Haak Fabian, Karli Tobias, Takes Martin, Zech Christoph J, Kollmar Otto, Soysal Savas D
Clarunis, Department of Visceral Surgery, University Digestive Health Care Center, St. Clara Hospital and University Hospital Basel, 4058 Basel, Switzerland.
Department of Visceral, Transplant, Thoracic and Vascular Surgery, Division of Hepatobiliary Surgery and Visceral Transplant Surgery, University Hospital Leipzig, 04103 Leipzig, Germany.
J Clin Med. 2024 Jun 2;13(11):3279. doi: 10.3390/jcm13113279.
: International guidelines recommend transarterial chemoembolization (TACE) for intermediate-stage hepatocellular carcinoma (HCC). However, it is used outside these recommendations and has proven beneficial in prolonging survival. Since the role of TACE outside BCLC stage B is unclear, the present study analyzed the results of TACE performed at a tertiary center in Switzerland for different treatment groups, and aims to highlight the treatment outcomes for these groups. : This retrospective cohort study includes 101 HCC patients undergoing TACE at our center. Patients were further subdivided into groups according to therapy combinations (therapies applied before and after index TACE). Kaplan-Meier survival curves were calculated for the Barcelona Center for Liver Cancer (BCLC) subgroups. : After TACE, the median survival was 28.1 months for BCLC 0, 31.5 months for BCLC A, 20.5 months for BCLC B, 10.8 for BCLC C, and 7.5 months for BCLC D. A lesion size larger than 55 mm was negatively associated with survival (HR 2.8, 95% CI 1.15-6.78). Complications occurred after TACE procedures: Clavien-Dindo I + II = 30, Clavien-Dindo > 3 = 2. : TACE was performed in a substantial part of our cohort outside of routinely used treatment guidelines. The combination of the survival data and complication rate in these patients suggests it was a safe and beneficial strategy. Furthermore, our data show that in our cohort, the survival benefit associated with TACE was restricted to patients with a lesion size smaller than 55 mm.
国际指南推荐经动脉化疗栓塞术（TACE）用于中期肝细胞癌（HCC）。然而，该方法在这些推荐范围之外也有应用，且已证明对延长生存期有益。由于TACE在巴塞罗那临床肝癌（BCLC）分期B期之外的作用尚不清楚，本研究分析了瑞士一家三级中心针对不同治疗组进行TACE的结果，旨在突出这些组别的治疗效果。：这项回顾性队列研究纳入了在我们中心接受TACE治疗的101例HCC患者。患者根据治疗组合（首次TACE前后应用的治疗方法）进一步细分。计算了巴塞罗那肝癌中心（BCLC）各亚组的Kaplan-Meier生存曲线。：TACE治疗后，BCLC 0期的中位生存期为28.1个月，BCLC A期为31.5个月，BCLC B期为20.5个月，BCLC C期为10.8个月，BCLC D期为7.5个月。肿瘤大小大于55 mm与生存期呈负相关（风险比2.8，95%置信区间1.15 - 6.78）。TACE术后出现了并发症：Clavien-Dindo I + II级 = 30例，Clavien-Dindo > 3级 = 2例。：在我们的队列中，相当一部分患者接受了超出常规治疗指南的TACE治疗。这些患者的生存数据和并发症发生率表明这是一种安全且有益的策略。此外，我们的数据显示，在我们的队列中，与TACE相关的生存获益仅限于肿瘤大小小于55 mm的患者。
