TACE sequential MWA guided by cone-beam computed tomography in the treatment of small hepatocellular carcinoma under the hepatic dome
Abstract Purpose An assessment is being conducted to determine the safety and effectiveness of using Cone-beam computed tomography (CBCT)-guided transcatheter arterial chemoembolization (TACE) and microwave ablation (MWA) sequentially to treat small hepatocellular carcinomas (HCCs) located in the he...
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-023-11066-z |
| _version_ | 1827910788323475456 |
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| author | Zhaonan Li Kaihao Xu Xueliang Zhou Dechao Jiao Xinwei Han |
| author_facet | Zhaonan Li Kaihao Xu Xueliang Zhou Dechao Jiao Xinwei Han |
| author_sort | Zhaonan Li |
| collection | DOAJ |
| description | Abstract Purpose An assessment is being conducted to determine the safety and effectiveness of using Cone-beam computed tomography (CBCT)-guided transcatheter arterial chemoembolization (TACE) and microwave ablation (MWA) sequentially to treat small hepatocellular carcinomas (HCCs) located in the hepatic dome. Materials and methods Fifty-three patients with small HCCs in the hepatic dome who underwent TACE combined with simultaneous CBCT-guided MWA were studied. Inclusion criteria were a single HCCs ≤ 5.0 cm or a maximum of three. The safety and interventional-related complications were monitored, and local tumor progression (LTP), overall survival (OS), and prognostic factors for LTP/OS were evaluated. Results The procedures were successfully accomplished in all patients. According to Common Terminology Criteria for Adverse Events (CTCAE), adverse reactions and complications are mainly Grade 1 or 2 (mild symptoms, no or local/noninvasive intervention indicated). Liver and kidney function and alpha-fetoprotein (AFP) levels remained within a reasonable range after 4 weeks of treatment (both p < 0.001). The mean LTP was 44.406 months (95% CI: 39.429, 49.383) and the mean OS rate was 55.157 months (95% CI: 52.559, 57.754). The combination treatment achieved 1-, 3-, and 5-year LTP rates of 92.5%, 69.6%, and 34.5%, respectively; and 1-, 3-, and 5-year OS rates of 100.0%, 88.4%, and 70.2%, respectively. Results from both univariate and multivariate Cox regression analyses showed that the tumor diameter (< 3 cm) and the distance to the hepatic dome (≥ 5 mm, < 10 mm) had a significant impact on the patient’s LTP and OS, and were related to better survival. Conclusion CBCT-guided TACE combined with simultaneous MWA was a safe and successful treatment of HCCs located under the hepatic dome. |
| first_indexed | 2024-03-13T01:54:29Z |
| format | Article |
| id | doaj.art-7583cf2443ca45a9805b5a28ecb7f264 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-03-13T01:54:29Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-7583cf2443ca45a9805b5a28ecb7f2642023-07-02T11:18:14ZengBMCBMC Cancer1471-24072023-06-012311910.1186/s12885-023-11066-zTACE sequential MWA guided by cone-beam computed tomography in the treatment of small hepatocellular carcinoma under the hepatic domeZhaonan Li0Kaihao Xu1Xueliang Zhou2Dechao Jiao3Xinwei Han4Medical School, Southeast UniversityDepartment of Interventional Radiology, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Interventional Radiology, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Interventional Radiology, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Interventional Radiology, The First Affiliated Hospital of Zhengzhou UniversityAbstract Purpose An assessment is being conducted to determine the safety and effectiveness of using Cone-beam computed tomography (CBCT)-guided transcatheter arterial chemoembolization (TACE) and microwave ablation (MWA) sequentially to treat small hepatocellular carcinomas (HCCs) located in the hepatic dome. Materials and methods Fifty-three patients with small HCCs in the hepatic dome who underwent TACE combined with simultaneous CBCT-guided MWA were studied. Inclusion criteria were a single HCCs ≤ 5.0 cm or a maximum of three. The safety and interventional-related complications were monitored, and local tumor progression (LTP), overall survival (OS), and prognostic factors for LTP/OS were evaluated. Results The procedures were successfully accomplished in all patients. According to Common Terminology Criteria for Adverse Events (CTCAE), adverse reactions and complications are mainly Grade 1 or 2 (mild symptoms, no or local/noninvasive intervention indicated). Liver and kidney function and alpha-fetoprotein (AFP) levels remained within a reasonable range after 4 weeks of treatment (both p < 0.001). The mean LTP was 44.406 months (95% CI: 39.429, 49.383) and the mean OS rate was 55.157 months (95% CI: 52.559, 57.754). The combination treatment achieved 1-, 3-, and 5-year LTP rates of 92.5%, 69.6%, and 34.5%, respectively; and 1-, 3-, and 5-year OS rates of 100.0%, 88.4%, and 70.2%, respectively. Results from both univariate and multivariate Cox regression analyses showed that the tumor diameter (< 3 cm) and the distance to the hepatic dome (≥ 5 mm, < 10 mm) had a significant impact on the patient’s LTP and OS, and were related to better survival. Conclusion CBCT-guided TACE combined with simultaneous MWA was a safe and successful treatment of HCCs located under the hepatic dome.https://doi.org/10.1186/s12885-023-11066-zMicrowave ablationTranscatheter arterial chemoembolizationHepatocellular CarcinomaTumor ablationInterventional radiology |
| spellingShingle | Zhaonan Li Kaihao Xu Xueliang Zhou Dechao Jiao Xinwei Han TACE sequential MWA guided by cone-beam computed tomography in the treatment of small hepatocellular carcinoma under the hepatic dome BMC Cancer Microwave ablation Transcatheter arterial chemoembolization Hepatocellular Carcinoma Tumor ablation Interventional radiology |
| title | TACE sequential MWA guided by cone-beam computed tomography in the treatment of small hepatocellular carcinoma under the hepatic dome |
| title_full | TACE sequential MWA guided by cone-beam computed tomography in the treatment of small hepatocellular carcinoma under the hepatic dome |
| title_fullStr | TACE sequential MWA guided by cone-beam computed tomography in the treatment of small hepatocellular carcinoma under the hepatic dome |
| title_full_unstemmed | TACE sequential MWA guided by cone-beam computed tomography in the treatment of small hepatocellular carcinoma under the hepatic dome |
| title_short | TACE sequential MWA guided by cone-beam computed tomography in the treatment of small hepatocellular carcinoma under the hepatic dome |
| title_sort | tace sequential mwa guided by cone beam computed tomography in the treatment of small hepatocellular carcinoma under the hepatic dome |
| topic | Microwave ablation Transcatheter arterial chemoembolization Hepatocellular Carcinoma Tumor ablation Interventional radiology |
| url | https://doi.org/10.1186/s12885-023-11066-z |
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