Transcatheter Arterial Chemoembolization With or Without Radiofrequency Ablation: Outcomes in Patients With Barcelona Clinic Liver Cancer Stage B Hepatocellular Carcinoma.

Abstract

The objective of our study was to clarify the indications for transcatheter arterial chemoembolization (TACE) of the hepatic artery combined with radiofrequency ablation (RFA), which we refer to as "TACE-RFA," for patients with hepatocellular carcinoma (HCC) beyond the Milan criteria. This study assessed the prognoses of patients with intermediate-stage HCC, which we defined as Barcelona Clinic Liver Cancer (BCLC) stage B (hereafter referred to as BCLC-B), according to the BCLC-B substages through treatment in a multicenter study. Two-hundred thirty patients with intermediate-stage HCC who were treated from January 2000 to December 2015 were enrolled. These patients were divided into four classes (B1-B4) according to the Bolondi classification. Between these substages, the prognosis of patients who underwent TACE-RFA was compared with that of patients who underwent TACE, the latter of which is the suggested standard therapy for patients with BCLC-B HCC. TACE-RFA and hepatic resection survival curves were better than those of TACE (p < 0.001 for TACE-RFA vs TACE). In particular, for substages B1 and B2, the overall survival rates of patients who underwent TACE-RFA were significantly higher than those who underwent TACE (B1, p < 0.001 for TACE-RFA vs TACE; B2, p = 0.015 for TACE-RFA vs TACE). The indications for TACE-RFA may be expanding to BCLC-B HCC. For patients with disease classified as substages B1 and B2, TACE-RFA may be a better treatment modality than TACE alone.