Clinical efficacy of chemoembolization with simultaneous radiofrequency ablation for treatment of adrenal metastases from hepatocellular carcinoma

Hongjun Yuan, Fengyong Liu, Xin Li, Yang Guan, Maoqiang Wang

This study investigated the safety and efficacy of transcatheter arterial chemoembolization (TACE) with simultaneous radiofrequency ablation (RFA) as treatment for adrenal metastases (AM) from hepatocellular carcinoma(HCC). The records of 63 patients with AM who were treated at our Hospital between February 2013 and August 2016 were retrospectively reviewed. Patients were divided into a TACE+RFA group (n = 38) and a control group that received TACE alone (n = 25) according to different treatment methods. The success rate, tumor control rate, and safety of these groups were compared, and survival was evaluated using the Kaplan-Meier method. All treatments could be completed technically successful in both groups. The tumor control rate at first imaging after 1 months was 92.1% (35/38) in the TACE+RFA group and 76.0% (19/25) in the TACE group(P = 0.041). The assisted local tumor control rate allowing repeated interventions in case of local recurrence was 70.0% (7/10) in the TACE+RFA group and 30.8% (4/13) in the TACE group (P = 0.039). During the follow up period, the TACE+RFA group had better survival than the TACE group at 1 year (92.1% vs. 88.0%), 2 years (73.7% vs. 64.0%), and 3 years (55.3% vs. 44.0%) (P = 0.040). The mean survival time was 26.8 ± 2.0 months (95% CI, 22.8-30.7) in the TACE+RFA group and 17.5 ± 2.2 months (95% CI, 13.1-21.8) in the TACE group. TACE+RFA led to better control of local disease progression and longer survival time than TACE alone in the treatment of AM from HCC. Although patients given TACE+RFA had more complications than those given TACE alone, these complications were easily managed.