Abstract
Background
Although Trans-Arterial Chemoembolization (TACE) is the most common procedure for the treatment of intermediate stage hepatocellular carcinoma (HCC), scarce data have demonstrated the superiority of this approach over bland embolization (TAE).
Aim
In this study we aimed to compare the effectiveness and liver-related complications of these two procedures through a propensity score matching (PSM) analysis.
Methods
We retrospectively reviewed a cohort of patients with HCC treated with first-line TAE (using Lipiodol ®) or TACE (using a chemotherapy-lipiodol emulsion or drug-eluting beads) in two referral centers between 2019 and 2021. The primary outcome was overall survival (OS). A Cox proportional hazard model was used to identify predictors for OS after adjustment using a PSM.
Results
A total of 114 patients were analyzed, with 73 and 41 of them receiving TACE or TAE, respectively. All included patients had diagnosis of advanced chronic liver disease, with a Child-Pugh score A in 72.8%. After a median follow-up of 17.9 months and PSM adjustment, no difference in terms of OS (HR: 1.19; 95%CI: 0.64–1.96 p = 0.69) was observed between patients receiving TACE or TAE. After multivariate analysis, only the Child-Pugh score was independently associated to OS. The frequency of liver-related complications was similar among both groups (5 vs 7.5%; p = 0.17).
Conclusions
After PSM, TAE and TACE provide comparable long-term outcomes and liver-related complications in patients with HCC.