Title: Sequential Transarterial Chemoembolization and Early Radiofrequency Ablation
Improves Clinical Outcomes for Early-intermediate Hepatocellular Carcinoma in a 10-year
Single-center Comparative Study
Version: 3 Date: 20 Dec 2020
Reviewer's report:
This retrospective study investigated early RFA (TACE+eRFA) in 96 patients vs. 34 patients
with late RFA(TACE+lRFA) (1-2 TACE before RFA). The results showed a significant
difference of mOS (46 months vs 33 months; P < 0.001)#mTTP (28 months vs 14 months; P
#0.00)#ORR (89.6% vs 61.8%, P=0.000) and DCR (94.8% vs 73.5% P=0.002) between two
groups. Multivariable analysis showed that BCLC stage was an independent risk factor for OS
(P=0.038).
The study is important for clear demonstration that early RFA after TACE will have better
outcomes compared with RFA after 1-2 sessions of RFA.
Minor comments
1. The time of RFA after TACE was dependent on the disappearance of syndrome after
embolization and the recovery of liver function. Please provide the mean, median and range of
interval between RFA and TACE.
2. The TACE+ late RFA group is defined as received 1-2 TACE before RFA, then combined
with RFA treatment. Please provide the interval between two TACE and the proportion of one
or two TACE. Why define 1 or 2 TACE, on demand or 2 TACE as routine practice.
3. Please provide more detailed baseline characteristics between two groups regarding tumor
number and maximal tumor size. Since BCLC stage B has wide heterogeneity, the B1 or B2
may have different outcomes.
Title: Sequential Transarterial Chemoembolization and Early Radiofrequency Ablation
Improves Clinical Outcomes for Early-intermediate Hepatocellular Carcinoma in a 10-year
Single-center Comparative Study
Version: 3 Date: 20 Dec 2020
Reviewer's report:
This retrospective study investigated early RFA (TACE+eRFA) in 96 patients vs. 34 patients
with late RFA(TACE+lRFA) (1-2 TACE before RFA). The results showed a significant
difference of mOS (46 months vs 33 months; P < 0.001)#mTTP (28 months vs 14 months; P
#0.00)#ORR (89.6% vs 61.8%, P=0.000) and DCR (94.8% vs 73.5% P=0.002) between two
groups. Multivariable analysis showed that BCLC stage was an independent risk factor for OS
(P=0.038).
The study is important for clear demonstration that early RFA after TACE will have better
outcomes compared with RFA after 1-2 sessions of RFA.
Minor comments
1. The time of RFA after TACE was dependent on the disappearance of syndrome after
embolization and the recovery of liver function. Please provide the mean, median and range of
interval between RFA and TACE.
2. The TACE+ late RFA group is defined as received 1-2 TACE before RFA, then combined
with RFA treatment. Please provide the interval between two TACE and the proportion of one
or two TACE. Why define 1 or 2 TACE, on demand or 2 TACE as routine practice.
3. Please provide more detailed baseline characteristics between two groups regarding tumor
number and maximal tumor size. Since BCLC stage B has wide heterogeneity, the B1 or B2
may have different outcomes.
Please review this paper.
user
Title: Sequential Transarterial Chemoembolization and Early Radiofrequency Ablation
Improves Clinical Outcomes for Early-intermediate Hepatocellular Carcinoma in a 10-year
Single-center Comparative Study
Version: 3 Date: 20 Dec 2020
Reviewer's report:
This retrospective study investigated early RFA (TACE+eRFA) in 96 patients vs. 34 patients
with late RFA(TACE+lRFA) (1-2 TACE before RFA). The results showed a significant
difference of mOS (46 months vs 33 months; P < 0.001)#mTTP (28 months vs 14 months; P
#0.00)#ORR (89.6% vs 61.8%, P=0.000) and DCR (94.8% vs 73.5% P=0.002) between two
groups. Multivariable analysis showed that BCLC stage was an independent risk factor for OS
(P=0.038).
The study is important for clear demonstration that early RFA after TACE will have better
outcomes compared with RFA after 1-2 sessions of RFA.
Minor comments
1. The time of RFA after TACE was dependent on the disappearance of syndrome after
embolization and the recovery of liver function. Please provide the mean, median and range of
interval between RFA and TACE.
2. The TACE+ late RFA group is defined as received 1-2 TACE before RFA, then combined
with RFA treatment. Please provide the interval between two TACE and the proportion of one
or two TACE. Why define 1 or 2 TACE, on demand or 2 TACE as routine practice.
3. Please provide more detailed baseline characteristics between two groups regarding tumor
number and maximal tumor size. Since BCLC stage B has wide heterogeneity, the B1 or B2
may have different outcomes.
assistant