Iodized Oil Transarterial Chemoembolization and Radiofrequency Ablation for Small Periportal Hepatocellular Carcinoma: Comparison with Nonperiportal Hepatocellular Carcinoma

摘要

Abstract Purpose This study aims to evaluate the treatment outcomes of iodized oil transarterial chemoembolization (TACE) and subsequent radiofrequency ablation (RFA) for small (≤3?cm) periportal hepatocellular carcinoma (HCC) compared with nonperiportal HCC. Methods Twenty-three patients [periportal group (PG); mean age, 59.8?years; 22 men, 1 woman] with periportal HCC (in contact with the portal vein >3?mm in diameter) and 279 patients [nonperiportal group (NPG); mean age, 59.1?years; 234 men, 45 women] with nonperiportal HCC were treated between March 2010 and January 2014. All cases were contraindicated for ultrasound-guided RFA or resection. Mean tumor size was 1.2?cm in each group. The baseline characteristics were not different between the groups, except for alpha-fetoprotein level (41.0?ng/dL in NPG vs. 8.8?ng/dL in PG, p ?=?0.001). Local tumor progression (LTP), disease-free survival (DFS), overall survival (OS), intrasegmental recurrence, and complications were analyzed using the Kaplan–Meier method and Fisher’s exact test. Results TACE and RFA were successfully performed in all patients. Mean follow-up period of PG and NPG was 33.8 and 42.8?months, respectively. LTP ( p ?=?0.701), DFS ( p ?=?0.718), and OS ( p ?=?0.359) were not different between the two groups. Intrasegmental recurrence occurred in two patients (one in each group), and its incidence was not different ( p ?=?0.212). Complications requiring further treatment occurred in 1/23 (4.3%) in PG and 5/279 (1.8%) in NPG. No procedure-related mortality occurred. Conclusions Iodized oil TACE and subsequent RFA are effective alternative treatments for small periportal HCC (≤3?cm) when percutaneous ultrasound- or CT-guided RFA or resection is not feasible.