Comparison of initial tumor responses to transarterial bland embolization and drug-eluting beads-transarterial chemoembolization in the management of hepatocellular carcinoma: a propensity-score matching analysis

Guo, Jianxi1; Wang, Weidong2; Zhang, Yanfang1; Xu, Linfeng2; Kong, Jian1

2021-07-01

10.21037/jgo-21-370

Journal of Gastrointestinal Oncology   影响因子和分区

2078-6891

2219-679X

Background: Transarterial bland embolization (TABE) is widely used to treat the spontaneous rupture of hepatocellular carcinoma (HCC), and can lead to ischemic necrosis of the tumor. In this study, we used the propensity-score matching (PSM) method to compare the initial responses of treatment-naive HCC patients to TABE and drug-eluting beads-transarterial chemoembolization (DEB-TACE), and the safety of these treatments. Methods: Patients with treatment-naive HCC, who had been admitted to 2 medical centers from January 2016 to December 2020, were enrolled as the research subjects. The data of 26 patients treated with TABE for ruptured HCC and 52 patients treated with DEB-TACE for primary HCC were collected according to our inclusion and exclusion criteria, and a PSM analysis was conducted to assess the safety and effectiveness of these two interventional techniques 1 month postoperatively. Results: In relation to ruptured HCC, TABE had a hemostatic success rate of 97.0%. Before PSM, the TABE group had a larger maximum tumor diameter (P<0.05), a higher proportion of multiple tumors (P<0.05), a higher proportion of Child-Pugh class B ( P<0.05), and a higher proportion of Barcelona Clinic Liver Cancer (BCLC) stage B ( P<0.05) than the DEB-TACE group. After PSM, the baseline characteristics of these two groups were well balanced, and there was no significant difference in patients' initial therapeutic responses and tumor recurrence rates (both P>0.05). The multivariate regression analysis showed that tumor size was an independent predictor of the objective response rate (ORR) [odds ratio (OR): 3.312; 95% CI: 0.152-5.944; P<0.05]. Tumor number and BCLC stage also affected ORR; however, ORR was not significantly correlated with the interventional technique (TABE vs. DEB-TACE; P>0.05). The incidences of post-embolization syndrome (PES) and 48-h hepatotoxicity were significantly lower in the TABE group than the DEB-TACE group (both P<0.05), but there was no significant difference in hepatotoxicity after 1 month (P>0.05). Conclusions: TABE is highly effective at managing hemorrhage from ruptured HCC. The initial therapeutic response of HCC to TABE is similar to that to DEB-TACE; however, TABE is associated with lower hepatotoxicity and fewer adverse effects, which paves the way for subsequent treatments and systemic therapies.

Hepatocellular carcinoma (HCC) initial response propensity-score matching (PSM) transarterial bland embolization (TABE) drug-eluting beads-transarterial chemoembolization (DEB-TACE)

SCI

英语

第一 ; 通讯

Key-AreaResearch and Development Program of Guangdong Province, China[2020B010165004]

Oncology ; Gastroenterology & Hepatology

Oncology ; Gastroenterology & Hepatology

WOS:000683893200001

AME PUBL CO

Web of Science

1.Southern Univ Sci & Technol, Dept Intervent Radiol, Shenzhen Peoples Hosp, Second Clin Med Coll,Jinan Univ,Affiliated Hosp 1, 1017 Dongmen Bei Rd, Shenzhen 518020, Peoples R China
2.Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Dept Intervent Radiol, 107 Yanjiang Xi Rd, Guangzhou 510000, Peoples R China

Guo, Jianxi,Wang, Weidong,Zhang, Yanfang,et al. Comparison of initial tumor responses to transarterial bland embolization and drug-eluting beads-transarterial chemoembolization in the management of hepatocellular carcinoma: a propensity-score matching analysis[J]. Journal of Gastrointestinal Oncology,2021.

Guo, Jianxi,Wang, Weidong,Zhang, Yanfang,Xu, Linfeng,&Kong, Jian.(2021).Comparison of initial tumor responses to transarterial bland embolization and drug-eluting beads-transarterial chemoembolization in the management of hepatocellular carcinoma: a propensity-score matching analysis.Journal of Gastrointestinal Oncology.

Guo, Jianxi,et al."Comparison of initial tumor responses to transarterial bland embolization and drug-eluting beads-transarterial chemoembolization in the management of hepatocellular carcinoma: a propensity-score matching analysis".Journal of Gastrointestinal Oncology (2021).