Single medium-sized hepatocellular carcinoma treated with sequential conventional transarterial chemoembolization (cTACE) and microwave ablation at 4 weeks versus cTACE alone: a propensity score
Abstract Background Microwave ablation (MWA) is a potentially curative treatment for unresectable patients with hepatocellular carcinoma (HCC) ≤ 3 cm, while its therapeutic efficacy decreases significantly for HCC > 3cm. Previous studies have demonstrated that conventional transarterial chemoembo...
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | World Journal of Surgical Oncology |
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| Online Access: | https://doi.org/10.1186/s12957-022-02643-w |
| _version_ | 1818253021435396096 |
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| author | Zi-yi Zhu Mu Yuan Pei-Pei Yang Bo Xie Jian-zhu Wei Zhong-qiang Qin Zhen Qian Zhao-Ying Wang Long-Fei Fan Jing-yu Qian Yu-lin Tan |
| author_facet | Zi-yi Zhu Mu Yuan Pei-Pei Yang Bo Xie Jian-zhu Wei Zhong-qiang Qin Zhen Qian Zhao-Ying Wang Long-Fei Fan Jing-yu Qian Yu-lin Tan |
| author_sort | Zi-yi Zhu |
| collection | DOAJ |
| description | Abstract Background Microwave ablation (MWA) is a potentially curative treatment for unresectable patients with hepatocellular carcinoma (HCC) ≤ 3 cm, while its therapeutic efficacy decreases significantly for HCC > 3cm. Previous studies have demonstrated that conventional transarterial chemoembolization (cTACE) combined with MWA (cTACE-MWA) may improve local tumor control rate and reduce the recurrence rate for HCC > 3cm. However, there have been few study designs to analyze the clinical efficacy of cTACE-MWA for medium-sized HCC (3–5cm). Therefore, this study aims to compare the clinical efficacy and safety of cTACE-MWA with cTACE alone for a single medium-sized HCC of 3–5 cm in diameter. Methods We retrospectively investigate the data of 90 patients with a single medium-sized HCC who were referred to our hospital and underwent cTACE-MWA or cTACE alone from December 2017 to March 2020. Then, patients were identified with propensity score-matched (1:1). The local tumor response to treatment and time to progression (TTP) were compared using mRECIST criteria between the cTACE-MWA group and the cTACE group. Results A total of 42 patients were included after matching (cTACE-MWA: 21; cTACE: 21). Comparing with cTACE, cTACE-MWA demonstrate significantly better local tumor control (ORR: 95.2% vs 61.9%, p = 0.02; DCR: 95.2% vs 66.7%, p = 0.045) and TTP (median 19.8 months vs 6.8 months, p < 0.001). The 1- and 2-year cumulative probabilities of OS were 100% and 95% in the cTACE-MWA group, which were significantly higher than those in the cTACE group (95% and 76%) (p = 0.032). Multivariate Cox regression analysis illustrates that cTACE-MWA was associated with better TTP (hazard ratio, 0.28; 95% CI: 0.1, 0.76; p = 0.012), but tumor size was associated with worse TTP (hazard ratio, 1.71; 95% CI: 1.01, 2.89; p = 0.045). Conclusions cTACE followed by MWA improved TTP and OS in patients with a single medium-sized HCC, and no major complication was observed in this study. |
| first_indexed | 2024-12-12T16:33:27Z |
| format | Article |
| id | doaj.art-8f5c7d76b5ec4c77b664b060b67a0836 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-12-12T16:33:27Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
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| series | World Journal of Surgical Oncology |
| spelling | doaj.art-8f5c7d76b5ec4c77b664b060b67a08362022-12-22T00:18:43ZengBMCWorld Journal of Surgical Oncology1477-78192022-06-0120111210.1186/s12957-022-02643-wSingle medium-sized hepatocellular carcinoma treated with sequential conventional transarterial chemoembolization (cTACE) and microwave ablation at 4 weeks versus cTACE alone: a propensity scoreZi-yi Zhu0Mu Yuan1Pei-Pei Yang2Bo Xie3Jian-zhu Wei4Zhong-qiang Qin5Zhen Qian6Zhao-Ying Wang7Long-Fei Fan8Jing-yu Qian9Yu-lin Tan10Department of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical ColleagueDepartment of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical ColleagueDepartment of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical ColleagueDepartment of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical ColleagueDepartment of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical ColleagueDepartment of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical ColleagueDepartment of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical ColleagueDepartment