Long-Term Outcomes of Transarterial Chemoembolization Combined with Radiofrequency Ablation Versus Transarterial Chemoembolization Alone for Recurrent Hepatocellular Carcinoma After Surgical Resection

Background Ultrasound (US)-guided radiofrequency ablation (RFA) for small hepatocellular carcinoma (HCC) is often infeasible due to unfavorable location and poor conspicuity. Those small HCCs can be treated with combined transarterial chemoembolization (TACE) and RFA. Purpose To evaluate long-term outcomes of combined TACE and RFA for small treatment-naïve HCC infeasible for US-guided RFA. Material and Methods Between February 2009 and January 2014, 69 patients with small (≤3 cm) HCC infeasible for US-guided RFA received TACE and subsequent RFA in one session as a first-line treatment. Local tumor progression (LTP), overall survival (OS), and event-free survival rates were evaluated. Univariate and multivariate analyses were conducted to identify prognostic factors. Results Cumulative rates of LTP were 4.4%, 6.8%, 8.2%, 9.5%, and 9.5% at one, two, three, five, and seven years, respectively. Cumulative one-, two-, three-, five-, and seven-year OS rates were 100%, 95%, 89%, 80%, and 80%, respectively. Cumulative one-, two-, three-, five-, and seven-year event-free survival rates were 81%, 63%, 54%, 31%, and 20%, respectively. No significant prognostic factors for LTP, OS, and event-free survival were identified in univariate analysis. Conclusion Combined TACE and RFA appears to be an effective treatment for small treatment-naïve HCC infeasible for US-guided RFA in terms of LTP and OS.

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4:21 PM Abstract No. 281 Long-term outcomes in superselective transarterial chemoembolization using lipiodol with 3D: safety margin versus radiofrequency ablation for solitary small hepatocellular carcinoma

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2018.01.312 ◽

2018 ◽

Vol 29 (4) ◽

pp. S121

Author(s):

T. Matsumoto ◽

H. Nishiofuku ◽

T. Tanaka ◽

T. Sato ◽

T. Masada ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Radiofrequency Ablation ◽

Transarterial Chemoembolization ◽

Safety Margin ◽

Small Hepatocellular Carcinoma ◽

Long Term Outcomes

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Role of Radiofrequency Ablation in Patients with Hepatocellular Carcinoma Who Undergo Prior Transarterial Chemoembolization: Long-Term Outcomes and Predictive Factors

Gut and Liver ◽

10.5009/gnl13356 ◽

2014 ◽

Vol 8 (5) ◽

pp. 543-551 ◽

Cited By ~ 11

Author(s):

Won Sohn ◽

Moon Seok Choi ◽

Ju Yeon Cho ◽

Geum-Youn Gwak ◽

Yong-Han Paik ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Radiofrequency Ablation ◽

Predictive Factors ◽

Transarterial Chemoembolization ◽

Long Term Outcomes

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Sequential transarterial chemoembolization and early radiofrequency ablation improves clinical outcomes for early-intermediate hepatocellular carcinoma in a 10-year single-center comparative study

BMC Gastroenterology ◽

10.1186/s12876-021-01765-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Liangliang Yan ◽

Yanqiao Ren ◽

Kun Qian ◽

Xuefeng Kan ◽

Hongsen Zhang ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Radiofrequency Ablation ◽

Combination Therapy ◽

Clinical Outcomes ◽

Transarterial Chemoembolization ◽

Response Rate ◽

Multivariable Analysis ◽

Complication Rates ◽

Tace Treatment

Abstract Background Transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) are effective treatment methods for unresectable hepatocellular carcinoma (HCC). However, there is still a lack of clinical research on whether early sequential RFA, compared with late combination therapy, can improve the long-term efficacy of initial TACE treatment. Methods This retrospective study investigated a cohort of patients who underwent combination therapy using TACE and RFA (TACE followed by RFA) from January 2010 to January 2020 at our medical centre. A total of 96 patients underwent TACE combined with early RFA (usually during the first hospitalization), which was called TACE + eRFA. Thirty-four patients received 1–2 palliative TACE treatments first and then underwent TACE treatment combined with late RFA (TACE + lRFA). All patients continued to receive palliative TACE treatments after intrahepatic lesion progression until reaching intolerance. The overall survival (OS) rate, time to tumour progression (TTP), tumour response rate and major complication rates were compared between the two groups. Results There were significant differences in the median OS (46 months vs 33 months; P = 0.013), median TTP (28 months vs 14 months; P < 0.00), objective response rate (ORR) (89.6% vs 61.8%, P = 0.000) and disease control rate (DCR) (94.8% vs 73.5% P = 0.002) between the two groups. Multivariable analysis revealed that the Barcelona Clinic Liver Cancer stage was an independent risk factor for OS. Meanwhile, multivariable analysis revealed that TACE + eRFA was associated with an enhanced TTP. Conclusion Early sequential RFA treatment in patients with early-intermediate HCC can improve local tumour control and clinical outcomes while reducing the frequency of TACE treatment. In clinical practice, in HCC patients initially treated with TACE, it is recommended to combine RFA as soon as possible to obtain long-term survival.

