Cancer Management and Research (Apr 2020)
Long-Term Survival in Patients Receiving Combination Therapy with Resection and Radiofrequency Ablation for Multi-Focal Hepatocellular Carcinoma Classified as Barcelona Clinic Liver Cancer Stage B: A Retrospective Controlled Study
Abstract
Jun Yan,1– 3,* Zhongsong Man,3,* Qian Lu,1 Kuansheng Ma2 1Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Institute for Precision Medicine, Tsinghua University, Beijing, People’s Republic of China; 2The Institute of Hepatobiliary Surgery, The First Hospital Affiliated of Army Medical University, Chongqing, People’s Republic of China; 3Center of Hepatobiliary Pancreatic Disease, Xuzhou Central Hospital, Jiangsu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Kuansheng MaThe Institute of Hepatobiliary Surgery, The First Hospital Affiliated of Army Medical University, Chongqing, People’s Republic of ChinaEmail [email protected] LuBeijing Tsinghua Changgung Hospital, School of Clinical Medicine, Institute for Precision Medicine, Tsinghua University, Beijing, People’s Republic of ChinaEmail [email protected]: To evaluate the survival outcomes of combined liver resection (LR) and radiofrequency ablation (RFA) on multi-focal hepatocellular carcinoma (HCC) in patients with Barcelona clinic liver cancer (BCLC) stage B.Methods: A total of 210 cases of HCC were included in this study. In 42 cases, patients were treated with combination therapy using LR and RFA (LRCRFA). In 84 cases, patients underwent transarterial chemoembolization (TACE), and in another 84 cases, patients underwent LR; both the TACE and LR groups served as controls. It both categorized as BCLC stage B for LRCRFA and TACE groups but as BCLC stage A for LR group.Results: The overall survival (OS) rate of the LRCRFA group was significantly higher than that of the TACE group (P< 0.001) but was not significantly different when compared with the LR group (P=0.544). The disease-free survival (DFS) rate of the LRCRFA group was significantly lower than that of the LR group (P=0.029). Patients with ≤ 4 tumors or those with ≤ 5 tumors no larger than 6 cm in diameter experienced better long-term outcomes than other patients in the same LRCRFA group. The OS rates and DFS rates were not significantly different from those of patients in the LR group (P> 0.05). Having more than 2 existing tumors was an independent risk factor for OS rate.Conclusion: Combination therapy using LR and RFA can more effectively improve the prognosis of these patients than TACE. Patients with BCLC stage B HCC with ≤ 4 tumors or ≤ 5 tumors smaller than 6 cm in diameter are the ideal candidates for the application of LRCRFA.Keywords: hepatocellular carcinoma, surgical resection, radiofrequency ablation, transarterial chemoembolization, survival, Barcelona clinic liver cancer stage
