Segmental versus subsegmental transarterial chemoembolization (TACE) for small (< 3 cm) hepatocellular carcinoma...

Area of Science:

• Hepatobiliary Medicine
• Interventional Radiology
• Oncology

Background:

• Small hepatocellular carcinoma (HCC) requires effective treatment to improve patient outcomes.
• Transarterial chemoembolization (TACE) is a standard treatment for HCC.
• Segmental (s-) and subsegmental (ss-) TACE are two approaches with differing target areas.

Purpose of the Study:

• To compare the efficacy of s-TACE and ss-TACE for small HCC.
• To evaluate early complete response (CR), local tumor progression (LTP), and impact on hepatic function (ALBI score).

Main Methods:

• A retrospective study of 114 lesions in 89 patients treated with s-TACE or ss-TACE for small HCC ( < 3 cm).
• Primary endpoints: 1-month CR and LTP rate.
• Secondary endpoint: ALBI score changes.
• Propensity score matching (PSM) was used to minimize bias.

Main Results:

• No significant difference in 1-month CR rates between s-TACE and ss-TACE (74% vs. 83%, p=0.24).
• ss-TACE demonstrated a significantly higher LTP rate (38% vs. 7.5%, p=0.001) compared to s-TACE, confirmed by PSM (HR 4).
• No significant differences in liver function deterioration were observed between the groups.

Conclusions:

• s-TACE is associated with a lower local tumor progression rate compared to ss-TACE in small HCC.
• Both s-TACE and ss-TACE show similar early complete response rates.
• Neither TACE approach significantly impacts liver function differently.