scholarly journals Comparative Analysis of Radiofrequency Ablation and Microwave Ablation for Critically Located Hepatocellular Carcinomas Smaller than 5 cm

2021 ◽  
Author(s):  
Ravindran Ramalingam ◽  
Amar Mukund ◽  
Karan Manoj Anandpara ◽  
Yashwant Patidar ◽  
Shiv Kumar Sarin
Keyword(s):  
Radiofrequency Ablation ◽  
Tumor Progression ◽  
Microwave Ablation ◽  
Treatment Effectiveness ◽  
Local Tumor Progression ◽  
Local Tumor ◽  
Hepatocellular Carcinomas ◽  
Critical Location ◽  
Critical Locations

Abstract Purpose To compare the safety and efficacy of radiofrequency ablation (RFA) versus microwave ablation (MWA) for hepatocellular carcinomas (HCC) smaller than 5 cm in critical locations. Methods Single-center retrospective study of all patients who underwent RFA/MWA for HCC from July 2015 to Dec 2019. Critical location includes exophytic tumors, tumors ≤ 5 mm from the diaphragm, heart, gallbladder, kidney, gastrointestinal tract, and ≤ 10 mm from large vessels with caliber of ≥ 3 mm. Treatment effectiveness, local tumor progression, and complication rates were evaluated. Results Out of 119 patients with 147 HCC nodules in critical location, 65 (M:F = 49:16; mean age–61.7) were included in RFA group and 54 (M:F =43:11; mean age–60.5) in MWA group. Mean follow-up period was 16.5 and 14.8 months, respectively. At first follow-up imaging, 66/78 tumors in RFA group and 57/69 tumors in MWA group showed complete ablation with primary treatment effectiveness rates of 84.6% and 82.6%, respectively (p = 0.741). Local tumor progression (LTP) rate was 21.8% (17/78) and 20.3% (14/69), respectively (p = 0.826). Median time to LTP was 12 and 13.5 months, respectively. Fourteen tumors in RFA group and 12 in MWA group underwent reablation with a secondary treatment effectiveness rates of 78.6% (14/17) and 83.3% (12/14), respectively (p = 0.757). Mean LTP-free survival was 37.2 and 28.1 months, respectively. The total complication rate was 36.9% and 31.5%, respectively (p = 0.535) with no major complications in both the groups. Conclusion Our data suggest that both MWA and RFA are equally safe and effective for treating HCCs < 5 cm in critical locations.

scholarly journals Percutaneous radiofrequency ablation with a multiple-electrode switching system for medium-sized hepatocellular carcinomas

2020 ◽  
Author(s):  
Yunhua Tan ◽  
Xuesong Li ◽  
Qiang Wang ◽  
Kun Li ◽  
Kuansheng Ma
Keyword(s):  
Radiofrequency Ablation ◽  
Tumor Progression ◽  
Local Tumor Progression ◽  
Switching System ◽  
Local Tumor ◽  
Short Term ◽  
Ablation Volume ◽  
Hepatocellular Carcinomas ◽  
Multiple Electrode

OBJECTIVE: To retrospectively evaluate the safety and short-term therapeutic efficacy of radiofrequency ablation (RFA) with a multiple-electrode switching system (MESS) to treat medium-sized (3.1-5.0 cm) hepatocellular carcinomas (HCCs). SUMMARY OF BACKGROUND DATA: Conventional monopolar RFA is limited in achieving local control for tumors larger than 3 cm. Therefore, MESS-RFA was developed, and can create a sufficiently large ablation volume including the target tumor and a 5−10 mm safety margin in medium-sized tumors METHODS: We performed a total of 168 RFAs with a MESS on 166 patients. The patients were treated under ultrasonographic guidance by percutaneous switching system RFA with a multichannel RF generator and two or three internally cooled electrodes. Technical effectiveness, local progression, and remote recurrence of HCC were determined. RESULTS: For the 166 isolated HCC tumors, the complete ablation rate of MESS-RFA was 98.79% (164/166). Mean ablation time per procedure was 12.33±3.01 min; mean ablation diameter was 5.79±0.61 cm. The complication rate was 2.41%. During follow-up (averaging 16.54 months), local tumor progression occurred in 15/166 patients (9.03%) with technical effectiveness, while new HCCs were detected in 40/166 patients (24.09%). Multivariate analyses revealed that local tumor progression was only associated with serum AFP levels above 100 ng/ml as a risk factor. CONCLUSION: MESS-RFA for achieving sufficient ablation volume is safe and efficient. This method also showed relatively successful therapeutic effectiveness on short-term follow up in the treatment of medium-sized HCCs.

scholarly journals Small single perivascular hepatocellular carcinoma: comparisons of radiofrequency ablation and microwave ablation by using propensity score analysis

2021 ◽  
Author(s):  
Chao An ◽  
Wang-Zhong Li ◽  
Zhi-Mei Huang ◽  
Xiao-Ling Yu ◽  
Yu-Zhi Han ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Tumor Progression ◽  
Significant Interaction ◽  
Microwave Ablation ◽  
Disease Free Survival ◽  
Tumor Control ◽  
Local Tumor Progression ◽  
Local Tumor ◽  
First Line

