BACKGROUND There is lack of data for identifying optimal local therapy for the management of recurrent hepatocellular carcinoma (HCC) after hepatic resection. AIMS A retrospective study was performed to compare the effectiveness of transarterial chemoembolization (TACE) plus radiofrequency ablation (RFA) with that of TACE alone for recurrent HCC. METHODS From 2007 to 2013, patients with recurrent HCC ≤ 5 cm were treated with either TACE plus RFA (n = 96) or TACE (n = 63). Inverse probability of treatment weighting was used to make allowances for imbalances in treatment assignment. The disease-free survival (DFS) and overall survival (OS) were retrospectively analyzed. RESULTS The TACE group had lower pretreatment Child-Pugh class (P = 0.025) and shorter pretreatment interval of recurrence (P = 0.028). The 1-, 3-, and 5-year DFS rates for the TACE-RFA group were 55.1%, 22.5%, and 9.7%, respectively, and 41.1%, 9.9%, and 4.9%, respectively, for the TACE group. The OS rates at 1, 3, and 5 years were 82.3%, 42.7%, and 16.5%, respectively, in the TACE-RFA group, and 75.9%, 30.7%, and 11.3%, respectively, in the TACE group. Cirrhosis was significantly associated with disease progression (hazard ratio [HR] 1.53; 95% CI 1.09-2.14; P = 0.014). CONCLUSIONS In patients with recurrent HCC ≤ 5 cm, TACE-RFA shows better DFS than TACE alone as a first-line local therapy.

中文翻译：

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手术切除后复发性肝细胞癌的经皮动脉栓塞联合射频消融与单独经动脉化学栓塞的长期结果。

背景技术缺乏用于鉴定肝切除术后复发性肝细胞癌（HCC）管理的最佳局部疗法的数据。目的进行一项回顾性研究，以比较经肝动脉化疗栓塞（TACE）加射频消融（RFA）与单独使用TACE对复发性HCC的有效性。方法2007年至2013年，复发性HCC≤5 cm的患者接受TACE加RFA（n = 96）或TACE（n = 63）治疗。使用治疗权重的逆概率来考虑治疗分配的不平衡。回顾性分析无病生存期（DFS）和总体生存期（OS）。结果TACE组儿童的Child-Pugh分级较低（P = 0.025），而复发的预处理间隔较短（P = 0.028）。1、3，TACE-RFA组的5年和DFS率分别为55.1％，22.5％和9.7％，TACE组为41.1％，9.9％和4.9％。在TACE-RFA组中，第1年，第3年和第5年的OS率分别为82.3％，42.7％和16.5％，在TACE组中分别为75.9％，30.7％和11.3％。肝硬化与疾病进展显着相关（危险比[HR] 1.53； 95％CI 1.09-2.14； P = 0.014）。结论对于复发性HCC≤5 cm的患者，作为一线局部治疗，TACE-RFA的DFS优于单独的TACE。肝硬化与疾病进展显着相关（危险比[HR] 1.53； 95％CI 1.09-2.14； P = 0.014）。结论对于复发性HCC≤5 cm的患者，作为一线局部治疗，TACE-RFA的DFS优于单独的TACE。肝硬化与疾病进展显着相关（危险比[HR] 1.53； 95％CI 1.09-2.14； P = 0.014）。结论对于复发性HCC≤5 cm的患者，作为一线局部治疗，TACE-RFA的DFS优于单独的TACE。