Incomplete radiofrequency ablation following transarterial chemoembolization accelerates the progression of large hepatocellular carcinoma

被引:7
作者
Mu, Shangdong [1 ]
Chen, Qingjuan [1 ]
Li, Shuo [1 ]
Wang, Dongfeng [1 ]
Zhao, Yongchang [2 ]
Li, Xiang [1 ]
Fu, Wei [2 ]
Fan, Zhigang [1 ]
Tian, Shan [1 ]
Li, Zeng [1 ,3 ]
机构
[1] Xi An Jiao Tong Univ, Dept Oncol, Hosp 3201, Hlth Sci Ctr, Hanzhong, Shaanxi, Peoples R China
[2] Xi An Jiao Tong Univ, Dept Imaging, Hosp 3201, Hlth Sci Ctr, Hanzhong, Shaanxi, Peoples R China
[3] Xi An Jiao Tong Univ, Dept Oncol, Hosp 3201, Hlth Sci Ctr, 783 Tianhan Rd, Hanzhong 723000, Shaanxi, Peoples R China
关键词
Hepatocellular carcinoma; insufficient ablation; progression; radiofrequency ablation; transarterial chemoembolization; TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION; PROGNOSTIC-FACTORS; RECURRENCE; EFFICACY; PREDICT; SAFETY; TACE;
D O I
10.4103/jcrt.jcrt_2296_22
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To examine post-operative progression and risk impact of insufficient radiofrequency ablation (RFA) following transarterial chemoembolization (TACE) for the prognosis of large hepatocellular carcinoma (HCC).Materials and Methods: From January 2014 to January 2021 were analyzed. A total of 343 patients with large HCC (diameter >5 cm) who received TACE combined with RFA were enrolled and were divided into two groups: complete ablation (CA, n = 172) and insufficient ablation (IA, n = 171). Overall survival (OS) and progression-free survival (PFS) were determined by the Kaplan-Meier curve and compared with the log-rank test. To find parameters influencing OS and PFS, clinicopathological variables underwent univariate and multivariate analysis.Results: The cumulative 1-, 3-, and 5-year OS and PFS rates of the CA group were significantly higher than that of the IA group (P < 0.001). 25 (41%) patients in local tumor progression (LTP), 36 (59%) in intrahepatic distant recurrence (IDR), and 0 (0%) in extrahepatic distant recurrence (EDR) in the CA group. 51 (32.1%) patients in LTP, 96 (60.4%) patients in IDR, and 12 (7.5%) cases in EDR in the IA group. The recurrence patterns of the two groups were statistically significant difference (P = 0.039). In multivariate analysis, inadequate ablation and conjunction with TKIs were both significant risk factors for OS and PFS. Apart from these, older age and >7 cm of tumor size were indicators of poor OS and multiple tumors were indicators of poor PFS.Conclusion: Insufficient ablation causes a poor survival outcome of TACE combined with RFA for large HCC, particularly, which can promote IDR.
引用
收藏
页码:924 / 932
页数:9
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