Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, 100021, China.
Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
Clin Res Hepatol Gastroenterol. 2022 Apr;46(4):101878. doi: 10.1016/j.clinre.2022.101878. Epub 2022 Feb 11.
To evaluate the effectiveness of radiofrequency ablation (RFA) as a curative therapy for BCLC B1 stage (beyond Milan criteria but within up-to-seven criteria) hepatocellular carcinoma (HCC) followed by downstageing by using transarterial chemoembolization (TACE).
We retrospectively recruited patients underwent RFA alone and who underwent RFA following downstaging into BCLC B1 stage using TACE between April 2011 and August 2017. Overall survival (OS) and recurrence-free survival (RFS) were compared using the Kaplan-Meier method. A propensity score analysis was performed to reduce potential bias.
The downstaging TACE+RFA and RFA alone group comprised 50 and 110 patients, respectively. After propensity score matching, the 1-, 2-, and 3-year OS rates were 100%, 92%, 74%, respectively, the 1-, 2-, and 3-year RFS rates were 40%, 36%, and 20%, respectively, for patients in the downstaging TACE+RFA group. The 1-, 2-, and 3-year OS rates were 96%, 90%, and 82%, respectively, the 1-, 2-, and 3-year RFS rates were 51%, 32%, and 32%, respectively, for patients in the RFA group. No statistical differences were observed between the two groups in terms of OS and RFS before and after matching.
RFA after downstaging into BCLC B1 stage using TACE offered a safe and effective treatment regime for patients with HCC beyond the up-to-seven criteria. The intermediate-term OS and RFS of RFA following downstaging into BCLC B1 stage using TACE for HCC were similar to that of patients who were initially in BCLC B1stage.
评估射频消融（RFA）联合经动脉化疗栓塞（TACE）降期治疗巴塞罗那临床肝癌分期（BCLC）B1 期（超出米兰标准但符合 up-to-seven 标准）肝癌的疗效。
我们回顾性招募了 2011 年 4 月至 2017 年 8 月期间单独接受 RFA 治疗和接受 RFA 联合 TACE 降期治疗的患者。采用 Kaplan-Meier 法比较总生存期（OS）和无复发生存期（RFS）。采用倾向评分分析以减少潜在的偏倚。
降期 TACE+RFA 组和 RFA 组分别有 50 例和 110 例患者。经倾向评分匹配后，降期 TACE+RFA 组患者的 1、2、3 年 OS 率分别为 100%、92%、74%，1、2、3 年 RFS 率分别为 40%、36%、20%；RFA 组患者的 1、2、3 年 OS 率分别为 96%、90%、82%，1、2、3 年 RFS 率分别为 51%、32%、32%。匹配前后两组患者的 OS 和 RFS 差异均无统计学意义。
TACE 降期联合 RFA 治疗超出 up-to-seven 标准的肝癌患者是一种安全有效的治疗方案。TACE 降期联合 RFA 治疗肝癌的中期 OS 和 RFS 与初始 BCLC B1 期患者相似。
