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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 38 Issue 9
Sep.  2022
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Article Navigation >  Journal of Clinical Hepatology  > 2022  >  38(9): 2053-2060

Clinical effect of transcatheter arterial chemoembolization combined with microwave ablation versus repeat resection in treatment of recurrent hepatocellular carcinoma

DOI: 10.3969/j.issn.1001-5256.2022.09.020
  • 1.

    The Second People's Hospital of Neijiang, Neijiang, Sichuan 641000, China

  • 2.

    School of Clinical Medicine, Southwest Medical University, Luzhou, Sichuan 646000, China

  • 3.

    Department of Hepatobiliary Surgery, Chengdu First People's Hospital, Chengdu 610000, China

Research funding:

Major National Science and Technology Projects (2018ZX09303-014);

Scientific Research Project Plan of Sichuan Medical Association (S20062)

More Information
  • Corresponding author: DING Bing, scdingbing@sina.com(ORCID: 0000-0003-4432-9599)
  • Received Date: 2022-01-12
  • Accepted Date: 2022-02-15
  • Published Date: 2022-09-20
    Abstract
  •   Objective  To investigate the clinical effect of transcatheter arterial chemoembolization (TACE) combined with microwave ablation (MWA) (TACE-MWA) versus repeat resection (RR) in the treatment of recurrent hepatocellular carcinoma (RHCC).  Methods  A total of 178 patients with RHCC who were admitted to The Second People's Hospital of Neijiang from June 2015 to September 2020 were enrolled, and according to the treatment modality, they were divided into RR group with 64 patients and TACE-MWA group with 114 patients. Baseline demographic data, liver function, and tumor conditions before treatment were recorded, and the patients were followed up to October 2021 to compare postoperative overall survival (OS) time and recurrence-free survival (RFS) time between the two groups. Subgroup analysis based on recurrence pattern (recurrence time and tumor size) was performed, and the influencing factors for prognosis were analyzed. The independent samples t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data; the Kaplan-Meier method was used for postoperative survival rate, the Log-rank test was used for survival difference analysis, and a multivariate Cox regression analysis was used to investigate independent risk factors for survival.  Results   The multivariate analysis showed that tumor diameter, alpha-fetoprotein (AFP) level, alanine aminotransferase, albumin, and time to recurrence were independent prognostic factors for OS (all P < 0.05), and AFP level and time to recurrence were independent prognostic factors for RFS (both P < 0.05). For RHCC with late recurrence (> 2 years), there were significant differences between the two groups in median OS (54.0 months vs 36.0 months, χ2=6.171, P=0.013) and median RFS (28.0 months vs 21.0 months, χ2= 5.211, P=0.022). For RHCC with a tumor diameter of ≤5 cm, there was a significant difference in median OS between the two groups (33.0 months vs 27.0 months, χ2=6.447, P=0.011).  Conclusion  RR has a similar clinical effect to TACE-MWA in RHCC with early recurrence or a tumor diameter of > 5 cm, but RR should be the first choice for RHCC with late recurrence or a tumor diameter of ≤5 cm.

     

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