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Radiofrequency ablation combined with transarterial chemoembolization versus hepatectomy for patients with hepatocellular carcinoma within Milan criteria: a retrospective case–control study

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Abstract

Proposal

To compare the effectiveness of TACE + RFA with hepatectomy in patients with HCC within Milan criteria.

Methods

It is a retrospective matched case–control study from January 2006 to December 2010 in a tertiary cancer center. 74 patients with HCC within Milan criteria initially treated with TACE + RFA were identified and compared with 148 matched controls selected from a pool of 782 patients who received hepatectomy. Patients were matched with respect to age, gender, tumor size and number, AFP and liver function test.

Results

The 1, 3, and 5 years overall survival (OS) was 94.6, 75.1 and 55.3%, respectively, in the combination group, and 91.2, 64.4, and 47.7%, respectively, in the hepatectomy group (P = 0.488). The 1, 3, and 5 years disease-free survival (DFS) in the combination group was 87.8, 48.3, and 33.5%, respectively, and 68.9, 49.2, and 40.9%, respectively, in the hepatectomy group (P = 0.619). In subgroups analyses according to the tumor size and number, no significant difference was identified in either OS or DFS for patients with single tumor smaller than 3.0 cm, 3.0–5.0 cm, and multiple tumors. Multivariate analysis showed that tumor size, ALT, and CLIP score were significant prognostic factors for OS, and ALT and Child–Pugh class were significant prognostic factors for DFS.

Conclusion

TACE + RFA is safe and as effective as hepatectomy for patients with HCC within Milan criteria.

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Abbreviations

HCC:

Hepatocellular carcinoma

TACE:

Transarterial chemoembolization

RFA:

Radiofrequency ablation

PEI:

Percutaneous ethanol injection

IRB:

Institutional review board

CT:

Computed tomography

MRI:

Magnetic resonance imaging

OS:

Overall survival

DFS:

Disease-free survival

MDT:

Multidisciplinary team

WBC:

White blood cell

HGB:

Hemoglobin

PLT:

Platelets

ALT:

Alanine aminotransferase

ALB:

Serum albumin

TBIL:

Total bilirubin

AFP:

α-Fetoprotein

HBV:

Hepatitis B virus

HCV:

Hepatitis C virus

CLIP:

Cancer of Liver Italian Program

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Author notes

    Authors and Affiliations

    1. Department of Hepatobiliary Surgery, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China

      A. K. Bholee, Z. Zhou, J. Chen, L. Xu, Y. Zhang & M. Chen

    2. State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China

      A. K. Bholee, K. Peng, Z. Zhou, J. Chen, L. Xu, Y. Zhang & M. Chen

    3. Department of Radiology, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China

      K. Peng

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    1. A. K. Bholee
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    Correspondence to Y. Zhang or M. Chen.

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    Ethics approval and consent to participate

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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    Publication consent was obtained from all authors.

    Conflict of interest

    The authors declare that they have no competing interest.

    Funding

    This study was funded by the project grants from the Health Medical Collaborative Innovation Program of Guangzhou (201400000001-3), and the National Natural Science Foundation of China (NSFC, 81572387).

    Additional information

    A. K. Bholee and K. Peng contribute to this work equally.

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    Bholee, A.K., Peng, K., Zhou, Z. et al. Radiofrequency ablation combined with transarterial chemoembolization versus hepatectomy for patients with hepatocellular carcinoma within Milan criteria: a retrospective case–control study. Clin Transl Oncol 19, 844–852 (2017). https://doi.org/10.1007/s12094-016-1611-0

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    • DOI: https://doi.org/10.1007/s12094-016-1611-0

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