Comparison of the Efficacy and Safety of Transarterial Chemoembolization Plus Microwave Ablation versus Surgical Resection in Patients with Solitary Large Hepatocellular Carcinoma: A Propensity Score-Matched Analysis

Abstract

Yongchao Zhang,1 Hualei Chen,1 Shanshan Chen,1 Youjia Duan,1 Long Cheng,1 Jie Gao,2,* Wei Li1,3,* 1Cancer Center, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Hepatobiliary Surgery, Peking University People’s Hospital, Beijing, People’s Republic of China; 3Cancer Center, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jie Gao, Department of Hepatobiliary Surgery, Peking University People’s Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, People’s Republic of China, Email [email protected] Wei Li, Cancer Center, Beijing Ditan Hospital, Capital Medical University, 8 Jingshun East Street, Chaoyang District, Beijing, 100015, People’s Republic of China, Email [email protected]: The liver resection for solitary large hepatocellular carcinoma (SLHCC) remains controversial due to the high risk of complications and recurrence after resection. This study aimed to compare the efficacy and safety of transcatheter arterial chemoembolization (TACE) plus microwave ablation (MWA) with resection for SLHCC.Methods: We retrospectively analyzed a total of 148 patients who were treated with either TACE-MWA (n = 94) or resection (n = 54) for SLHCC (≥ 5 cm). A matched cohort composed of 86 patients was included after propensity score matching (PSM). The primary endpoint was overall survival (OS), and the secondary endpoints were progression-free survival (PFS) and safety.Results: The TACE-MWA group was older with higher ALT and AST (all P 0.05). For SLHCC patients with tumor size ≥ 7cm, TACE-MWA showed favorable OS than liver resection. The TACE-MWA group exhibited a lower rate of major complications and shorter hospital stay than the resection group.Conclusion: TACE-MWA showed comparable efficacy to liver resection in patients with SLHCC, but better safety and shorter hospital stay. TACE-MWA might provide a longer OS than liver resection for SLHCC patients with tumor size ≥ 7cm.Keywords: transarterial embolization, microwave ablation, hepatocellular carcinoma, liver resection

Keywords

• transarterial embolization
• microwave ablation
• hepatocellular carcinoma
• liver resection.