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Transarterial Chemoembolization Combined with Lenvatinib Plus Sequential Microwave Ablation for Large Hepatocellular
Lu Tang1, Yingwen Hou1, Zhimei Huang1
1Department of Minimally Invasive Interventional Radiology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China (L.T., Y.H., Z.H., J.H.); State Key Laboratory of Oncology in South China, Guangzhou 510060, Guangdong, China (L.T., Y.H., Z.H., J.H.); Guangdong Provincial Clinical Research Center for Cancer, Guangzhou 510060, Guangdong, China (L.T., Y.H., Z.H., J.H.); Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, Guangdong, China (L.T., Y.H., Z.H., J.H.).
Rationale And Objectives:
The aim of this study was to investigate the efficacy and safety of transarterial chemoembolization (TACE) combined with Lenvatinib plus sequential microwave ablation (MWA) for the treatment of patients with large hepatocellular carcinoma (HCC) beyond up-to-seven criteria.
Materials And Methods:
This retrospective cohort study assessed the medical records of patients with large HCC who underwent TACE combined with Lenvatinib plus sequential MWA (TLM) or TACE plus sequential MWA (TM). Lenvatinib was administered to patients within 3-5 days after TACE and sequential MWA was performed once they met the criteria for curative ablation after TACE or the combination therapy. The progression-free survival (PFS), overall survival (OS) and treatment-related complications were compared between two groups.
Results:
Of the 81 patients who underwent TLM or TM, 64 who met the eligibility criteria were included in this study. Among them, 28 patients underwent TLM and 36 underwent TM. The inverse probability weighting method (IPTW) was used to balance differences between two groups. The TLM group had longer PFS than the TM group (median, before IPTW: 18.53 vs. 5.62 months, p < 0.001; median, after IPTW: 28.27 vs. 5.30 months, p < 0.001). Univariate and multivariate analyses revealed that TLM and the maximum tumor diameter were independent prognostic factors for PFS. The overall incidence rate of minor complications related to TACE or MWA was lower in the TLM group (32.1% vs. 66.7%, p = 0.006).
Conclusion:
TACE combined with Lenvatinib plus sequential MWA can prolong the progression-free survival of patients with large HCC beyond up-to-seven criteria.
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