Percutaneous ablation for locally advanced hepatocellular carcinoma with tumor portal invasion.

Abstract

INTRODUCTION\nWe aim to assess the outcomes of percutaneous ablation of locally advanced HCC in a tertiary center, which is usually not indicated. We compared to sorafenib or trans-arterial radioembolization (TARE).\n\n\nMETHODS\nWe included 272 patients with HCC and tumor portal invasion treated by percutaneous ablation (n\u2009=\u200944) assessed retrospectively from one center compared to a control group from the SARAH trial including patients treated with sorafenib (n\u2009=\u2009123) or TARE (n\u2009=\u2009105). A propensity-score matching was performed in a subgroup of patients with similar baselines characteristics.\n\n\nRESULTS\n84% of patients treated by ablation were male with a unique nodule (median size 50\u2009mm) in 72.7% of the case. Complete tumor ablation was achieved in 75% of the patients with 20% Dindo-Clavien III-V adverse events including 6.8% of 90-days mortality. Sum of tumor size ≥70\u2009mm was associated with incomplete ablation (p\u2009=\u20090.0239) and a higher risk of death (p\u2009=\u20090.0375). Patients in control group had a higher tumor burden, and more Vp3/4 compared to ablation group. Median overall survival was similar in the ablation and in the control group (16.4 and 14.0 months respectively, p\u2009=\u20090.48). The median progression-free survival was 6.6 months in ablation group compared to 4.2 months in the control group (p\u2009=\u20090.12).\n\n\nCONCLUSION\nPercutaneous ablation for locally advanced HCC was feasible and associated with similar long-term outcomes to sorafenib or TARE.