• J Formos Med Assoc · Mar 2018

    Combined resection and radiofrequency ablation versus transarterial embolization for intermediate-stage hepatocellular carcinoma: A propensity score matching study.

    • Wendell Espinosa, Yueh-Wei Liu, Chih-Chi Wang, Chih-Che Lin, Jing-Houng Wang, Sheng-Nan Lu, and Chao-Hung Hung.
    • Department of Internal Medicine, Dr. Pablo O. Torre Memorial Hospital, Bacolod City, Philippines; Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
    • J Formos Med Assoc. 2018 Mar 1; 117 (3): 197-203.

    Background/PurposeThis study aimed to compare the outcomes of combined hepatic resection (HR) plus intraoperative radiofrequency ablation (RFA) and transarterial embolization (TAE) for Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma (HCC) in case-controlled patient groups using the propensity score.MethodsA total of 179 patients with multifocal HCC treated with HR plus RFA (n = 26) or TAE (n = 153) were retrospectively studied. All patients were classified as BCLC stage B and Child-Pugh class A. Analyses were performed over all participants as well as for propensity score-matched (1:3) patients to adjust for baseline differences. Cumulative overall survival (OS) and time to progression (TTP) were compared between the two groups using the Kaplan-Meier method, and independent predictors were identified by multivariate Cox regression analysis.ResultsPatients treated with HR plus RFA had better OS and longer TTP than those with TAE (p = 0.011 and p < 0.001, respectively). Multivariate Cox regression analysis showed that combined therapy (hazard ratio 0.31; 95% confidence interval (CI), 0.12-0.78; p = 0.013), BCLC substage B2 (hazard ratio 1.82; 95% CI, 1.13-2.92; p = 0.013) and alpha-fetoprotein ≥ 400 ng/ml (hazard ratio 1.85; 95% CI, 1.12-3.05; p = 0.016) were independent factors associated with OS. After propensity score matching, combined therapy was the significant factor associated with OS and TTP by univariate and multivariate analyses.ConclusionCombined HR plus RFA may provide survival advantage compared to TAE in patients with BCLC stage B HCC.Copyright © 2017. Published by Elsevier B.V.

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