Preliminary evaluation of clinical efficacy and safety of FUA combined with TACE in the treatment of large hepatocellular carcinoma with maximum diameter above 10 cm.

Retrospective analysis of 19 cases of HCC treated by FUA ablation combined with TACE in our hospital during the past 5 years, altogether 34 lesions, with maximum tumor diameter above 10 cm Among these 19 patients, BCLC stage B was seen in 8 cases, C in 11 cases. The effect of local lesion ablation was evaluated by enhanced MRI after operation, by application of MRECIST standard the complications, total survival rate, median survival time, tumor progression time and local recurrence time were followed up.

(1) All 34 lesions were treated with complete ablation (CR) or partial ablation (PR), CR:10.5% (2/19), PR:89.5% (17/19). (2) In 17 patients with elevated serum AFP, their AFP values were all decreased to certain degree one month after the procedure, including AFP dropped to normal in 2 cases, to over 50% in 11 and dropped below 50% in 4 cases. (3) OS was 8 to 69 months, median OS was 16 months, TTR was 3 to 34 months, median TTR was 6 months, TTP was 2 to 34 months, and median TTP was 5 months. The cumulative survival rates of 1 year, 2 years, and 3 years were 63.2%, 26.3% and 15.8%. (4) Major complications of FUA included: fever, skin injury, pain in the operated site, liver function damage, pathological fracture of ribs, 84.4% (38/45) mild. No treatment related death or other serious complications.

Preliminary studies show that FUA ablation combined with TACE to treat maximum diameter of above 10cm HCC, is a promising and safe way to obtain better survival benefit, , thus, it’s worthy of further exploration.