Transarterial chemoembolization combined with microwave ablation versus repeated resection for recurrent small hepatocellular carcinoma after resection: What is the better treatment?

IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology Pub Date : 2024-12-01 DOI:10.1016/j.crad.2024.08.020

J. Ji , L.-l. Yan , Y. Ma , C. Xu , W.-Z. Zhou , P.-h. Lv

{"title":"Transarterial chemoembolization combined with microwave ablation versus repeated resection for recurrent small hepatocellular carcinoma after resection: What is the better treatment?","authors":"J. Ji , L.-l. Yan , Y. Ma , C. Xu , W.-Z. Zhou , P.-h. Lv","doi":"10.1016/j.crad.2024.08.020","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to compare the effectiveness of transcatheter arterial chemoembolization combined with microwave ablation (TACE-MWA) versus repeated hepatic resection (RHR) in patients with recurrent small hepatocellular carcinoma (sHCC) following primary resection.</div></div><div><h3>Materials and Methods</h3><div>A total of 59 patients diagnosed with recurrent sHCC (≤3 cm) and treated with either TACE-MWA or RHR were recruited from two centers between June 2015 and October 2021. Patients were matched using propensity scores at a 1:1 ratio. Disease-free survival (DFS), overall survival (OS), and complications were assessed and compared between the two treatment groups.</div></div><div><h3>Results</h3><div>After propensity score matching, 38 patients were included, with 19 in each group. Prior to matching, the 1-, 3-, and 5-year DFS rates for the TACE-MWA group were 68.1%, 46.6%, and 23.3%, respectively, and for the RHR group, they were 84.6%, 47.3%, and 47.3%, respectively. The corresponding 1-, 3-, and 5-year OS rates for TACE-MWA were 100.0%, 83.7%, and 47.8%, while for RHR, they were 100.0%, 95.0%, and 45.2%. After matching, the 1-, 3-, and 5-year DFS rates were 78.0%, 48.3%, and 24.1% for TACE-MWA, and 77.5%, 38.7%, and 38.7% for RHR. The 1-, 3-, and 5-year OS rates for TACE-MWA were 100.0%, 88.9%, and 54.9%, and for RHR, they were 100.0%, 93.3%, and 44.4%. Statistical analysis showed no significant differences in DFS rates (P=0.834 before matching, P=0.490 after matching) or OS rates (P=0.825 before matching, P=0.625 after matching) between the two groups.</div></div><div><h3>Conclusions</h3><div>TACE-MWA demonstrates comparable effectiveness to RHR in managing recurrent sHCC.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"79 12","pages":"Pages e1443-e1450"},"PeriodicalIF":2.1000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical radiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S000992602400432X","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

This study aimed to compare the effectiveness of transcatheter arterial chemoembolization combined with microwave ablation (TACE-MWA) versus repeated hepatic resection (RHR) in patients with recurrent small hepatocellular carcinoma (sHCC) following primary resection.

Materials and Methods

A total of 59 patients diagnosed with recurrent sHCC (≤3 cm) and treated with either TACE-MWA or RHR were recruited from two centers between June 2015 and October 2021. Patients were matched using propensity scores at a 1:1 ratio. Disease-free survival (DFS), overall survival (OS), and complications were assessed and compared between the two treatment groups.

Results

After propensity score matching, 38 patients were included, with 19 in each group. Prior to matching, the 1-, 3-, and 5-year DFS rates for the TACE-MWA group were 68.1%, 46.6%, and 23.3%, respectively, and for the RHR group, they were 84.6%, 47.3%, and 47.3%, respectively. The corresponding 1-, 3-, and 5-year OS rates for TACE-MWA were 100.0%, 83.7%, and 47.8%, while for RHR, they were 100.0%, 95.0%, and 45.2%. After matching, the 1-, 3-, and 5-year DFS rates were 78.0%, 48.3%, and 24.1% for TACE-MWA, and 77.5%, 38.7%, and 38.7% for RHR. The 1-, 3-, and 5-year OS rates for TACE-MWA were 100.0%, 88.9%, and 54.9%, and for RHR, they were 100.0%, 93.3%, and 44.4%. Statistical analysis showed no significant differences in DFS rates (P=0.834 before matching, P=0.490 after matching) or OS rates (P=0.825 before matching, P=0.625 after matching) between the two groups.

Conclusions

TACE-MWA demonstrates comparable effectiveness to RHR in managing recurrent sHCC.

查看原文本刊更多论文

经动脉化疗栓塞联合微波消融与反复切除术治疗切除术后复发的小肝癌：哪种治疗方法更好？

本研究旨在比较经导管动脉化疗栓塞联合微波消融术（TACE-MWA）与重复肝切除术（RHR）对初次切除术后复发的小肝细胞癌（sHCC）患者的疗效。2015年6月至2021年10月期间，两个中心共招募了59名确诊为复发性sHCC（≤3厘米）并接受TACE-MWA或RHR治疗的患者。患者按 1:1 的比例进行倾向评分匹配。对两组患者的无病生存期（DFS）、总生存期（OS）和并发症进行了评估和比较。经过倾向评分匹配后，共纳入 38 例患者，每组 19 例。匹配前，TACE-MWA 组的 1 年、3 年和 5 年 DFS 率分别为 68.1%、46.6% 和 23.3%，RHR 组分别为 84.6%、47.3% 和 47.3%。TACE-MWA相应的1年、3年和5年OS率分别为100.0%、83.7%和47.8%，而RHR则分别为100.0%、95.0%和45.2%。匹配后，TACE-MWA 的 1 年、3 年和 5 年 DFS 率分别为 78.0%、48.3% 和 24.1%，RHR 的 1 年、3 年和 5 年 DFS 率分别为 77.5%、38.7% 和 38.7%。TACE-MWA的1年、3年和5年OS率分别为100.0%、88.9%和54.9%，RHR的1年、3年和5年OS率分别为100.0%、93.3%和44.4%。统计分析显示，两组患者的 DFS 率（配对前 P=0.834，配对后 P=0.490）或 OS 率（配对前 P=0.825，配对后 P=0.625）无明显差异。TACE-MWA在治疗复发性sHCC方面的疗效与RHR相当。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical radiology 医学-核医学

CiteScore

4.70

自引率

3.80%

发文量

528

审稿时长

76 days

期刊介绍： Clinical Radiology is published by Elsevier on behalf of The Royal College of Radiologists. Clinical Radiology is an International Journal bringing you original research, editorials and review articles on all aspects of diagnostic imaging, including: • Computed tomography • Magnetic resonance imaging • Ultrasonography • Digital radiology • Interventional radiology • Radiography • Nuclear medicine Papers on radiological protection, quality assurance, audit in radiology and matters relating to radiological training and education are also included. In addition, each issue contains correspondence, book reviews and notices of forthcoming events.