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Master Thesis

Endoarterial treatment in combination with percutaneous thermoablation for medium-sized and oligonodular hepatocellular carcinomas

Abstract : Background & Aims: The association of transcatheter arterial chemotherapy infusion (TAC) with percutaneous ablation (PT) has been introduced as a method to increase the size of the ablative zone and treat satellites micronodules. The aim of this study was to evaluate the efficacy of PT and TAC performed in a single session for hepatocellular carcinomas (HCCs) between 30 and 50 mm or oligonodular HCC up to 30 mm.
Methods: Thirty patients with a histologically proven HCC, uninodular between 30 and 50 mm or oligonodular (n≤3) up to 30 mm, treatment-naïve and non-metastatic, received the combination treatment (“PT+TAC group”). A “control” group consisted of 34 patients with uninodular HCC up to 30 mm without any poor prognostic criteria treated with PT alone (“PT group”).
Results: The majority of patients were cirrhotic (90% vs 91%, respectively for the PT+TAC and PT groups), Child-Pugh A (83% vs 85%), with a Performans Status of 0 (80% vs 79%). There was no significant difference in the median alpha-fetoprotein level (15 vs 9.3 μg/l, p=0.39). The 1-, 3-, and 5-year OS was no significantly different in both groups: 100%, 82% and 48.5% in the PT+TAC group vs 94.1%, 72.7% and 65.2% in the PT group (p=0.88). The 1-, 3-, and 5-year relapse-free survival was significantly lower in the PT+TAC group: 59.3%, 18.5% and 5.6% vs 89.3%, 46.4% and 24.5%, in the PT group (p=0.02).
Conclusion: The combination treatment for HCC between 30 and 50 mm or oligonodular up to 30 mm, showed a similar OS, compared to uninodular HCC up to 30 mm without poor prognostic criteria, treated with PT alone, at the price of earlier tumor recurrence.
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Master Thesis
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Submitted on : Friday, January 10, 2020 - 6:33:30 PM
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Dann Ouizeman. Endoarterial treatment in combination with percutaneous thermoablation for medium-sized and oligonodular hepatocellular carcinomas. Human health and pathology. 2019. ⟨dumas-02435472⟩

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