Faculty Collaboration Database

Combination transarterial chemoembolization and microwave ablation improves local tumor control for 3- to 5-cm hepatocellular carcinoma when compared with transarterial chemoembolization alone. Abdom Radiol (NY) 2018 Sep;43(9):2497-2504

Date

02/17/2018

Pubmed ID

29450606

DOI

10.1007/s00261-018-1464-9

Scopus ID

2-s2.0-85042101509 (requires institutional sign-in at Scopus site)   33 Citations

Abstract

PURPOSE: To compare transarterial chemoembolization (TACE) monotherapy to combination TACE and microwave ablation (MWA) for local control of 3- to 5-cm hepatocellular carcinoma (HCC).

METHODS: Patients with HCC between 3 and 5 cm treated with TACE monotherapy or combination TACE + MWA at a single institution between 2007 and 2016 were retrospectively reviewed. Twenty-four HCCs (median diameter 3.8 cm) in 16 patients (13 males; median age 64 years) were treated using TACE monotherapy. Combination TACE + MWA was used to treat 23 HCCs (median diameter 4.2 cm) in 22 patients (18 males; median age 61 years). Microwave ablation was performed at a target time of two weeks following TACE. Individual tumors were followed by serial contrast-enhanced CT or MR. Response to treatment was evaluated on a tumor-by-tumor basis using mRECIST criteria with the primary outcome being local tumor progression (LTP). Data were analyzed using Fisher's exact test for categorical variables and Wilcoxon rank sum test for continuous variables. Time to LTP was estimated with the Kaplan-Meier method.

RESULTS: Relative to TACE monotherapy, TACE + MWA provided a trend toward both a lower rate of LTP (34.8% vs. 62.5%, p = 0.11) and a higher complete response rate (65.2% vs. 37.5%; p = 0.12). Time to LTP (22.3 months vs. 4.2 months; p = 0.001) was significantly longer in the TACE + MWA group compared to TACE monotherapy.

CONCLUSIONS: Combination therapy with TACE and microwave ablation improves local control and increases time to LTP for 3-5 cm HCC.

Author List

Smolock AR, Cristescu MM, Hinshaw A, Woo KM, Wells SA, Ziemlewicz TJ, Lubner MG, Dalvie PS, Louis Hinshaw J, Brace CL, Ozkan OS, Lee FT Jr, Laeseke P

Author

Mircea M. Cristescu MD Assistant Professor in the Radiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Carcinoma, Hepatocellular
Catheter Ablation
Chemoembolization, Therapeutic
Combined Modality Therapy
Contrast Media
Female
Humans
Liver Neoplasms
Magnetic Resonance Imaging
Male
Microwaves
Middle Aged
Tomography, X-Ray Computed