Suppr
超能文献

经动脉化疗栓塞联合微波消融与再次切除治疗切除术后复发性小肝细胞癌：哪种治疗方法更好？

Transarterial chemoembolization combined with microwave ablation versus repeated resection for recurrent small hepatocellular carcinoma after resection: What is the better treatment?

作者信息

Ji J, Yan L-L, Ma Y, Xu C, Zhou W-Z, Lv P-H

机构信息

Department of Interventional Radiology, Northern Jiangsu People's Hospital, 98 West Nantong Road, Yangzhou 225001, China.

Department of Radiology, Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Gulou District, Nanjing 210029, China.

出版信息

Clin Radiol. 2024 Dec;79(12):e1443-e1450. doi: 10.1016/j.crad.2024.08.020. Epub 2024 Aug 22.

DOI:10.1016/j.crad.2024.08.020

PMID:39299845

Abstract

PURPOSE

This study aimed to compare the effectiveness of transcatheter arterial chemoembolization combined with microwave ablation (TACE-MWA) versus repeated hepatic resection (RHR) in patients with recurrent small hepatocellular carcinoma (sHCC) following primary resection.

MATERIALS AND METHODS

A total of 59 patients diagnosed with recurrent sHCC (≤3 cm) and treated with either TACE-MWA or RHR were recruited from two centers between June 2015 and October 2021. Patients were matched using propensity scores at a 1:1 ratio. Disease-free survival (DFS), overall survival (OS), and complications were assessed and compared between the two treatment groups.

RESULTS

After propensity score matching, 38 patients were included, with 19 in each group. Prior to matching, the 1-, 3-, and 5-year DFS rates for the TACE-MWA group were 68.1%, 46.6%, and 23.3%, respectively, and for the RHR group, they were 84.6%, 47.3%, and 47.3%, respectively. The corresponding 1-, 3-, and 5-year OS rates for TACE-MWA were 100.0%, 83.7%, and 47.8%, while for RHR, they were 100.0%, 95.0%, and 45.2%. After matching, the 1-, 3-, and 5-year DFS rates were 78.0%, 48.3%, and 24.1% for TACE-MWA, and 77.5%, 38.7%, and 38.7% for RHR. The 1-, 3-, and 5-year OS rates for TACE-MWA were 100.0%, 88.9%, and 54.9%, and for RHR, they were 100.0%, 93.3%, and 44.4%. Statistical analysis showed no significant differences in DFS rates (P=0.834 before matching, P=0.490 after matching) or OS rates (P=0.825 before matching, P=0.625 after matching) between the two groups.

CONCLUSIONS

TACE-MWA demonstrates comparable effectiveness to RHR in managing recurrent sHCC.

摘要

目的

本研究旨在比较经动脉化疗栓塞联合微波消融（TACE-MWA）与再次肝切除（RHR）治疗原发性切除术后复发性小肝细胞癌（sHCC）患者的疗效。

材料与方法

2015年6月至2021年10月期间，从两个中心招募了59例诊断为复发性sHCC（≤3 cm）并接受TACE-MWA或RHR治疗的患者。患者按倾向得分以1:1的比例进行匹配。评估并比较两个治疗组的无病生存期（DFS）、总生存期（OS）和并发症。

结果

倾向得分匹配后，纳入38例患者，每组19例。匹配前，TACE-MWA组的1年、3年和5年DFS率分别为68.1%、46.6%和23.3%，RHR组分别为84.6%、47.3%和47.3%。TACE-MWA组相应的1年、3年和5年OS率分别为100.0%、83.7%和47.8%，而RHR组分别为100.0%、95.0%和45.2%。匹配后，TACE-MWA组的1年、3年和5年DFS率分别为78.0%、48.3%和24.1%，RHR组分别为77.5%、38.7%和38.7%。TACE-MWA组的1年、3年和5年OS率分别为100.0%、88.9%和54.9%，RHR组分别为100.0%、93.3%和44.4%。统计分析显示，两组之间的DFS率（匹配前P=0.834，匹配后P=0.490）或OS率（匹配前P=0.825，匹配后P=0.625）无显著差异。