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Transarterial Chemoembolization Combined With Radiofrequency Ablation Versus Repeat Hepatectomy for Recurrent Hepatocellular Carcinoma After Curative Resection: A 10-Year Single-Center Comparative Study

Frontiers in Oncology ◽

10.3389/fonc.2021.713432 ◽

2021 ◽

Vol 11 ◽

Author(s):

Xin Zheng ◽

Yanqiao Ren ◽

Hanqing Hu ◽

Kun Qian

Keyword(s):

Hepatocellular Carcinoma ◽

Radiofrequency Ablation ◽

Transarterial Chemoembolization ◽

Curative Resection ◽

Progression Free Survival ◽

Repeat Hepatectomy ◽

Tumor Diameter ◽

Recurrent Hepatocellular Carcinoma ◽

Significant Difference ◽

Hepatectomy Group

BackgroundThe purpose of this study was to compare the efficacy and safety of transarterial chemoembolization (TACE) in combination with radiofrequency ablation (RFA) (TACE-RFA) and repeat hepatectomy in the treatment of recurrent hepatocellular carcinoma (HCC) after curative resection.MethodsThis retrospective study evaluated consecutive medical records of patients who received either TACE-RFA or repeat hepatectomy between January 2010 and May 2021. Overall survival (OS), progression-free survival (PFS), and complications were compared.ResultsOf the 2672 patients who received either TACE-RFA or repeat hepatectomy, 111 eligible patients were included in our study, 63 in the TACE-RFA group and 48 in the repeat hepatectomy group. The median OS was 38 months in the TACE-RFA group and 42 months in the repeat hepatectomy group, with no statistically difference between the two groups (P=0.45). Meanwhile, there was also no statistically significant difference in PFS between the two groups (P=0.634). Although both groups achieved similar outcomes, the rate of major complications was significantly higher in the repeat hepatectomy group (P=0.003).ConclusionsPatients with recurrent HCC in the TACE-RFA group and the repeat hepatectomy group had similar OS and PFS regardless of the patient’s tumor diameter, but the TACE-RFA group was safer and more minimally invasive.

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Comparison of short- and long-term outcomes of patients with hepatocellular carcinoma undergoing surgical resection, local ablation, angiological treatment or palliation: Single center results over 35 years

10.21203/rs.2.12755/v1 ◽

2019 ◽

Author(s):

Valtteri Kairaluoma ◽

Mira Karjalainen ◽

Juha Saarnio ◽

Jarmo Niemelä ◽

Heikki Huhta ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Surgical Resection ◽

Survival Rates ◽

Confounding Factors ◽

Single Center ◽

Long Term Outcomes ◽

Local Ablation ◽

Short And Long Term ◽

Overall Survival Rates

Abstract Background Hepatocellular carcinoma (HCC) is one leading cause of cancer mortality often presenting at inoperable stage. The aim of this study was to examine and compare surgically resected, locally ablated, angiologically treated and palliatively treated HCC patients’ short- and long-term outcomes in a single center over 35 year period. Methods All HCC diagnosed in Oulu University Hospital between 1983-2018 were identified from hospital records (n=273). Patients underwent hepatic resection (n=49), local ablation (RF, laser ablation or PEI; n=25), angiological treatments (TACE, TAE and SIRT; n=48) or palliative treatment (chemotherapy, best supportive care; n=151). Primary outcomes of the study were postoperative complications within 30 days after the operation, and short- (30- and 90-day) and long-term (1, 3 and 5-year) survival. Results were adjusted with sex, age, comorbidities, cirrhosis, Child-Pugh index points, ASA status, year of operation and stage. Results Surgically resected patients were younger than patients in other groups. Recurrence and local recidives occurred more often in local ablation group and in angiological treatment group (p<0.001). Surgical resection rate was 17.9%. Overall complication rates in surgical resection, local ablation and angiological group were 71.5%, 32.0% and 58.3%, (p<0.001). Major complications in respective groups occurred in 28.6%, 8.0% and 27.1%. Overall survival rates in surgical resection group were at 30 and 90 days, 1-, 3 and 5-years 95.9%, 95.9%, 85.1%, 59.0% and 51.2%. In local ablation group, respective overall survival rates were 100.0%, 100.0%, 86.1%, 43.1% and 18.8%, and in angiological group 95.8%, 93.6%, 56.1%, 26.3% and 6.6%. In cox regression model adjusted for confounding factors, local ablation and angiological treatment were significant risk factors for mortality. Prognosis was poor in palliatively treated patients. Conclusions Based on our study on Northern Finland population, the surgical resection of HCC seems to be the most effective treatment considering long-term survival and tumor recurrence after adjustment for confounding factors.

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