Transcatheter chemoembolization plus percutaneous radiofrequency ablation versus laparoscopic radiofrequency ablation: improved outcome for inoperable hepatocellular carcinoma

Aims To retrospectively compare the efficacy of transcatheter chemoembolization (TACE) plus percutaneous radiofrequency ablation (PRFA) (hereafter, TACE + PRFA) and laparoscopic radiofrequency ablation (LRFA) in the treatment of inoperable hepatocellular carcinoma (HCC). Methods From July 2014 to De...

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Autores principales:	Bin Chai, Wei Wang, Fuquan Wang, Guofeng Zhou, Chuansheng Zheng
Formato:	article
Lenguaje:	EN
Publicado:	Taylor & Francis Group 2021
Materias:	hepatocellular carcinoma radiofrequency ablation transcatheter chemoembolization laparoscopic surgical procedure survival Medical technology R855-855.5
Acceso en línea:	https://doaj.org/article/496a2990a029407ebb217a8face1907c
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spelling	oai:doaj.org-article:496a2990a029407ebb217a8face1907c2021-12-01T14:40:58ZTranscatheter chemoembolization plus percutaneous radiofrequency ablation versus laparoscopic radiofrequency ablation: improved outcome for inoperable hepatocellular carcinoma0265-67361464-515710.1080/02656736.2021.1970825https://doaj.org/article/496a2990a029407ebb217a8face1907c2021-01-01T00:00:00Zhttp://dx.doi.org/10.1080/02656736.2021.1970825https://doaj.org/toc/0265-6736https://doaj.org/toc/1464-5157Aims To retrospectively compare the efficacy of transcatheter chemoembolization (TACE) plus percutaneous radiofrequency ablation (PRFA) (hereafter, TACE + PRFA) and laparoscopic radiofrequency ablation (LRFA) in the treatment of inoperable hepatocellular carcinoma (HCC). Methods From July 2014 to December 2017, 132 consecutive patients with inoperable HCC were treated with TACE + PRFA (n = 86) or LRFA (n = 46). Overall survival (OS) and recurrence-free survival (RFS) were analyzed using log-rank test and Cox regression analysis. Propensity score matched (PSM) analyses based on patient and tumor characteristics were also conducted. Additionally, we performed exploratory analyses to determine the effectiveness of TACE + PRFA and LRFA in clinically relevant subsets. Results The baseline characteristics of TACE + PRFA patients displayed relatively inferior liver status and a higher rate of BCLC-B disease. For unmatched patients, median OS (55.0 vs. 42.0 months; p = .019) and RFS (20.0 vs. 11.0 months; p < .001) were significantly longer in TACE + PRFA group than that in the LRFA group. After PSM, 39 matched pairs were identified. The difference in median OS (60.0 vs. 44.0 months; p = .009) and RFS (27.0 vs. 11.0 months; p < .001) between the two groups remained significant. Multivariate analysis in matched patients showed that treatment modality and response to initial treatment were significant predictors of OS and RFS, while recurrence after resection was an independent prognostic factor of OS. The benefits of TACE + PRFA were consistent across all the subgroups examined. The different treatments had shared a similar complication rate. Conclusions Compared to LRFA, TACE + PRFA results in improved OS and RFS in patients not amenable to resection.Bin ChaiWei WangFuquan WangGuofeng ZhouChuansheng ZhengTaylor & Francis Grouparticlehepatocellular carcinomaradiofrequency ablationtranscatheter chemoembolizationlaparoscopic surgical proceduresurvivalMedical technologyR855-855.5ENInternational Journal of Hyperthermia, Vol 38, Iss 1, Pp 1685-1694 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	hepatocellular carcinoma radiofrequency ablation transcatheter chemoembolization laparoscopic surgical procedure survival Medical technology R855-855.5
spellingShingle	hepatocellular carcinoma radiofrequency ablation transcatheter chemoembolization laparoscopic surgical procedure survival Medical technology R855-855.5 Bin Chai Wei Wang Fuquan Wang Guofeng Zhou Chuansheng Zheng Transcatheter chemoembolization plus percutaneous radiofrequency ablation versus laparoscopic radiofrequency ablation: improved outcome for inoperable hepatocellular carcinoma
description	Aims To retrospectively compare the efficacy of transcatheter chemoembolization (TACE) plus percutaneous radiofrequency ablation (PRFA) (hereafter, TACE + PRFA) and laparoscopic radiofrequency ablation (LRFA) in the treatment of inoperable hepatocellular carcinoma (HCC). Methods From July 2014 to December 2017, 132 consecutive patients with inoperable HCC were treated with TACE + PRFA (n = 86) or LRFA (n = 46). Overall survival (OS) and recurrence-free survival (RFS) were analyzed using log-rank test and Cox regression analysis. Propensity score matched (PSM) analyses based on patient and tumor characteristics were also conducted. Additionally, we performed exploratory analyses to determine the effectiveness of TACE + PRFA and LRFA in clinically relevant subsets. Results The baseline characteristics of TACE + PRFA patients displayed relatively inferior liver status and a higher rate of BCLC-B disease. For unmatched patients, median OS (55.0 vs. 42.0 months; p = .019) and RFS (20.0 vs. 11.0 months; p < .001) were significantly longer in TACE + PRFA group than that in the LRFA group. After PSM, 39 matched pairs were identified. The difference in median OS (60.0 vs. 44.0 months; p = .009) and RFS (27.0 vs. 11.0 months; p < .001) between the two groups remained significant. Multivariate analysis in matched patients showed that treatment modality and response to initial treatment were significant predictors of OS and RFS, while recurrence after resection was an independent prognostic factor of OS. The benefits of TACE + PRFA were consistent across all the subgroups examined. The different treatments had shared a similar complication rate. Conclusions Compared to LRFA, TACE + PRFA results in improved OS and RFS in patients not amenable to resection.
format	article
author	Bin Chai Wei Wang Fuquan Wang Guofeng Zhou Chuansheng Zheng
author_facet	Bin Chai Wei Wang Fuquan Wang Guofeng Zhou Chuansheng Zheng
author_sort	Bin Chai
title	Transcatheter chemoembolization plus percutaneous radiofrequency ablation versus laparoscopic radiofrequency ablation: improved outcome for inoperable hepatocellular carcinoma
title_short	Transcatheter chemoembolization plus percutaneous radiofrequency ablation versus laparoscopic radiofrequency ablation: improved outcome for inoperable hepatocellular carcinoma
title_full	Transcatheter chemoembolization plus percutaneous radiofrequency ablation versus laparoscopic radiofrequency ablation: improved outcome for inoperable hepatocellular carcinoma
title_fullStr	Transcatheter chemoembolization plus percutaneous radiofrequency ablation versus laparoscopic radiofrequency ablation: improved outcome for inoperable hepatocellular carcinoma
title_full_unstemmed	Transcatheter chemoembolization plus percutaneous radiofrequency ablation versus laparoscopic radiofrequency ablation: improved outcome for inoperable hepatocellular carcinoma
title_sort	transcatheter chemoembolization plus percutaneous radiofrequency ablation versus laparoscopic radiofrequency ablation: improved outcome for inoperable hepatocellular carcinoma
publisher	Taylor & Francis Group
publishDate	2021
url	https://doaj.org/article/496a2990a029407ebb217a8face1907c
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_version_	1718404988298854400

Transcatheter chemoembolization plus percutaneous radiofrequency ablation versus laparoscopic radiofrequency ablation: improved outcome for inoperable hepatocellular carcinoma

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