Transarterial chemoembolization as a substitute to radiofrequency ablation for treating Barcelona Clinic Liver Cancer stage 0/A hepatocellular carcinoma

Kentaro Ishikawa; Tetsuhiro Chiba; Yoshihiko Ooka; Eiichiro Suzuki; Sadahisa Ogasawara; Takahiro Maeda; Masayuki Yokoyama; Masanori Inoue; Toru Wakamatsu; Yuko Kusakabe; Tomoko Saito; Akinobu Tawada; Makoto Arai; Tatsuo Kanda; Hitoshi Maruyama; Fumio Imazeki; Naoya Kato

doi:10.18632/oncotarget.25108

Transarterial chemoembolization as a substitute to radiofrequency ablation for treating Barcelona Clinic Liver Cancer stage 0/A hepatocellular carcinoma

Oncotarget. 2018 Apr 20;9(30):21560-21568. doi: 10.18632/oncotarget.25108.

Authors

Kentaro Ishikawa¹, Tetsuhiro Chiba¹, Yoshihiko Ooka¹, Eiichiro Suzuki¹, Sadahisa Ogasawara¹, Takahiro Maeda¹, Masayuki Yokoyama¹, Masanori Inoue¹, Toru Wakamatsu¹, Yuko Kusakabe¹, Tomoko Saito¹, Akinobu Tawada¹, Makoto Arai¹, Tatsuo Kanda¹, Hitoshi Maruyama¹, Fumio Imazeki¹, Naoya Kato¹

Affiliation

¹ Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan.

Abstract

Background and aim: Transarterial chemoembolization (TACE) is the standard procedure for treating Barcelona clinic liver cancer (BCLC) stage B hepatocellular carcinoma (HCC). However, it is often carried out in the treatment of BCLC stage 0/A HCC for various reasons. This study aimed to elucidate the prognosis for BCLC stage 0/A HCC patients treated with TACE or with radiofrequency ablation (RFA).

Materials and methods: The prognosis of 242 BCLC stage 0/A HCC patients within Milan criteria who underwent initially TACE or RFA were retrospectively analyzed using propensity score matching analysis.

Results: The analyses of baseline patient characteristics revealed that the maximum tumor size and the proportion of BCLC stage A patients were significantly higher in patients treated with TACE than in those treated with RFA (P<0.001 and 0.047, respectively). After adjusting these factors using propensity score matching (1:3 matching), patients treated with TACE (n=32) and those treated with RFA (n=96) were further analyzed. The local recurrence rate was significantly higher in the TACE group than in the RFA group (P<0.001). However, the overall survival (OS) in HCC patients treated with TACE was comparable to that in HCC patients treated with RFA (1 year, 93.5 vs. 95.8%; 3 years, 75.4 vs. 85.8%; 5 years, 61.8 vs. 70.7%; P=0.196). Multivariate analyses followed by univariate analyses revealed that serum bilirubin level (P=0.032), serum albumin level (P=0.008), HBV-DNA (P=0.013), and tumor number (P=0.021) were independent predictors of OS.

Conclusion: TACE can substitute RFA at least in some patients with BCLC 0/A HCC.

Keywords: Barcelona Clinic Liver Cancer (BCLC) staging; hepatocellular carcinoma; propensity score matching; radiofrequency ablation; transarterial chemoembolization.