Published in:
01-11-2017 | Clinical Investigation
Transarterial Chemoembolization Monotherapy Versus Combined Transarterial Chemoembolization–Microwave Ablation Therapy for Hepatocellular Carcinoma Tumors ≤5 cm: A Propensity Analysis at a Single Center
Published in: CardioVascular and Interventional Radiology | Issue 11/2017
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Purpose
To compare effectiveness of transarterial chemoembolization (TACE) combined with microwave ablation (MWA; TACE–MWA) with TACE alone for treating hepatocellular carcinoma (HCC) tumors ≤5 cm.
Materials and Methods
We reviewed data of 244 patients treated for HCC by TACE–MWA or TACE from June 2014 to December 2015. Median follow-up period was 505 days (TACE–MWA group: 485 days; TACE group: 542 days). Patients were propensity score matched (1:2 ratio); outcomes of TACE–MWA and TACE groups were compared. Primary endpoints were tumor responses, including tumor necrosis rates after initial treatment, tumor responses at 6 months [per modified Response Evaluation Criteria in Solid Tumors (mRECIST)], and time to tumor progression (TTP). Secondary endpoints were overall survival (OS) and re-intervention times.
Results
After initial treatments, tumor necrosis rates were higher in the TACE–MWA group (n = 48; 92.1% [58/63]) than the TACE group (n = 96; 46.3% [56/121]; P < 0.001). At 6 months’ follow-up, the TACE–MWA group had better tumor responses (CR + PR + SD [per mRECIST]: TACE–MWA, 95.8%; TACE, 64.5%; P < 0.001). The TACE–MWA group had better TTP (P < 0.001), but did not significantly differ in OS (P = 0.317). TACE–MWA decreased re-TACE times from 1.90 to 0.52; and re-MWA times from 0.22 to 0.17. In subgroup analysis, TACE–MWA also showed better TTP in patients with tumors ≤3 cm (P < 0.001) and 3–5 cm (P = 0.004).
Conclusions
Compared with TACE, TACE–MWA leads to better responses for HCC tumors ≤5 cm.