Comparison of Survival Outcomes in Transarterial Ethanol Ablation and Liver Resection for Solitary Hepatocellular Carcinoma ≤ 5 cm in Patients Stratified by Liver Function.

Autor: Yu SCH; Department of Imaging and Interventional Radiology, Main Clinical Block and Trauma Centre, The Chinese University of Hong Kong, Prince of Wales Hospital, c/o Rm 2A061, 2/F, Main Clinical Block and Trauma Centre, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong SAR. simonyu@cuhk.edu.hk.; Vascular and Interventional Radiology Foundation Clinical Science Center, Shatin, Hong Kong SAR. simonyu@cuhk.edu.hk., Hui JWY; Department of Imaging and Interventional Radiology, Main Clinical Block and Trauma Centre, The Chinese University of Hong Kong, Prince of Wales Hospital, c/o Rm 2A061, 2/F, Main Clinical Block and Trauma Centre, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong SAR.; Vascular and Interventional Radiology Foundation Clinical Science Center, Shatin, Hong Kong SAR., Chong CCN; Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR., Cho CCM; Department of Imaging and Interventional Radiology, Main Clinical Block and Trauma Centre, The Chinese University of Hong Kong, Prince of Wales Hospital, c/o Rm 2A061, 2/F, Main Clinical Block and Trauma Centre, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong SAR.; Vascular and Interventional Radiology Foundation Clinical Science Center, Shatin, Hong Kong SAR., Cheung S; Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR., Wong J; Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR., Lee KF; Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR.
Jazyk: angličtina
Zdroj: Cardiovascular and interventional radiology [Cardiovasc Intervent Radiol] 2022 Mar; Vol. 45 (3), pp. 315-327. Date of Electronic Publication: 2021 Oct 05.
DOI: 10.1007/s00270-021-02768-7
Abstrakt: Purpose: To compare the survival outcomes of patients treated with transarterial ethanol ablation (TEA) with those treated with liver resection (LR) for solitary HCC less than 5 cm in diameter, in patients stratified according to liver function using ALBI grade.
Materials and Methods: This retrospective study approved by the Institutional Committee included all treatment-naïve patients with solitary HCC (≤ 5 cm) and Child-Pugh score 5, and who had received TEA (33 patients) or LR (192 patients) between 2004 and 2012. Treatment outcomes were compared between patients treated with TEA and LR after a period of at least 7 years of follow-up. Comparison was repeated for those patients with ALBI grade 2 or 3.
Results: Both overall survival (OS, months) and recurrence-free survival (RFS months) were significantly longer in the LR group (OS: LR 129.7[119.5, 140], TEA 69.1[55.9, 82.3], P < 0.0001; RFS: LR 91.3[43.5, 139.1], TEA 13.8 [11, 16.5], P < 0.0001). In patients with ALBI grade 2 or 3, there was no significant difference between the groups in OS or RFS (OS: LR 43.1[0, 91.2], TEA 55.4 [43.7, 67.2], P = 0.65; RFS: LR 17.8 [11.4, 24.2], TEA 11.9 [6.7, 17.1], P = 0.132). Transient epigastric discomfort and low-grade fever without consequence occurred in 8 patients (8/33 or 24.2%) in the TEA group.
Conclusion: The overall survival after LR for HCCs ≤ 5 cm was superior to that after TEA but similar when compared in patients with ALBI grade 2 or 3, the ALBI grade is useful for patient selection for TEA or LR for HCCs ≤ 5 cm.
(© 2021. Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).)
Databáze: MEDLINE
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