TY - JOUR
T1 - Conventional vs. Drug-Eluting Beads Transarterial Chemoembolization for Unresectable Hepatocellular Carcinoma—A Propensity Score Weighted Comparison of Efficacy and Safety
AU - Savic, Lynn Jeanette
AU - Chen, Evan
AU - Nezami, Nariman
AU - Murali, Nikitha
AU - Hamm, Charlie Alexander
AU - Wang, Clinton
AU - Lin, Ming De
AU - Schlachter, Todd
AU - Hong, Kelvin
AU - Georgiades, Christos
AU - Chapiro, Julius
AU - Laage Gaupp, Fabian M.
N1 - Funding Information:
The authors have no conflict of interest to declare. Outside the submitted work, L.J.S. received a Postdoctoral Fellowship grant from the Leopoldina during the conduct of the study. L.J.S. is currently a fellow of the BIH Charité Clinician Scientist Program funded by the Charité—Universitätsmedizin Berlin and the Berlin Institute of Health. L.J.S. currently receives research grants from the Berliner Krebsgesellschaft e.V. and the Collaborative Research Center (CRC) 1340 “Matrix in Vision” funded by the Deutsche Forschungsgemeinschaft (DFG). C.A.H. is currently a fellow of the BIH Charité Junior Digital Clinician Scientist Program funded by the Charité—Universitätsmedizin Berlin and the Berlin Institute of Health. Grants from the National Institutes of Health (NIH; NCI R01 CA206180; L.J.S., J.C., M.L.) and the Society of Interventional Oncology (L.J.S., J.C.) were received outside the submitted work. M.L. is a Visage Imaging Inc. employee.
Publisher Copyright:
© 2022 by the authors.
PY - 2022/12
Y1 - 2022/12
N2 - This study compared the efficacy and safety of conventional transarterial chemoembolization (cTACE) with drug-eluting beads (DEB)-TACE in patients with unresectable hepatocellular carcinoma (HCC). This retrospective analysis included 370 patients with HCC treated with cTACE (n = 248) or DEB-TACE (n = 122) (January 2000–July 2014). Overall survival (OS) was assessed using uni- and multivariate Cox proportional hazards models and Kaplan-Meier analysis. Additionally, baseline imaging was assessed, and clinical and laboratory toxicities were recorded. Propensity score weighting via a generalized boosted model was applied to account for group heterogeneity. There was no significant difference in OS between cTACE (20 months) and DEB-TACE patients (24.3 months, ratio 1.271, 95% confidence interval 0.876–1.69; p = 0.392). However, in patients with infiltrative disease, cTACE achieved longer OS (25.1 months) compared to DEB-TACE (9.2 months, ratio 0.366, 0.191–0.702; p = 0.003), whereas DEB-TACE proved more effective in nodular disease (39.4 months) than cTACE (18 months, ratio 0.458, 0.308–0681; p = 0.007). Adverse events occurred with similar frequency, except for abdominal pain, which was observed more frequently after DEB-TACE (101/116; 87.1%) than cTACE (119/157; 75.8%; p = 0.02). In conclusion, these findings suggest that tumor morphology and distribution should be used as parameters to inform decisions on the selection of embolic materials for TACE for a more personalized treatment planning in patients with unresectable HCC.
AB - This study compared the efficacy and safety of conventional transarterial chemoembolization (cTACE) with drug-eluting beads (DEB)-TACE in patients with unresectable hepatocellular carcinoma (HCC). This retrospective analysis included 370 patients with HCC treated with cTACE (n = 248) or DEB-TACE (n = 122) (January 2000–July 2014). Overall survival (OS) was assessed using uni- and multivariate Cox proportional hazards models and Kaplan-Meier analysis. Additionally, baseline imaging was assessed, and clinical and laboratory toxicities were recorded. Propensity score weighting via a generalized boosted model was applied to account for group heterogeneity. There was no significant difference in OS between cTACE (20 months) and DEB-TACE patients (24.3 months, ratio 1.271, 95% confidence interval 0.876–1.69; p = 0.392). However, in patients with infiltrative disease, cTACE achieved longer OS (25.1 months) compared to DEB-TACE (9.2 months, ratio 0.366, 0.191–0.702; p = 0.003), whereas DEB-TACE proved more effective in nodular disease (39.4 months) than cTACE (18 months, ratio 0.458, 0.308–0681; p = 0.007). Adverse events occurred with similar frequency, except for abdominal pain, which was observed more frequently after DEB-TACE (101/116; 87.1%) than cTACE (119/157; 75.8%; p = 0.02). In conclusion, these findings suggest that tumor morphology and distribution should be used as parameters to inform decisions on the selection of embolic materials for TACE for a more personalized treatment planning in patients with unresectable HCC.
KW - TACE
KW - drug-eluting beads
KW - hepatocellular carcinoma
KW - lipiodol
KW - outcome
KW - prognostic prediction
KW - propensity score analysis
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U2 - 10.3390/cancers14235847
DO - 10.3390/cancers14235847
M3 - Article
C2 - 36497329
AN - SCOPUS:85143594825
SN - 2072-6694
VL - 14
JO - Cancers
JF - Cancers
IS - 23
M1 - 5847
ER -