Background: Limited therapies are available for large (≥40 mm) unresectable hepatocellular carcinoma (HCC). Currently, the standard treatment with transarterial chemoembolisation (TACE) is unsatisfactory with high recurrence rate and limited effect on survival. Laser Ablation (LA) has emerged as a relatively new technique characterized by high efficacy and good safety. This study is aimed to evaluate the efficacy of LA in comparison to TACE in patients with large HCC. Methods: Eighty-two patients with a single HCC nodule ≥40 mm (BCLC stage A or B) were enrolled in this case-control study. Forty-one patients were treated with LA and 41 patients were treated with TACE. Response to therapy was evaluated according to the mRECIST criteria. Survival was calculated with Kaplan-Meier from the time of cancer diagnosis to death with values censored at the date of the last follow-up. Results: Twenty-six (63.4%) and 8 (19.5%) patients had a complete response after LA and TACE, respectively (p < 0.001). Subsequently we stratified the HCCs in 3 categories according to the nodule size: 40-50 mm, 51-60 mm, and >60 mm. LA resulted superior to TACE especially in nodules ranging between 51 and 60 mm in diameter, with a complete response rate post-LA and post-TACE of 75% and 14.3%, respectively (p = 0.0133). The 36 months cumulative survival rate in patients treated with LA and TACE was 55.4% and 48.8%, respectively. The disease recurrence rates after LA and TACE were 19.5% and 75.0%, respectively. Conclusions: LA is a more effective therapeutic option than TACE in patients with solitary large HCC.
Laser ablation is superior to TACE in large-sized hepatocellular carcinoma: A pilot case-control study / Morisco F.; Camera S.; Guarino M.; Tortora R.; Cossiga V.; Vitiello A.; Cordone G.; Caporaso N.; Di Costanzo G.G.; Zoli M.; Garuti F.; Neri A.; Piscaglia F.; Lenzi B.; Valente M.; Trevisani F.; Bolondi L.; Biselli M.; Caraceni P.; Cucchetti A.; Domenicali M.; Gramenzi A.; Magalotti D.; Serra C.; Venerandi L.; Cappelli A.; Golfieri R.; Mosconi C.; Renzulli M.; Giannini E.G.; Brunacci M.; Moscatelli A.; Pellegatta G.; Savarino V.; Caturelli E.; Roselli P.; Lauria V.; Pelecca G.; Dell'Isola S.; Ialungo A.M.; Rastrelli E.; Cabibbo G.; Camma C.; Attardo S.; Rossi M.; Cavani G.; Virdone R.; Affronti A.; Nardone G.; Felder M.; Mega A.; Ciccarese F.; Del Poggio P.; Olmi S.; Foschi F.G.; Bevilacqua V.; Dall'Aglio A.C.; Ercolani G.; Fiorini E.; Casadei Gardini A.; Lanzi A.; Mirici Cappa F.; Sacco R.; Mismas V.; Svegliati Barone G.; Schiada L.; Farinati F.; Gazzola A.; Murer F.; Pozzan C.; Vanin V.; Rapaccini G.L.; de Matthaeis N.; Gasbarrini A.; Rinninella E.; Olivani A.; Missale G.; Biasini E.; Di Marco M.; Balsamo C.; Vavassori E.; Masotto A.; Marchetti F.; Valerio M.; Marra F.; Aburas S.; Campani C.; Dragoni G.; Borzio F.; Benvegnu L.; Festi D.; Marasco G.; Ravaioli F.. - In: ONCOTARGET. - ISSN 1949-2553. - ELETTRONICO. - 9:(2018), pp. 17483-17490. [10.18632/oncotarget.24756]
Laser ablation is superior to TACE in large-sized hepatocellular carcinoma: A pilot case-control study
Guarino M.;Tortora R.;Caporaso N.;Valente M.;Trevisani F.;Domenicali M.;Serra C.;Mosconi C.;Savarino V.;Roselli P.;Lauria V.;Ercolani G.;Balsamo C.;Aburas S.;Campani C.Membro del Collaboration Group
;Dragoni G.Membro del Collaboration Group
;Marasco G.;
2018
Abstract
Background: Limited therapies are available for large (≥40 mm) unresectable hepatocellular carcinoma (HCC). Currently, the standard treatment with transarterial chemoembolisation (TACE) is unsatisfactory with high recurrence rate and limited effect on survival. Laser Ablation (LA) has emerged as a relatively new technique characterized by high efficacy and good safety. This study is aimed to evaluate the efficacy of LA in comparison to TACE in patients with large HCC. Methods: Eighty-two patients with a single HCC nodule ≥40 mm (BCLC stage A or B) were enrolled in this case-control study. Forty-one patients were treated with LA and 41 patients were treated with TACE. Response to therapy was evaluated according to the mRECIST criteria. Survival was calculated with Kaplan-Meier from the time of cancer diagnosis to death with values censored at the date of the last follow-up. Results: Twenty-six (63.4%) and 8 (19.5%) patients had a complete response after LA and TACE, respectively (p < 0.001). Subsequently we stratified the HCCs in 3 categories according to the nodule size: 40-50 mm, 51-60 mm, and >60 mm. LA resulted superior to TACE especially in nodules ranging between 51 and 60 mm in diameter, with a complete response rate post-LA and post-TACE of 75% and 14.3%, respectively (p = 0.0133). The 36 months cumulative survival rate in patients treated with LA and TACE was 55.4% and 48.8%, respectively. The disease recurrence rates after LA and TACE were 19.5% and 75.0%, respectively. Conclusions: LA is a more effective therapeutic option than TACE in patients with solitary large HCC.
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