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Oncotarget. 2018 Apr 20;9(30):21560-21568. doi: 10.18632/oncotarget.25108. eCollection 2018 Apr 20.

Transarterial chemoembolization as a substitute to radiofrequency ablation for treating Barcelona Clinic Liver Cancer stage 0/A hepatocellular carcinoma.

Author information

1
Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan.

Abstract

Background and Aim:

Transarterial 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 Methods:

The 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.

Results:

The 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.

Conclusion:

TACE can substitute RFA at least in some patients with BCLC 0/A HCC.

KEYWORDS:

Barcelona Clinic Liver Cancer (BCLC) staging; hepatocellular carcinoma; propensity score matching; radiofrequency ablation; transarterial chemoembolization

Conflict of interest statement

CONFLICTS OF INTEREST The authors declare no conflicts of interest.

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