Iodine-125 implantation plus transarterial chemoembolization for the treatment of hepatocellular carcinoma of 3–5 cm: A propensity score matching study

BackgroundBoth iodine-125 implantation and transarterial chemoembolization (TACE) are feasible options for hepatocellular carcinoma (HCC). The aim of the research is to investigate whether iodine-125 implantation combined with TACE could improve the overall survival of patients with HCC of 3–5 cm.Methods144 patients with HCC of 3–5 cm who underwent iodine-125 implantation plus TACE and TACE alone were retrospectively enrolled in this study. To reduce the selection bias, 55 matched pairs of patients were generated by propensity score matching (PSM). Their overall survival was compared by the Kaplan–Meier method. Independent prognostic factors were identified by Cox proportional hazards regression model.Resultspatients receiving iodine-125 implantation plus TACE have significantly better overall survival than patients receiving TACE alone (P < 0.001). After PSM, treatment of iodine-125 plus TACE still provide better survival (1-year, 89.1% vs. 65.5%; 3-year, 51.0% vs. 7.4%; P < 0.001). In multivariate analysis, BCLC stage, vascular invasion and treatment modality independently predicted the prognosis. No severe adverse events occurred in both groups.Conclusionfor HCC patients of 3–5 cm for whom surgical intervention is not an option, iodine-125 implantation combined with TACE might be an effective and viable alternative to provide better overall survival.