Purpose: This study aimed to compare the effectiveness of transcatheter arterial chemoembolization combined with microwave ablation (TACE-MWA) versus repeated hepatic resection (RHR) in patients with recurrent small hepatocellular carcinoma (sHCC) following primary resection.
Materials and methods: A total of 59 patients diagnosed with recurrent sHCC (≤3 cm) and treated with either TACE-MWA or RHR were recruited from two centers between June 2015 and October 2021. Patients were matched using propensity scores at a 1:1 ratio. Disease-free survival (DFS), overall survival (OS), and complications were assessed and compared between the two treatment groups.
Results: After propensity score matching, 38 patients were included, with 19 in each group. Prior to matching, the 1-, 3-, and 5-year DFS rates for the TACE-MWA group were 68.1%, 46.6%, and 23.3%, respectively, and for the RHR group, they were 84.6%, 47.3%, and 47.3%, respectively. The corresponding 1-, 3-, and 5-year OS rates for TACE-MWA were 100.0%, 83.7%, and 47.8%, while for RHR, they were 100.0%, 95.0%, and 45.2%. After matching, the 1-, 3-, and 5-year DFS rates were 78.0%, 48.3%, and 24.1% for TACE-MWA, and 77.5%, 38.7%, and 38.7% for RHR. The 1-, 3-, and 5-year OS rates for TACE-MWA were 100.0%, 88.9%, and 54.9%, and for RHR, they were 100.0%, 93.3%, and 44.4%. Statistical analysis showed no significant differences in DFS rates (P=0.834 before matching, P=0.490 after matching) or OS rates (P=0.825 before matching, P=0.625 after matching) between the two groups.
Conclusions: TACE-MWA demonstrates comparable effectiveness to RHR in managing recurrent sHCC.
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