Efficacy of radiofrequency ablation following transarterial chemoembolisation combined with sorafenib for intermediate stage recurrent hepatocellular carcinoma: a retrospective, multicentre, cohort study

被引:10
作者
Wang, Xiao-Hui [1 ]
Liang, Wei [2 ]
Li, Hui [3 ]
Xie, Xiao-Yan [4 ]
Li, Shao-Qiang [5 ]
Chen, Min-Shan [6 ]
Liang, Ping [7 ]
Mao, Xian-Hai [1 ]
Zhou, Qun-Fang [7 ]
机构
[1] Hunan Normal Univ, Hunan Prov Peoples Hosp, Affiliated Hosp 1, Dept Hepatobiliary Surg, Changsha 410005, Hunan, Peoples R China
[2] Guangzhou Med Univ, Affiliated Hosp 2, Dept Minimally Invas Intervent Radiol, Guangzhou 510260, Peoples R China
[3] Sun Yat Sen Univ, Canc Ctr, Dept Minimally Invas Intervent Radiol, Guangzhou 510060, Guangdong, Peoples R China
[4] Sun Yat Sen Univ, Affiliated Hosp 1, Inst Diagnost & Intervent Ultrasound, Dept Med Ultrason, Guangzhou 510060, Peoples R China
[5] Sun Yat Sen Univ, Affiliated Hosp 1, Dept Liver Surg, Guangzhou 510060, Guangdong, Peoples R China
[6] Sun Yat Sen Univ, Canc Ctr, Dept Liver Surg, Guangzhou 510060, Guangdong, Peoples R China
[7] Chinese Peoples Liberat Army Gen Hosp, Dept Intervent Ultrasound, 28 Fuxing Rd, Beijing 100853, Peoples R China
基金
中国国家自然科学基金;
关键词
Recurrent hepatocellular carcinoma; Intermediate-stage; Transarterial chemoembolisation; Sorafenib; Radiofrequency ablation; TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION; PHASE-II; 1ST-LINE TREATMENT; OPEN-LABEL; RESECTION; CANCER; MRECIST;
D O I
10.1016/j.eclinm.2022.101816
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background The evidence of radiofrequency ablation (RFA) following transarterial chemoembolisation (TACE) combined with sorafenib for intermediate-stage recurrent hepatocellular carcinoma (RHCC) is limited. Patient responses to this treatment vary because of the heterogeneous nature of RHCC, making it important to identify patients who are most likely to benefit from this combination therapy. The aim of this study was to evaluate the efficacy of RFA following TACE and sorafenib for the intermediate-stage RHCC.Methods This retrospective, multicentre, cohort study included 363 patients with intermediate-stage RHCC underwent TACE combined with sorafenib (TACE-sorafenib group) or RFA following TACE and sorafenib (TACE-sorafenib + RFA group) between January 01, 2009 to December 31, 2015 from four institutions in China. Overall survival (OS), progression-free survival (PFS) and efficacy of patients were compared between the two groups by propensity score-matching (PSM).Findings The 1-, 3-, and 5-year OS rates were 97.7%, 83.7%, 54.7% in TACE-sorafenib + RFA group, and 93.3%, 57.0%, 32.7% in TACE-sorafenib group. The 1-, 2-, and 3-year PFS rates were 85.3%, 58.0%, 26.9% in TACE-sorafenib + RFA group, and 55.3%, 30.7%, 15.3% in TACE-sorafenib group. Compared with the TACE-sorafenib group, the TACE-sorafenib + RFA group had significantly longer OS (HR, 0.54; 95%CI, 0.40-0.73; P < 0.001) and PFS (HR, 0.52; 95% CI, 0.41-0.66; P < 0.001). Subgroup analysis was conducted to precisely screen out the beneficial population from RFA treatment.Interpretation Our findings suggest that addition of RFA following TACE and sorafenib combination was superior to TACE combined with sorafenib for intermediate-stage RHCC, resulting in longer OS and PFS. Patients who had good response to TACE and achieved downstaging successfully could not benefit from the RFA therapy.Funding This research was funded by National Natural Science Foundation of China (No. 81627803), Chen Xiao-Ping Science and Technology Development Fund (CXPJJH1200009-06).Copyright (c) 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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页数:11
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