Conventional Transarterial Chemoembolization Followed by Radiofrequency Ablation Safe, Effective in HCC
In patients with ultrasound (US)-invisible early stage hepatocellular carcinoma (HCC), the combined therapy of conventional transarterial chemoembolization (cTACE) followed by fluoroscopy-guided radiofrequency ablation (RFA) was safe and effective resulting in less local tumor progression (LTP) and time to progression (TTP), according to a new study in the Korean Journal of Radiology.
In this retrospective review, the authors’ hospital database was searched for patients with ultrasound (US)-invisible early stage HCC who were treated with cTACE alone or a combination of cTACE followed by fluoroscopy-guided RFA targeting intratumoral iodized oil retention from January 2008 to June 2016. The searched identified 167 patients with 85 in the cTACE alone group and 82 in the combined treatment group.
At 1-, 3-, and 5-years, the group who received cTACE alone had LTP rates of 12.5%, 31.7%, and 37.0%, respectively, compared to 7.3%, 16.5%, and 16.5%, respectively, in the combined group (P = 0.013). At 1-, 3-, and 5-years, cumulative OS rates in the cTACE alone group were 100%, 93.2%, and 87.7%, respectively, and 100%, 96.6%, and 87.4%, respectively, in the combined group (P = 0.686). In the cTACE alone group the median TTP was 18 months compared with 24 months in the combined group (P = 0.037). Tumor diameter > 20 mm and cTACE monotherapy were independent risk factors for LTP and TTP.
“Combined therapy using cTACE followed by fluoroscopy-guided RFA is a safe and effective treatment of US-invisible early stage HCC (BCLC stage 0 or A). This strategy provides less LTP and longer TTP than cTACE monotherapy,” the authors concluded.
Lee H, Yoon CJ, Seong NJ, Jeong SH, Kim JW. Comparison of Combined Therapy Using Conventional Chemoembolization and Radiofrequency Ablation Versus Conventional Chemoembolization for Ultrasound-Invisible Early-Stage Hepatocellular Carcinoma (Barcelona Clinic Liver Cancer Stage 0 or A). Korean J Radiol. 2018;19(6):1130-1139. doi: 10.3348/kjr.2018.19.6.1130. Epub 2018 Oct 18.