Xie Yong, Lyu Tianshi, Song Li, Tong Xiaoqiang, Wang Jian, Zou Yinghua
Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, China.
Front Oncol. 2024 Apr 5;14:1347675. doi: 10.3389/fonc.2024.1347675. eCollection 2024.
BACKGROUND/OBJECTIVE: Treatment of hepatocellular carcinoma (HCC) with ablation alone often results in high rates of recurrence and metastasis, reaching up to 25.9% within two years. Therefore, this study aimed to examine the efficacy and safety of transarterial chemoembolization (TACE)-assisted multi-image guided radiofrequency ablation (RFA) for the treatment of stage Ia HCC according to the China liver cancer staging (CNLC).
This study enrolled and analyzed a total of 118 patients diagnosed with HCC, each with a single nodular lesion no larger than 5 cm, who received TACE-RFA as first-line therapy between February 1, 2014, and December 31, 2021. The median/mean follow-up period was 29.0 months [95% confidence interval (CI): 21.8-36.2 months] and 31.8 months (95% CI: 27.5-36.0 months), respectively. We assessed the treatment's effectiveness, potential complications, and survival rate.
The technical success rate was 100% (118/118) after the initial treatment. Out of the total, 3 out of 118 patients (2.5%) developed local tumor progression (LTP) during the follow-up period. The median time for LTP was 29.0 months (95%CI: 21.9-36.1 months; mean: 31.5 months; range 1-92 months). At 1, 3, 5, and 7 years after treatment, the cumulative LTP rates were 0%, 4.6%, 4.6%, and 4.6%, respectively. The overall survival rates at 1, 3, 5, and 7 years were 100%, 95.2%, 95.2%, and 95.2%, respectively. In total, 28 patients experienced minor Grade B complications, and no major complications or treatment-related mortality occurred.
The treatment of CNLC stage Ia HCC using TACE-assisted multi-image-guided RFA was found to be both safe and feasible.
背景/目的：单独使用消融治疗肝细胞癌（HCC）往往导致高复发率和转移率，两年内高达25.9%。因此，本研究旨在根据中国肝癌分期（CNLC），探讨经动脉化疗栓塞术（TACE）辅助多影像引导下射频消融术（RFA）治疗Ia期HCC的疗效和安全性。
本研究纳入并分析了118例确诊为HCC的患者，均为单个结节性病变且直径不超过5 cm，于2014年2月1日至2021年12月31日接受TACE-RFA作为一线治疗。中位/平均随访期分别为29.0个月[95%置信区间（CI）：21.8 - 36.2个月]和31.8个月（95% CI：27.5 - 36.0个月）。我们评估了治疗效果、潜在并发症和生存率。
初始治疗后技术成功率为100%（118/118）。随访期间，118例患者中有3例（2.5%）出现局部肿瘤进展（LTP）。LTP的中位时间为29.0个月（95%CI：21.9 - 36.1个月；均值：31.5个月；范围1 - 92个月）。治疗后1年、3年、5年和7年的累积LTP率分别为0%、4.6%、4.6%和4.6%。1年、3年、5年和7年的总生存率分别为100%、95.2%、95.2%和95.2%。共有28例患者出现B级轻微并发症，未发生严重并发症或与治疗相关的死亡。
发现使用TACE辅助多影像引导下RFA治疗CNLC Ia期HCC是安全可行的。
