King Abdulaziz Medical City, Jeddah, Saudi Arabia.
King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
Gulf J Oncolog. 2022 May;1(39):56-62.
Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver. Most patients with HCC are unsuitable for surgical therapies. Therefore, nonsurgical therapies play a central role in the management of this disease. Several percutaneous treatment modalities are available for HCC including radiofrequency ablation (RFA), transarterial chemoembolization (TACE), and transarterial radioembolization (TARE). In this study, we aim to evaluate the clinical outcomes, morbidity and mortality rates, and survival rates of four treatment modalities for HCC (RFA, TACE, TARE, and Sorafenib) and compare the success rate of each modality.
A retrospective observational study was conducted at King Abdulaziz Medical City in Jeddah, Saudi Arabia. The inclusion criteria were composed of patients diagnosed with HCC who received RFA, TACE, TARE, or Sorafenib treatments between 2008 and 2017. The primary outcome of this study was recurrence-free patients at the last follow-up.
A total of 108 patients were included in this study. The mean age of the patients was 68.01 ± 9.98 years. Eighty-Two patients (75.9%) underwent interventions with the intention to cure or stabilize HCC, while twentysix patients (24.1%) were started on Sorafenib as a palliative treatment. The five years recurrence-free rates were 41.2% with RFA, 40% with the combination of TACE and RFA, 23.3% with TACE, and 0% with TARE. All patients on Sorafenib died from advanced-stage HCC.
This study provides further evidence for the efficacy of several treatment modalities for the management of HCC. RFA and the combination of TACE and RFA showed better outcomes with a recurrence-free rate reaching up to 40%. TACE had a moderate survival benefit up to 23.3%. TARE showed negative survival benefits. Sorafenib continues to be an important palliative treatment but does not offer curative potential.
肝细胞癌（HCC）是肝脏最常见的原发性恶性肿瘤。大多数 HCC 患者不适合手术治疗。因此，非手术治疗在该疾病的治疗中起着核心作用。几种经皮治疗方法可用于 HCC，包括射频消融（RFA）、经动脉化疗栓塞（TACE）和经动脉放射性栓塞（TARE）。在这项研究中，我们旨在评估 HCC 的四种治疗方法（RFA、TACE、TARE 和索拉非尼）的临床结果、发病率和死亡率以及生存率，并比较每种方法的成功率。
这是在沙特阿拉伯吉达的阿卜杜勒阿齐兹国王医疗城进行的回顾性观察性研究。纳入标准由 2008 年至 2017 年间接受 RFA、TACE、TARE 或索拉非尼治疗的 HCC 患者组成。本研究的主要结局是最后一次随访时无复发的患者。
本研究共纳入 108 例患者。患者的平均年龄为 68.01±9.98 岁。82 例（75.9%）患者接受了旨在治愈或稳定 HCC 的介入治疗，而 26 例（24.1%）患者开始使用索拉非尼进行姑息治疗。RFA 的五年无复发生存率为 41.2%，TACE 和 RFA 联合治疗的五年无复发生存率为 40%，TACE 的五年无复发生存率为 23.3%，TARE 的五年无复发生存率为 0%。所有接受索拉非尼治疗的患者均因晚期 HCC 死亡。
本研究进一步证实了几种治疗方法治疗 HCC 的疗效。RFA 和 TACE 联合 RFA 显示出更好的结果，无复发生存率高达 40%。TACE 具有适度的生存获益，达到 23.3%。TARE 显示出负面的生存获益。索拉非尼仍然是一种重要的姑息治疗方法，但没有治愈的潜力。
