89.9) for the treatment group and 92.0% (95% CI, 87.6 to 96.7), 86.0% (95% CI, 79.9 to 92.6) and 74.9% (95% CI, 65.5 to 85.7) for the control group (hazard ratio, 0.64; 95% CI, 0.36 to 1.14; P = .130), respectively. The recurrence rates were 40.1% (63/157) in the treatment group and 55.7% (88/158) in the control group. Majority of the adverse events were grade 0-1 (83.8%), with no treatment-related death in both groups.
Conclusion: Postoperative adjuvant HAIC with FOLFOX significantly improved the DFS benefits with acceptable toxicities in HCC patients with MVI.
Key takeaways:
1. Postoperative adjuvant hepatic arterial infusion chemotherapy (HAIC) with FOLFOX improved disease-free survival (DFS) benefits in hepatocellular carcinoma (HCC) patients with microvascular invasion (MVI) compared to routine follow-up.
2. The overall survival rates were similar between the treatment group and the control group, but the treatment group had lower recurrence rates than the control group.
3. The treatment was generally well-tolerated, with mostly grade 0-1 adverse events and no treatment-related deaths reported in either group.
Cancer-specific mortality after cryoablation vs heat- based thermal ablation in T1a renal cell carcinoma
J Urol. 2023 Jan;209(1):81-88. doi: 10.1097/JU.0000000000002984. Epub 2022 Nov 28.
Sorce G, Hoeh B, Hohenhorst L, Panunzio A, Tappero S, Tian Z, Kokorovic A, Larcher A, Capitanio U, Tilki D, Terrone C, Chun FKH, Antonelli A, Saad F, Shariat SF, Montorsi F, Briganti A, Karakiewicz PI.
Purpose: Guidelines suggest less favorable cancer control outcomes for local tumor destruction in T1a renal cell carcinoma patients with tumor size 3.1–4 cm. We compared cancer-specific mortality between cryoablation vs. heat-based thermal ablation in patients with tumor size 3.1–4 cm, as well as in patients with tumor size 3 cm.
Materials and methods: Within the Surveillance, Epidemiology, and End Results database (2004–2018), we identified patients with clinical T1a stage renal cell carcinoma treated with cryoablation or heat-based thermal ablation. After up to 2:1
ratio propensity score matching between patients treated with cryoablation vs. heat-based thermal ablation, we addressed cancer-specific mortality relying on competing risks regression models, adjusted for other-cause mortality and other covariates (age, tumor size, tumor grade and histological subtype).
Results: Of 1,468 assessable patients with tumor size 3.1–4 cm, 1,080 vs. 388 were treated with cryoablation vs heat-based thermal ablation, respectively. After up to 2:1 propensity score matching that resulted in 757 cryoablations vs 388 heat-based thermal ablations, in multivariable competing risks regression models, heat-based thermal ablation was associated with higher cancer-specific mortality (HR:2.02, P < .001), relative to cryoablation. Of 4,468 assessable patients with tumor size 3 cm, 3,354 vs 1,114 were treated with cryoablation vs heat-based thermal ablation, respectively. After up to 2:1 propensity score matching that resulted in 2,217 cryoablations vs 1,114 heat-based thermal ablations, in multivariable competing risks regression models, heat-based thermal ablation was not associated with higher cancer-specific mortality (HR:1.13, P = .5) relative to cryoablation.
Conclusions: Our findings corroborated that in cT1a patients with tumor size 3.1–4 cm, cancer-specific mortality is twofold higher after heat-based thermal ablation vs cryoablation. Conversely, in patients with tumor size 3 cm either ablation technique is equally valid. These findings should be considered at clinical decision making and informed consent.
Key takeaways:
1. The study compared cancer-specific mortality between cryoablation and heat-based thermal ablation in patients with T1a renal cell carcinoma. Cryoablation was found to be associated with lower cancer-specific mortality compared to heat-based thermal ablation in patients with tumor size 3.1–4 cm.
2. The study also found that in patients with tumor size 3 cm, both cryoablation and heat-based thermal ablation techniques were equally valid and there was no significant difference in cancer-specific mortality between the two techniques.
3. The study used the Surveillance, Epidemiology, and End Results (SEER) database from 2004–2018 and conducted up to 2:1 ratio propensity score matching between patients treated with cryoablation vs heat-based thermal ablation. The results highlight the importance of considering these findings in clinical decision making and informed consent.
18 IRQ | SUMMER 2023
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