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已发表论文
符合米兰标准的肝细胞癌患者经动脉化疗栓塞与射频消融疗效及安全性的比较：一项倾向评分匹配研究
Authors Tang W, Huang Y, Wang T, Yang J, Zhao Z
Received 25 September 2025
Accepted for publication 16 December 2025
Published 24 December 2025 Volume 2025:12 Pages 2939—2950
DOI https://doi.org/10.2147/JHC.S566767
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Mohamed Shaker
Wei Tang,* Ya’nan Huang,* Ting Wang, Jianfeng Yang, Zhenhua Zhao
Department of Radiology, Shaoxing People’s Hospital, Shaoxing, Zhejiang, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Zhenhua Zhao, Department of Radiology, Shaoxing People’s Hospital, No. 568 Zhongxing North Road, Yuecheng District, Shaoxing, Zhejiang, 312000, People’s Republic of China, Tel +0086-575-88508888, Email zhao2075@163.com
Objective: This study aims to compare the efficacy and safety of transarterial chemoembolization (TACE) and radio-frequency ablation (RFA) in the treatment of hepatocellular carcinoma (HCC) within the Milan criteria.
Materials and Methods: 162 patients with HCC who underwent TACE (n=97) or RFA (n=65) from February 2011 to December 2024. A matched cohort composed of 88 patients was included after propensity score matching (PSM). The primary endpoint was overall survival (OS), and the secondary endpoints were progression-free survival (PFS) and safety.
Results: Baseline characteristics were balanced between the two groups after propensity score matching. Before matching, the 1-, 3-, and 5-year OS rates were 71.0%, 48.7%, 34.1%, respectively, in the TACE group and 87.0%, 69.5%, 63.1%, respectively, in the RFA group (P = 0.006). The 1-, 2-, and 3-year PFS rates were 37.1%, 25.1%, 18.3% in TACE group, and 52.6%, 43.3%, 40.6% in RFA group (P=0.009). After matching, the 1-, 3-, and 5-year OS rates were81.2%, 48.1%, 37.1%, respectively, in the TACE group and 88.6%, 65.6%, and 54.6%, respectively, in the RFA group (p=0.15). The 1-, 2-, and 3-year PFS rates were 33.3%, 20.5%, 17.5% in TACE group, and52.3%, 40.2%, 37.8% in RFA group (P=0.036). Before and after PSM, the incidence of major complications (before PSM P=0.306, after PSM P=0.08) and length of hospital stay (before PSM P=0.25, after PSM P=0.406) were similar between the two groups.
Conclusion: In the treatment of HCC within the Milan criteria, RFA demonstrated a superior median PFS compared to TACE, although there was no significant difference in OS between the two therapies.
Plain Language Summary: Question: There is a paucity of comparative studies evaluating transarterial chemoembolization (TACE) versus radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) within Milan criteria.
Findings: Radiofrequency ablation (RFA) and transarterial chemoembolization (TACE) demonstrated comparable overall survival outcomes.
Clinical Relevance: For hepatocellular carcinoma (HCC) patients within Milan criteria who are ineligible for surgical resection or liver transplantation, radiofrequency ablation (RFA) is recommended as the preferred treatment option.
Keywords: carcinoma, hepatocellular, propensity score, chemoembolization, ablation
Department of Radiology, Shaoxing People’s Hospital, Shaoxing, Zhejiang, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Zhenhua Zhao, Department of Radiology, Shaoxing People’s Hospital, No. 568 Zhongxing North Road, Yuecheng District, Shaoxing, Zhejiang, 312000, People’s Republic of China, Tel +0086-575-88508888, Email zhao2075@163.com
Objective: This study aims to compare the efficacy and safety of transarterial chemoembolization (TACE) and radio-frequency ablation (RFA) in the treatment of hepatocellular carcinoma (HCC) within the Milan criteria.
Materials and Methods: 162 patients with HCC who underwent TACE (n=97) or RFA (n=65) from February 2011 to December 2024. A matched cohort composed of 88 patients was included after propensity score matching (PSM). The primary endpoint was overall survival (OS), and the secondary endpoints were progression-free survival (PFS) and safety.
Results: Baseline characteristics were balanced between the two groups after propensity score matching. Before matching, the 1-, 3-, and 5-year OS rates were 71.0%, 48.7%, 34.1%, respectively, in the TACE group and 87.0%, 69.5%, 63.1%, respectively, in the RFA group (P = 0.006). The 1-, 2-, and 3-year PFS rates were 37.1%, 25.1%, 18.3% in TACE group, and 52.6%, 43.3%, 40.6% in RFA group (P=0.009). After matching, the 1-, 3-, and 5-year OS rates were81.2%, 48.1%, 37.1%, respectively, in the TACE group and 88.6%, 65.6%, and 54.6%, respectively, in the RFA group (p=0.15). The 1-, 2-, and 3-year PFS rates were 33.3%, 20.5%, 17.5% in TACE group, and52.3%, 40.2%, 37.8% in RFA group (P=0.036). Before and after PSM, the incidence of major complications (before PSM P=0.306, after PSM P=0.08) and length of hospital stay (before PSM P=0.25, after PSM P=0.406) were similar between the two groups.
Conclusion: In the treatment of HCC within the Milan criteria, RFA demonstrated a superior median PFS compared to TACE, although there was no significant difference in OS between the two therapies.
Plain Language Summary: Question: There is a paucity of comparative studies evaluating transarterial chemoembolization (TACE) versus radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) within Milan criteria.
Findings: Radiofrequency ablation (RFA) and transarterial chemoembolization (TACE) demonstrated comparable overall survival outcomes.
Clinical Relevance: For hepatocellular carcinoma (HCC) patients within Milan criteria who are ineligible for surgical resection or liver transplantation, radiofrequency ablation (RFA) is recommended as the preferred treatment option.
Keywords: carcinoma, hepatocellular, propensity score, chemoembolization, ablation