991P - Real-world comparison of trans-arterial chemoembolization and bland embolization for the treatment of hepatocellular carcinoma: A propensity score analysis

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). 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 intermediate stage HCC treated with first-line TAE (using Lipiodol) or TACE (using either drug-eluting beads or a chemotherapy-lipiodol emulsion) in three referral centers in San José, Costa Rica, between 2019 and 2021. The primary outcome was overall survival (OS). Secondary outcomes included time to systemic treatment, time to liver transplantation, and liver-related complications. A Cox proportional hazard model was used to identify predictors for OS after adjustment using a PSM (1:1 greedy nearest-neighbour matching).

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% of cases. After a median follow-up time of 15.8 months and PSM adjustment, no difference in terms of OS (Hazard Ratio: 1.25; 95% Confidence Interval 95%: 0.69 – 2.23; p = 0.45), time to systemic treatment (HR: 1.52; 95%CI: 0.52 – 4.41; p = 0.44), and transplantation-free survival (HR: 0.34; 95%CI: 0.22 – 2.84; p = 0.30) was observed between patients receiving TACE or TAE. After multivariate analysis only the Child-Pugh score was independently associated to OS (Table). The frequency of liver-related complications was similar among both groups (5 vs 7.5%; p=0.17). Table: 991P

Multivariate analysis for Overall Survival after PSM adjustement

* Statistically significant at p<0.05

Conclusions

TAE and TACE provide similar long-term outcomes and liver-related complications in patients with intermediate HCC.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.