patients remained in each group. The median OS in the TACE-MWA and TACE-CRA groups was 20.9 months (95% CI 14.3–27.6 months), and 13.5 months (95% CI 8.4–18.6 months, P = 0.100), respectively. The median TTP in the TACE-MWA and TACE-CRA groups was 8.8 months (95% CI 4.3–13.4 months), and 8.6 months (95% CI 3.1–14.2 months, P = 0.909), respectively. The overall incidence rate of ablation-related complications was lower in the TACE-MWA group than in the TACE-CRA group (66.7 vs. 88.3%, P = 0.006). Multivariate analysis showed that the presence of portal vein tumor thrombus (PVTT) and the maximum diameter of intrahepatic tumor were significant prognostic factors for OS and TTP.Conclusion: The efficacy of TACE-MWA and TACE-CRA in the treatment of unresectable HCC was comparable. TACE-MWA was more promising because of a lower complication rate, especially with regard to thrombocytopenia. Further prospective randomized controlled trials are required to validate our findings.
Highlights
Hepatocellular carcinoma (HCC) has moved upward to become the fourth most common cause of cancer-related death in the world [1, 2]
Patients were divided into the Transcatheter arterial chemoembolization (TACE)-microwave ablation (MWA) group and TACE-CRA group based on the treatment they received
No significant differences were observed between the TACE-MWA group and the TACE-CRA group before and after propensity score matching (PSM) (Table 1)
Summary
Hepatocellular carcinoma (HCC) has moved upward to become the fourth most common cause of cancer-related death in the world [1, 2]. Transcatheter arterial chemoembolization (TACE) is the first-line treatment for patients with unresectable, intermediate-stage HCC, and effective in patients with advanced-stage HCC [2, 3]. Previous studies have found that MWA was comparable in efficacy and safety to RFA in treating small and medium-size intrahepatic tumors [11]. There are relatively few comparative studies on the treatment of HCC by MWA vs CRA, especially for large HCC. Combination therapy has become a common treatment strategy to improve local control and decrease distant recurrence, [9]. Transcatheter arterial chemoembolization (TACE) combined with ablation has been widely used for treating unresectable hepatocellular carcinoma (HCC). Purpose: To retrospectively evaluate the efficacy and safety of TACE combined with microwave ablation (MWA) vs TACE combined with cryoablation (CRA) in treating unresectable HCC
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
