Microwave ablation versus sorafenib for intermediate-Stage Hepatocellular carcinoma with transcatheter arterial chemoembolization refractoriness: a propensity score matching analysis.,International Journal of Hyperthermia

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Microwave ablation versus sorafenib for intermediate-Stage Hepatocellular carcinoma with transcatheter arterial chemoembolization refractoriness: a propensity score matching analysis.
International Journal of Hyperthermia ( IF 3.0 ) Pub Date : 2020-04-23 , DOI: 10.1080/02656736.2020.1752400
Shuanggang Chen _{1,

2} , Mengting Shi _{2,

3} , Lujun Shen _{1,

2} , Han Qi _{1,

2} , Weiqi Wan _{2,

3} , Fei Cao _{1,

2} , Lin Xie _{1,

2} , Ying Wu _{1,

2} , Guanjian Chen _{2,

3} , Jinqing Mo _{2,

3} , Guolian Zhu _{2,

4} , Dongdong Ye _{2,

3} , Yinqi Zhang _{2,

3} , Ziqing Feng _{2,

3} , Li Xu _{2,

5} , Weijun Fan _{1,

2}

Affiliation

Abstract

Purpose: To compared the benefits of sorafenib with microwave ablation (MWA) in intermediate-stage hepatocellular carcinoma (HCC) patients with tumor size ≤7 cm and tumor number ≤5 after Transcatheter Arterial Chemoembolization (TACE) failure.

Methods: A retrospective, single-center study was conducted using a one-to-one propensity score matching (PSM) analysis and involved 52 intermediate-stage HCC patients with absence of evidence of intrahepatic vascular invasion and extrahepatic metastasis after TACE failure and underwent treatment with MWA or sorafenib between 2007 and 2019. The overall survival (OS) and progression-free survival (PFS) were evaluated by the Kaplan-Meier method. The factors with OS and PFS were determined by Cox regression.

Results: Of the 52 patients included in our study, 30 (57.7%) underwent MWA and 22 (42.3%) received sorafenib. After PSM, 22 pairs were enrolled into different groups for further analysis. Patients in the MWA-group had a significantly longer median PFS than patients in the sorafenib-group on both before (median, 9.3 vs. 2.8 months, p = .001) and after PSM (median, 9.0 vs. 2.8 months, p = .006). They also had a significantly longer median OS than patients in the sorafenib-group on before (median, 48.8 vs. 16.6 months, p = .001) and after PSM (median, Not reached vs. 16.6 months, p = .001). Besides, Cox regression analysis showed that the treatment and age were the independent prognostic factors of OS and PFS (p＜0.05).

Conclusions: MWA was superior to sorafenib in improving survival for intermediate-stage hepatocellular carcinoma (HCC) patients with tumor size ≤7 cm and tumor number ≤5 after TACE failure.

Key Points
Compared with sorafenib, microwave ablation may be a more reasonable alternative treatment for intermediate-stage hepatocellular carcinoma (HCC) patients with tumor size ≤7 cm and tumor number ≤5 after TACE refractoriness.
The treatment (MWA vs sorafenib) and the age of patients were the independent prognostic factors of OS and PFS.

中文翻译：

微波消融与索拉非尼治疗经导管动脉化疗栓塞治疗难治性中年肝癌：倾向评分匹配分析。

摘要

目的：比较索拉非尼与微波消融（MWA）在经导管动脉化疗栓塞（TACE）失败后肿瘤尺寸≤7cm且肿瘤数目≤5的中期肝细胞癌（HCC）患者中的益处。

方法：采用一对一倾向评分匹配（PSM）分析进行回顾性单中心研究，研究对象为52例中位HCC患者，这些患者无证据表明TACE失败并接受治疗后肝内血管浸润和肝外转移在2007年至2019年期间接受MWA或索拉非尼治疗。通过Kaplan-Meier方法评估了总生存期（OS）和无进展生存期（PFS）。OS和PFS的因素通过Cox回归确定。

结果：在我们研究的52位患者中，有30位（57.7％）接受了MWA，而22位（42.3％）接受了索拉非尼。在PSM之后，将22对配对分为不同的组进行进一步分析。在PSM之前（中位9.3 vs. 2.8个月，p = .001）和PSM后（中位9.0 vs. 2.8个月，p = ），MWA组患者的PFS中值明显高于索拉非尼组。.006）。在PSM之前（中位，分别为48.8和16.6个月，p = .001）和PSM后（中位，未达到，与16.6个月，p = .001），患者的中位OS也明显长于索拉非尼组。此外，Cox回归分析显示治疗和年龄是OS和PFS的独立预后因素（p＜0.05）。

结论：在TACE失败后肿瘤尺寸≤7cm，肿瘤数目≤5的中期肝细胞癌（HCC）患者中，MWA优于索拉非尼。