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经皮射频消融联合或不联合碘油化疗治疗肝细胞癌:倾向评分匹配分析

Percutaneous Radiofrequency Ablation with or without Chemolipiodolization for Hepatocellular Carcinoma: A Propensity-Score-Matched Analysis.

作者信息

Takaki Kota, Nakano Masahito, Fukumori Kazuta, Yano Yoichi, Zaizen Yuki, Niizeki Takashi, Kuwaki Kotaro, Fukahori Masaru, Sakaue Takahiko, Yoshimura Sohei, Nakazaki Mika, Torimura Takuji

机构信息

Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan.

Division of Gastroenterology, Department of Medicine, Japan Community Health Care Organization, Saga Central Hospital, Saga 849-8522, Japan.

出版信息

J Clin Med. 2022 Mar 8;11(6):1483. doi: 10.3390/jcm11061483.

Abstract

Chemolipiodolization (CL) is less invasive than transarterial chemoembolization (TACE) for managing hepatocellular carcinoma (HCC) because it helps avoid embolization. However, the treatment outcomes of percutaneous radiofrequency ablation (PRFA) with or without CL for HCC remain unclear. Herein, we compared the prognostic factors for overall survival (OS) following PRFA with or without CL for HCC using propensity-score-matched analysis. A total of 221 patients with HCC treated with PRFA at Saga Central Hospital between April 2004 and October 2020, with or without CL, were enrolled. No significant difference was observed in OS between PRFA with and without CL cohorts (median survival time (MST): 4.5 vs. 5.4 years; = 0.0806). To reduce the confounding effects of 12 variables, we performed propensity-score-matched analysis to match patients treated with PRFA with or without CL. No significant difference was observed in OS between PRFA with and without CL cohorts (MST: 4.0 vs. 3.6 years; = 0.5474). After stratification according to tumor size, no significant difference was observed in OS for patients with tumor size ≥20 mm between PRFA with and without CL cohorts (MST: 3.5 vs. 3.4 years; = 0.8236). PRFA with CL was not a significant prognostic factor in both univariate and multivariate analyses ( = 0.5477 and 0.9600, respectively). Our findings suggest that PRFA with CL does not demonstrate more favorable prognosis than PRFA without CL for HCC, regardless of tumor size.

摘要

化学碘化油栓塞术(CL)在治疗肝细胞癌(HCC)方面比经动脉化疗栓塞术(TACE)侵入性更小,因为它有助于避免栓塞。然而,经皮射频消融术(PRFA)联合或不联合CL治疗HCC的疗效仍不明确。在此,我们使用倾向评分匹配分析比较了PRFA联合或不联合CL治疗HCC后总生存期(OS)的预后因素。2004年4月至2020年10月期间,在佐贺中央医院接受PRFA治疗的221例HCC患者被纳入研究,其中部分患者接受了CL治疗,部分未接受。接受CL和未接受CL的PRFA队列之间的OS无显著差异(中位生存时间(MST):4.5年 vs. 5.4年;P = 0.0806)。为减少12个变量的混杂效应,我们进行了倾向评分匹配分析,以匹配接受PRFA联合或不联合CL治疗的患者。接受CL和未接受CL的PRFA队列之间的OS无显著差异(MST:4.0年 vs. 3.6年;P = 0.5474)。根据肿瘤大小分层后,肿瘤大小≥20 mm的患者中,接受CL和未接受CL的PRFA队列之间的OS无显著差异(MST:3.5年 vs. 3.4年;P = 0.8236)。在单因素和多因素分析中,PRFA联合CL均不是显著的预后因素(分别为P = 0.5477和P = 0.9600)。我们的研究结果表明,无论肿瘤大小如何,PRFA联合CL治疗HCC的预后并不比不联合CL的PRFA更优。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8da6/8953328/f472096a47bc/jcm-11-01483-g001.jpg

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