Journal of vascular and interventional radiology : JVIR · 2025
Comparison of the Effectiveness of Transarterial Bland Embolization and Transarterial Chemoembolization for Intermediate-Stage Hepatocellular Carcinoma: A Propensity Score Matched Study of 980 Patients.
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Zhang Hongmin, Xu Jian, Meng Haoyu, Shen Lujun
Аннотация
PURPOSE: To assess the effectiveness of transarterial bland embolization (TAE) compared with transarterial chemoembolization (TACE) therapy in the treatment of patients with intermediate-stage hepatocellular carcinoma (HCC).
MATERIALS AND METHODS: A total of 2,031 patients with intermediate-stage HCC were screened, and 1,246 patients who underwent TAE or TACE as the first-choice treatment were retrospectively analyzed and baseline-matched according to the 2 treatment methods. Subgroup analysis was performed among patients according to the Up-to-7 criteria. The primary endpoint was overall survival (OS).
RESULTS: A total of 1,246 patients with HCC who underwent TAE or TACE were included; 720 patients underwent TACE, and 526 underwent TAE. The patients in the TAE group exhibited poorer liver function and a significantly higher rate of hepatitis B infection (P < .001) compared with the TACE group. After propensity score matching, 490 well-matched pairs of patients with intermediate-stage HCC were selected for analysis. Univariate analysis showed that TACE significantly prolonged patient survival compared with TAE (P < .001). The 1-, 2-, and 3-year OS rates were 75.9%, 58.9%, and 44.9% for the TACE group and 59.2%, 34.9%, and 23.8% for the TAE group. Multivariate analysis showed a hazard ratio of 0.556 (95% CI, 0.474-0.653; P < .001) for the TACE approach over the TAE approach for OS. The TACE group had a significantly higher overall response rate than the TAE group (33% vs 26%, P < .001).
CONCLUSIONS: TACE resulted in a higher response rate and longer OS compared with TAE as the initial treatment for intermediate-stage HCC.
MATERIALS AND METHODS: A total of 2,031 patients with intermediate-stage HCC were screened, and 1,246 patients who underwent TAE or TACE as the first-choice treatment were retrospectively analyzed and baseline-matched according to the 2 treatment methods. Subgroup analysis was performed among patients according to the Up-to-7 criteria. The primary endpoint was overall survival (OS).
RESULTS: A total of 1,246 patients with HCC who underwent TAE or TACE were included; 720 patients underwent TACE, and 526 underwent TAE. The patients in the TAE group exhibited poorer liver function and a significantly higher rate of hepatitis B infection (P < .001) compared with the TACE group. After propensity score matching, 490 well-matched pairs of patients with intermediate-stage HCC were selected for analysis. Univariate analysis showed that TACE significantly prolonged patient survival compared with TAE (P < .001). The 1-, 2-, and 3-year OS rates were 75.9%, 58.9%, and 44.9% for the TACE group and 59.2%, 34.9%, and 23.8% for the TAE group. Multivariate analysis showed a hazard ratio of 0.556 (95% CI, 0.474-0.653; P < .001) for the TACE approach over the TAE approach for OS. The TACE group had a significantly higher overall response rate than the TAE group (33% vs 26%, P < .001).
CONCLUSIONS: TACE resulted in a higher response rate and longer OS compared with TAE as the initial treatment for intermediate-stage HCC.