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Objectives <p>To compare segmental (s-) and subsegmental (ss-) transarterial chemoembolization (TACE) for small hepatocellular carcinoma (HCC), in terms of early complete response (CR), local tumor progression (LTP) and impact on hepatic function (ALBI score).</p> Materials and methods <p>A single-center retrospective study was conducted on consecutive patients who underwent s-TACE or ss-TACE as exclusive treatment for small (&lt; 3&#xa0;cm) HCC between 2021 and 2023. The primary endpoints were 1-month CR and LTP rate during follow-up. The effect of the treatments on hepatic function, as assessed by the ALBI score, was analyzed as a secondary endpoint. Propensity score matching (PSM), based on both baseline and procedural data, was applied to minimize selection bias.</p> Results <p>Eighty-nine patients with a total of 114 lesions were enrolled in a per-lesion analysis. No significant differences were found in terms of 1-month CR (74% vs.83%, <i>p</i> = 0.24). Twenty-five transplanted patients were censored at the date of transplantation. During a median follow-up of 16&#xa0;months (range 7–28&#xa0;months), ssTACE showed a significantly higher LTP rate compared to sTACE (38% vs. 7.5%, <i>p</i> = 0.001). The results were confirmed after applying PSM, with a hazard ratio of 4 (95% CI, 2–10) for LTP in the ssTACE group. The median time to LTP was similar for both groups (6.7&#xa0;months vs. 5.6&#xa0;months, <i>p</i> = 0.92). No differences were observed regarding the worsening of liver function.</p> Conclusions <p>Despite similar early CR rates, ssTACE showed a significantly higher LTP rate compared to sTACE, with no significant differences in liver function deterioration between the two approaches.</p>

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Segmental versus subsegmental transarterial chemoembolization (TACE) for small (< 3 cm) hepatocellular carcinoma (HCC): Less selective, more effective? A propensity score-matched analysis

  • 期刊论文

  • 发表日期：

    2026年1月8日

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  • Marco Fronda,
  • Andrea Doriguzzi Breatta,
  • Francesca Menchini,
  • Margherita Viglione,
  • Monica Balint,
  • Laura Bergamasco,
  • Paolo Fonio,
  • Irene Bargellini,
  • Marco Calandri

摘要

Objectives

To compare segmental (s-) and subsegmental (ss-) transarterial chemoembolization (TACE) for small hepatocellular carcinoma (HCC), in terms of early complete response (CR), local tumor progression (LTP) and impact on hepatic function (ALBI score).

Materials and methods

A single-center retrospective study was conducted on consecutive patients who underwent s-TACE or ss-TACE as exclusive treatment for small (< 3 cm) HCC between 2021 and 2023. The primary endpoints were 1-month CR and LTP rate during follow-up. The effect of the treatments on hepatic function, as assessed by the ALBI score, was analyzed as a secondary endpoint. Propensity score matching (PSM), based on both baseline and procedural data, was applied to minimize selection bias.

Results

Eighty-nine patients with a total of 114 lesions were enrolled in a per-lesion analysis. No significant differences were found in terms of 1-month CR (74% vs.83%, p = 0.24). Twenty-five transplanted patients were censored at the date of transplantation. During a median follow-up of 16 months (range 7–28 months), ssTACE showed a significantly higher LTP rate compared to sTACE (38% vs. 7.5%, p = 0.001). The results were confirmed after applying PSM, with a hazard ratio of 4 (95% CI, 2–10) for LTP in the ssTACE group. The median time to LTP was similar for both groups (6.7 months vs. 5.6 months, p = 0.92). No differences were observed regarding the worsening of liver function.

Conclusions

Despite similar early CR rates, ssTACE showed a significantly higher LTP rate compared to sTACE, with no significant differences in liver function deterioration between the two approaches.