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Abstract Details
Comparison of Trans-Arterial Chemoembolization and Bland Embolization for the Treatment of Hepatocellular Carcinoma: A Propensity Score Analysis
Cancers (Basel). 2021 Feb 15;13(4):812. doi: 10.3390/cancers13040812.
Gaël S Roth123, Maxime Benhamou4, Yann Teyssier15, Arnaud Seigneurin16, Mélodie Abousalihac12, Christian Sengel5, Olivier Seror478, Julien Ghelfi135, Nathalie Ganne-Carrié789, Lorraine Blaise9, Olivier Sutter4, Thomas Decaens123, Jean-Charles Nault789
Author information
1Faculty of Medicine, Grenoble-Alpes University, 38043 Grenoble, France.
2Department of Hepato-Gastroenterology and Digestive Oncology, CHU Grenoble-Alpes, 38043 Grenoble, France.
3Institute for Advanced Biosciences, INSERM U1209, CNRS UMR 5309, Grenoble-Alpes University, 38043 Grenoble, France.
4Functional Interventional Radiology Unit, Avicenne Hospital, Paris-Seine-Saint-Denis University Hospitals, Assistance-Publique Hôpitaux de Paris, 93000 Bobigny, France.
5Imaging Center, Clinical University of Radiology and Medical Imaging, CHU Grenoble-Alpes, 38043 Grenoble, France.
6Medical Assessment Service, CHU Grenoble-Alpes, 38043 Grenoble, France.
7Health Medicine and Human Biology Training and Research Unit, Paris Nord University, 93000 Bobigny, France.
8Functional Genomics of Solid Tumors Laboratory, Cordeliers Research Center-INSERM UMR 1138, Paris University, 75006 Paris, France.
9Department of Hepatology, Avicenne Hospital, Paris-Seine-Saint-Denis University Hospitals, Assistance-Publique Paris Hospitals, 93000 Bobigny, France.
Abstract
No definitive conclusion could be reached about the role of chemotherapy in adjunction of embolization in the treatment of hepatocellular carcinoma (HCC). We aim to compare radiological response, toxicity and long-term outcomes of patients with hepatocellular carcinoma (HCC) treated by trans-arterial bland embolization (TAE) versus trans-arterial chemoembolization (TACE). We retrospectively included 265 patients with HCC treated by a first session of TACE or TAE in two centers. Clinical and biological features were recorded before the treatment and radiological response was assessed after the first treatment using modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria. Correlation between the treatment and overall, progression-free and transplantation-free survival was performed after adjustment using a propensity score matching: 86 patients were treated by bland embolization and 179 patients by TACE, including 44 patients with drug-eluting beads and 135 with lipiodol TACE, 89.8% of patients were male with a median age of 65 years old. Cirrhosis was present in 90.9% of patients with a Child Pugh score A in 84% of cases. After adjustment, no difference in the rate of AE, including liver failure, was observed between the two treatments. TACE was associated with a significant increase in complete radiological response (odds ratio (OR) = 8.5 (95% confidence interval (CI): 2.8-25.4)) but not in the overall response rate (OR = 2.2 (95% CI = 0.8-5.8)). No difference in terms of overall survival (p = 0.3905), progression-free survival (p = 0.4478) and transplantation-free survival (p = 0.9020) was observed between TACE and TAE. TACE was associated with a higher rate of complete radiological response but without any impact on overall radiological response, progression-free survival and overall survival compared to TAE.