Pesudo-capsulated Hepatocellular Carcinoma: Hepatic Arterial Infusion Chemotherapy versus Transcatheter Arteial Chemoembolization

Abstract

Abstract Background The effectiveness and safety of hepatic arterial infusion chemotherapy (HAIC) or trans-arterial chemoembolization (TACE) for cases with single pseudo-capsuled hepatocellular carcinoma (pHCC), as well as their survival outcomes were investigated. Methods 196 cases with single pHCC (diameter > 5 cm) receiving initial HAIC (n = 92) and TACE (n = 104) were enrolled. The propensity score match (PSM) approach based on Cox models was employed to tune any possible imbalance in treatment assignment. The overall survival (OS), objective response rate (ORR), progression-free survival (PFS), and partial response rate (PRR) of the subjects were investigated by using the Log-rank test. The independent risk factors for outcomes were investigated by univariate and multivariate analyses and the results were analyzed by using the Cox regression model. Results The median follow-up of the subjects was 22.3 months. After PSM, no significant difference was found in OS of the HAIC and TACE groups (OS, 16.8 vs. 12.0 months; P = 0.267), while the median PFS of the TACE group was enhanced compared with the HAIC group (PFS, 5.7 vs. 2.8 months; P = 0.003). Moreover, PRR and ORR of the TACE group were enhanced compared with the HAIC group (PRR, 34.6% vs. 21.7%; P = 0.046; ORR, 35.6% vs. 21.7%; P = 0.033). The nomogram model showed high predictive accuracy and significant discrimination. Conclusions TACE therapy could improve the control of tumor progression compared with HAIC for cases with single pHCC.