Allan Ramos-Esquivel, Departament of Pharmacology, Faculty of Medicine, University of Costa Rica, San José, Costa Rica
Bruno Solís, Department of Radiology, Hospital San Juan de Dios, Caja Costarricense de Seguro Social, San José, Costa Rica
Wilberth Araya, Department of Radiology, Hospital San Juan de Dios, Caja Costarricense de Seguro Social, San José, Costa Rica
Esteban Garita-Rojas, Departament of Pharmacology, Faculty of Medicine, University of Costa Rica, San José, Costa Rica
Ana Marenco-Flores, Departament of Pharmacology, Faculty of Medicine, University of Costa Rica, San José, Costa Rica
Carlos Umaña, Department of Medical Oncolgy, Hospital Rafael Ángel Calderón Guardia, Caja Costarricense de Seguro Social. San José, Costa Rica
Background: Transarterial chemoembolization (TACE) is the most frequently used treatment for intermediate-stage hepatocellular carcinoma (HCC); however, evidence supporting its superiority over bland transarterial embolization (TAE) is limited. Objective: To compare the effectiveness and liver-related complications of TACE and TAE using propensity score matching (PSM). Method: We retrospectively analyzed patients with HCC treated with first-line TACE or TAE at two referral centers between 2019 and 2021. Overall survival (OS) was the primary outcome. Predictors of OS were evaluated using a Cox proportional hazards model after PSM adjustment. Results: A total of 114 patients were included (73 TACE, 41 TAE). Most patients had advanced chronic liver disease, and 72.8% were Child-Pugh A. After a median follow-up of 17.9 months and PSM adjustment, no significant difference in OS was observed between TACE and TAE (HR 1.19; 95% CI 0.64–1.96; p = 0.69). On multivariate analysis, only the Child-Pugh score was independently associated with OS. Liver-related complications were comparable between groups (OR TACE vs. TAE 3.7; 95% CI 0.90–14.62; p = 0.06). Conclusions: After PSM, TACE and TAE show similar long-term survival and liver-related complication rates in patients with HCC.
Keywords: Chemoembolization. Hepatocellular carcinoma. Propensity score.
