Amanda R Smolock1, Mircea M Cristescu1, Audrey Hinshaw1, Kaitlin M Woo2, Shane A Wells1, Timothy J Ziemlewicz1, Meghan G Lubner1, Prasad S Dalvie1, J Louis Hinshaw1, Christopher L Brace1,3,4, Orhan S Ozkan1, Fred T Lee1,3, Paul Laeseke5. 1. Departments of Radiology, University of Wisconsin Hospital and Clinics, 600 Highland Ave., MC 3252, Madison, WI, 53792, USA. 2. Departments of Biostatistics and Medical Informatics, University of Wisconsin Hospital and Clinics, 600 Highland Ave., MC 3252, Madison, WI, 53792, USA. 3. Departments of Biomedical Engineering, University of Wisconsin Hospital and Clinics, 600 Highland Ave., MC 3252, Madison, WI, 53792, USA. 4. Departments of Medical Physics, University of Wisconsin Hospital and Clinics, 600 Highland Ave., MC 3252, Madison, WI, 53792, USA. 5. Departments of Radiology, University of Wisconsin Hospital and Clinics, 600 Highland Ave., MC 3252, Madison, WI, 53792, USA. PLaeseke@uwhealth.org.
Abstract
PURPOSE: To compare transarterial chemoembolization (TACE) monotherapy to combination TACE and microwave ablation (MWA) for local control of 3- to 5-cm hepatocellular carcinoma (HCC). METHODS: Patients with HCC between 3 and 5 cm treated with TACE monotherapy or combination TACE + MWA at a single institution between 2007 and 2016 were retrospectively reviewed. Twenty-four HCCs (median diameter 3.8 cm) in 16 patients (13 males; median age 64 years) were treated using TACE monotherapy. Combination TACE + MWA was used to treat 23 HCCs (median diameter 4.2 cm) in 22 patients (18 males; median age 61 years). Microwave ablation was performed at a target time of two weeks following TACE. Individual tumors were followed by serial contrast-enhanced CT or MR. Response to treatment was evaluated on a tumor-by-tumor basis using mRECIST criteria with the primary outcome being local tumor progression (LTP). Data were analyzed using Fisher's exact test for categorical variables and Wilcoxon rank sum test for continuous variables. Time to LTP was estimated with the Kaplan-Meier method. RESULTS: Relative to TACE monotherapy, TACE + MWA provided a trend toward both a lower rate of LTP (34.8% vs. 62.5%, p = 0.11) and a higher complete response rate (65.2% vs. 37.5%; p = 0.12). Time to LTP (22.3 months vs. 4.2 months; p = 0.001) was significantly longer in the TACE + MWA group compared to TACE monotherapy. CONCLUSIONS: Combination therapy with TACE and microwave ablation improves local control and increases time to LTP for 3-5 cm HCC.
PURPOSE: To compare transarterial chemoembolization (TACE) monotherapy to combination TACE and microwave ablation (MWA) for local control of 3- to 5-cm hepatocellular carcinoma (HCC). METHODS:Patients with HCC between 3 and 5 cm treated with TACE monotherapy or combination TACE + MWA at a single institution between 2007 and 2016 were retrospectively reviewed. Twenty-four HCCs (median diameter 3.8 cm) in 16 patients (13 males; median age 64 years) were treated using TACE monotherapy. Combination TACE + MWA was used to treat 23 HCCs (median diameter 4.2 cm) in 22 patients (18 males; median age 61 years). Microwave ablation was performed at a target time of two weeks following TACE. Individual tumors were followed by serial contrast-enhanced CT or MR. Response to treatment was evaluated on a tumor-by-tumor basis using mRECIST criteria with the primary outcome being local tumor progression (LTP). Data were analyzed using Fisher's exact test for categorical variables and Wilcoxon rank sum test for continuous variables. Time to LTP was estimated with the Kaplan-Meier method. RESULTS: Relative to TACE monotherapy, TACE + MWA provided a trend toward both a lower rate of LTP (34.8% vs. 62.5%, p = 0.11) and a higher complete response rate (65.2% vs. 37.5%; p = 0.12). Time to LTP (22.3 months vs. 4.2 months; p = 0.001) was significantly longer in the TACE + MWA group compared to TACE monotherapy. CONCLUSIONS: Combination therapy with TACE and microwave ablation improves local control and increases time to LTP for 3-5 cm HCC.
Authors: John Reicher; Sebastian Mafeld; Georgia Priona; Helen L Reeves; Derek M Manas; Ralph Jackson; Peter Littler Journal: Cardiovasc Intervent Radiol Date: 2019-08-27 Impact factor: 2.740
Authors: Daniela Tabacelia; Cezar Stroescu; Radu Dumitru; Raluca Roxana Grigorescu; Alexandru Martiniuc; Ioana Alexandra Husar-Sburlan; Narcis Copca Journal: J Med Life Date: 2022-01
Authors: Keara English; N Patrik Brodin; Viswanathan Shankar; Shaoyu Zhu; Nitin Ohri; Yosef S Golowa; Jacob Cynamon; Sarah Bellemare; Andreas Kaubisch; Milan Kinkhabwala; Shalom Kalnicki; Madhur K Garg; Chandan Guha; Rafi Kabarriti Journal: JAMA Netw Open Date: 2020-11-02