Clinical Research Papers:
Transarterial chemoembolization as a substitute to radiofrequency ablation for treating Barcelona Clinic Liver Cancer stage 0/A hepatocellular carcinoma
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Kentaro Ishikawa1, Tetsuhiro Chiba1, Yoshihiko Ooka1, Eiichiro Suzuki1, Sadahisa Ogasawara1, Takahiro Maeda1, Masayuki Yokoyama1, Masanori Inoue1, Toru Wakamatsu1, Yuko Kusakabe1, Tomoko Saito1, Akinobu Tawada1, Makoto Arai1, Tatsuo Kanda1, Hitoshi Maruyama1, Fumio Imazeki1 and Naoya Kato1
1Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan
Tetsuhiro Chiba, email: firstname.lastname@example.org
Keywords: hepatocellular carcinoma; transarterial chemoembolization; radiofrequency ablation; Barcelona Clinic Liver Cancer (BCLC) staging; propensity score matching
Received: August 21, 2017 Accepted: March 11, 2018 Published: April 20, 2018
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.
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