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http://dx.doi.org/10.3348/kjr.2018.19.6.1130

Comparison of Combined Therapy Using Conventional Chemoembolization and Radiofrequency Ablation Versus Conventional Chemoembolization for Ultrasound-Invisible Early-Stage Hepatocellular Carcinoma (Barcelona Clinic Liver Cancer Stage 0 or A)  

Lee, Hyukjoon (Division of Vascular and Interventional Radiology, Department of Radiology, Seoul National University Bundang Hospital)
Yoon, Chang Jin (Division of Vascular and Interventional Radiology, Department of Radiology, Seoul National University Bundang Hospital)
Seong, Nak Jong (Division of Vascular and Interventional Radiology, Department of Radiology, Seoul National University Bundang Hospital)
Jeong, Sook-Hyang (Division of Internal Medicines, Seoul National University Bundang Hospital)
Kim, Jin-Wook (Division of Internal Medicines, Seoul National University Bundang Hospital)
Publication Information
Korean Journal of Radiology / v.19, no.6, 2018 , pp. 1130-1139 More about this Journal
Abstract
Objective: To compare the therapeutic efficacy between conventional transarterial chemoembolization (cTACE) and combined therapy using cTACE and radiofrequency ablation (RFA) in ultrasound (US)-invisible early stage hepatocellular carcinoma (HCC). Materials and Methods: From January 2008 to June 2016, 167 patients with US-invisible early stage HCCs were treated with cTACE alone (cTACE group; n = 85) or cTACE followed by immediate fluoroscopy-guided RFA targeting intratumoral iodized oil retention (combined group; n = 82). Procedure-related complications, local tumor progression (LTP), time to progression (TTP), and overall survival (OS) were compared between the two groups. Multivariate analyses were performed to identify prognostic factors. Results: There was no major complication in either group. The cTACE group showed higher 1-, 3-, and 5-year LTP rates than the combined group; i.e., 12.5%, 31.7%, and 37.0%, respectively, in the cTACE group; compared to 7.3%, 16.5%, and 16.5%, respectively, in the combined group; p = 0.013. The median TTP was 18 months in the cTACE group and 24 months in the combined group (p = 0.037). Cumulative 1-, 3-, and 5-year OS rates were 100%, 93.2%, and 87.7%, respectively, in the cTACE group and 100%, 96.6%, and 87.4%, respectively, in the combined group (p = 0.686). Tumor diameter > 20 mm and cTACE monotherapy were independent risk factors for LTP and TTP. Conclusion: Combined therapy using cTACE followed by fluoroscopy-guided RFA is a safe and effective treatment in US-invisible early stage HCCs. It provides less LTP and longer TTP than cTACE alone.
Keywords
Chemoembolization; Radiofrequency ablation; Hepatocellular carcinoma;
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