倾向评分分析比较经动脉化疗栓塞联合射频消融与单纯经动脉化疗栓塞治疗伴大血管侵犯的晚期肝细胞癌：一项回顾性队列研究

Comparison of Transcatheter Arterial Chemoembolization-Radiofrequency Ablation and Transcatheter Arterial Chemoembolization Alone for Advanced Hepatocellular Carcinoma with Macrovascular Invasion Using Propensity Score Analysis: A Retrospective Cohort Study.

作者信息

Liu Yao, Li Yuxin, Gao Fangyuan, Zhang Qun, Yang Xue, Zhu Bingbing, Niu Shuaishuai, Huang Yunyi, Hu Ying, Li Wei, Wang Xianbo

机构信息

Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.

Department of Gastroenterology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 101121, China.

出版信息

J Oncol. 2020 Aug 20;2020:1341863. doi: 10.1155/2020/1341863. eCollection 2020.

BACKGROUND

To compare the efficacies of transcatheter arterial chemoembolization (TACE) with radiofrequency ablation (RFA) (TACE + RFA) and TACE alone in patients with hepatocellular carcinoma (HCC) and macrovascular invasion (MVI).

METHODS

In total, 664 patients having HCC with MVI were included. Of these patients, 141 were treated with TACE + RFA, 254 with TACE alone, and 269 with supportive therapy (control group). The overall survival (OS) was compared among these groups. Propensity score matching (PSM) was performed for balancing the characteristics of the three groups.

RESULTS

After one-to-one PSM, the 12-month OS rates were higher in the TACE and TACE + RFA groups than in the control group (=0.0009 and =0.0017, respectively). Furthermore, higher 12-month OS rates were observed in the TACE + RFA group than in the TACE group (=0.0192). The 12-month OS rates of patients were remarkably higher in -fetoprotein (AFP) < 400 ng/ml, tumor < 3, tumor diameter < 5 cm, or portal vein tumor thrombosis (PVTT) group who were treated with TACE + RFA than in those who were treated with TACE (=0.0122, =0.0090, =0112, and =0.0071, respectively).

CONCLUSIONS

TACE + RFA provides a superior survival outcome than TACE alone in HCC patients, especially in AFP <400 ng/ml, tumor <3, tumor diameter <5 cm, or PVTT group.

背景

比较经动脉化疗栓塞术（TACE）联合射频消融术（RFA）（TACE+RFA）与单纯TACE治疗肝细胞癌（HCC）合并大血管侵犯（MVI）患者的疗效。

方法

共纳入664例HCC合并MVI患者。其中，141例接受TACE+RFA治疗，254例接受单纯TACE治疗，269例接受支持治疗（对照组）。比较三组患者的总生存期（OS）。采用倾向评分匹配（PSM）平衡三组患者的特征。

结果

经过一对一PSM后，TACE组和TACE+RFA组的12个月OS率高于对照组（分别为=0.0009和=0.0017）。此外，TACE+RFA组的12个月OS率高于TACE组（=0.0192）。TACE+RFA治疗的甲胎蛋白（AFP）<400 ng/ml、肿瘤<3、肿瘤直径<5 cm或门静脉癌栓（PVTT）组患者的12个月OS率显著高于TACE治疗组（分别为=0.0122、=0.0090、=0112和=0.0071）。