of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical ColleagueDepartment of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical ColleagueDepartment of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical ColleagueDepartment of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical ColleagueAbstract Background Microwave ablation (MWA) is a potentially curative treatment for unresectable patients with hepatocellular carcinoma (HCC) ≤ 3 cm, while its therapeutic efficacy decreases significantly for HCC > 3cm. Previous studies have demonstrated that conventional transarterial chemoembolization (cTACE) combined with MWA (cTACE-MWA) may improve local tumor control rate and reduce the recurrence rate for HCC > 3cm. However, there have been few study designs to analyze the clinical efficacy of cTACE-MWA for medium-sized HCC (3–5cm). Therefore, this study aims to compare the clinical efficacy and safety of cTACE-MWA with cTACE alone for a single medium-sized HCC of 3–5 cm in diameter. Methods We retrospectively investigate the data of 90 patients with a single medium-sized HCC who were referred to our hospital and underwent cTACE-MWA or cTACE alone from December 2017 to March 2020. Then, patients were identified with propensity score-matched (1:1). The local tumor response to treatment and time to progression (TTP) were compared using mRECIST criteria between the cTACE-MWA group and the cTACE group. Results A total of 42 patients were included after matching (cTACE-MWA: 21; cTACE: 21). Comparing with cTACE, cTACE-MWA demonstrate significantly better local tumor control (ORR: 95.2% vs 61.9%, p = 0.02; DCR: 95.2% vs 66.7%, p = 0.045) and TTP (median 19.8 months vs 6.8 months, p < 0.001). The 1- and 2-year cumulative probabilities of OS were 100% and 95% in the cTACE-MWA group, which were significantly higher than those in the cTACE group (95% and 76%) (p = 0.032). Multivariate Cox regression analysis illustrates that cTACE-MWA was associated with better TTP (hazard ratio, 0.28; 95% CI: 0.1, 0.76; p = 0.012), but tumor size was associated with worse TTP (hazard ratio, 1.71; 95% CI: 1.01, 2.89; p = 0.045). Conclusions cTACE followed by MWA improved TTP and OS in patients with a single medium-sized HCC, and no major complication was observed in this study.https://doi.org/10.1186/s12957-022-02643-wMicrowave ablationConventional transarterial chemoembolizationCombined treatmentHepatocellular carcinomaTime to progressionSurvival |
| spellingShingle | Zi-yi Zhu Mu Yuan Pei-Pei Yang Bo Xie Jian-zhu Wei Zhong-qiang Qin Zhen Qian Zhao-Ying Wang Long-Fei Fan Jing-yu Qian Yu-lin Tan Single medium-sized hepatocellular carcinoma treated with sequential conventional transarterial chemoembolization (cTACE) and microwave ablation at 4 weeks versus cTACE alone: a propensity score World Journal of Surgical Oncology Microwave ablation Conventional transarterial chemoembolization Combined treatment Hepatocellular carcinoma Time to progression Survival |
| title | Single medium-sized hepatocellular carcinoma treated with sequential conventional transarterial chemoembolization (cTACE) and microwave ablation at 4 weeks versus cTACE alone: a propensity score |
| title_full | Single medium-sized hepatocellular carcinoma treated with sequential conventional transarterial chemoembolization (cTACE) and microwave ablation at 4 weeks versus cTACE alone: a propensity score |
| title_fullStr | Single medium-sized hepatocellular carcinoma treated with sequential conventional transarterial chemoembolization (cTACE) and microwave ablation at 4 weeks versus cTACE alone: a propensity score |
| title_full_unstemmed | Single medium-sized hepatocellular carcinoma treated with sequential conventional transarterial chemoembolization (cTACE) and microwave ablation at 4 weeks versus cTACE alone: a propensity score |
| title_short | Single medium-sized hepatocellular carcinoma treated with sequential conventional transarterial chemoembolization (cTACE) and microwave ablation at 4 weeks versus cTACE alone: a propensity score |
| title_sort | single medium sized hepatocellular carcinoma treated with sequential conventional transarterial chemoembolization ctace and microwave ablation at 4 weeks versus ctace alone a propensity score |
| topic | Microwave ablation Conventional transarterial chemoembolization Combined treatment Hepatocellular carcinoma Time to progression Survival |
| url | https://doi.org/10.1186/s12957-022-02643-w |
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