Abstract Objectives We aimed to compare the therapeutic outcomes of radiofrequency ablation (RFA) and microwave ablation (MWA) as first-line therapies in patients with small single perivascular hepatocellular carcinoma (HCC). Methods A total of 144 eligible patients with small (≤ 3 cm) single perivascular (proximity to hepatic and portal veins) HCC who underwent RFA (N = 70) or MWA (N = 74) as first-line treatment were included. The overall survival (OS), disease-free survival (DFS), and local tumor progression (LTP) rates between the two ablation modalities were compared. The inverse probability of treatment weighting (IPTW) method was used to reduce selection bias. Subgroup analysis was performed according to the type of hepatic vessels. Results After a median follow-up time of 38.2 months, there were no significant differences in OS (5-year OS: RFA 77.7% vs. MWA 74.6%; p = 0.600) and DFS (5-year DFS: RFA 24.7% vs. MWA 40.4%; p = 0.570). However, a significantly higher LTP rate was observed in the RFA group than the MWA group (5-year LTP: RFA 24.3% vs. MWA 8.4%; p = 0.030). IPTW-adjusted analyses revealed similar results. The treatment modality (RFA vs. MWA: HR 7.861, 95% CI 1.642–37.635, p = 0.010) was an independent prognostic factor for LTP. We observed a significant interaction effect of ablation modality and type of peritumoral vessel on LTP (p = 0.034). For patients with periportal HCC, the LTP rate was significantly higher in the RFA group than in the MWA group (p = 0.045). However, this difference was not observed in patients with perivenous HCC (p = 0.116). Conclusions In patients with a small single periportal HCC, MWA exhibited better tumor control than RFA. Key Points • Microwave ablation exhibited better local tumor control than radiofrequency ablation for small single periportal hepatocellular carcinoma. • There was a significant interaction between the treatment effect of ablation modality and type of peritumoral vessel on local tumor progression. • The type of peritumoral vessel is vital in choosing ablation modalities for hepatocellular carcinoma.

scholarly journals Radiofrequency ablation combined with transarterial chemoembolization in treatment of hepatocellular carcinoma adjacent to the second hepatic hilus

2021 ◽  
Author(s):  
Meng-Li Chen ◽  
Hai-Liang Li ◽  
Chen-Yang Guo ◽  
Hao Zhang ◽  
Hang Yuan ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Tumor Progression ◽  
Transarterial Chemoembolization ◽  
Local Tumor Progression ◽  
Local Tumor ◽  
Period Range ◽  
Hepatic Hilus ◽  
Tumor Residue

Abstract Purpose To explore the efficacy and safety of using radiofrequency ablation (RFA) combined with transarterial chemoembolization (TACE) for treating hepatocellular carcinoma (HCC) adjacent to the second hepatic hilus. Methods Between February 2011 and June 2013, 17 patients with HCC underwent combination therapy of TACE and RFA under DSA and CT guidance at our institution. The 17 patients had a total of 23 hepatic tumors, 17 of which were adjacent to the second hepatic hilus. Results TACE combined with RFA was performed successfully in all 17 patients with no mortalities or major morbidities. During the 1-month follow-up, tumors of 15 patients (88.2%) were completely ablated after one therapy session and 2 patients had detectable tumor residue. During the follow-up time period (range 6–52 months), local tumor progression developed in 1 patient (1/17, 5.9%) and both local tumor progression and new tumors appeared in 1 patient (1/17, 5.9%). Also, new tumors developed in the untreated portions of the liver in 8 patients (8/17, 47.1%). No distant metastasis was found. Of the 17 patients, 6 (35.3%) died due to tumor progression (3/17, 17.6%), liver failure (2/17, 11.8%), or massive hemorrhage of the gastrointestinal tract (1/17, 5.9%). The overall survival rates were 94.1% (16/17), 82.4% (14/17), and 61.8% (11/17) at 12, 18, and 24 months, respectively, and the median survival time was 25 months (95% CI 18–27). Conclusion Treatment using combination of TACE and RFA is an effective and safe therapeutic strategy for treating HCC with tumor(s) adjacent to the second hepatic hilus.

Radiofrequency Ablation of Hepatic Metastases: Factors Influencing Local Tumor Progression

2014 ◽  
Vol 21 (9) ◽  
pp. 3090-3095 ◽  
Author(s):  
Chang-Hsien Liu ◽  
Chih-Yung Yu ◽  
Wei-Chou Chang ◽  
Ming-Shen Dai ◽  
Cheng-Wen Hsiao ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Tumor Progression ◽  
Hepatic Metastases ◽  
Local Tumor Progression ◽  
Local Tumor ◽  
Factors Influencing

scholarly journals Combination of radiofrequency ablation and transcatheter arterial chemoembolization to treat hepatocellular carcinoma: measurement of distance from needle tip to nodule for assessment of local tumor progression

2019 ◽  
Vol 47 (6) ◽  
pp. 2516-2523 ◽  
Author(s):  
Wang Haochen ◽  
Wang Jian ◽  
Song Li ◽  
Lv Tianshi ◽  
Tong Xiaoqiang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Factors ◽  
Radiofrequency Ablation ◽  
Tumor Progression ◽  
Minimum Distance ◽  
Transcatheter Arterial Chemoembolization ◽  
Three Dimensional ◽  
Local Tumor Progression ◽  
Local Tumor ◽  
Arterial Chemoembolization

Objective This study was performed to determine the relationship between the minimum distance from the radiofrequency ablation (RFA) needle tip to the tumor and local tumor progression (LTP) of hepatocellular carcinoma (HCC) nodules and identify prognostic factors for LTP. Methods We reviewed 197 patients (197 nodules) who underwent RFA after transcatheter arterial chemoembolization for HCC from January 2010 to January 2015. Three-dimensional registration of images was used to calculate the minimum distance from the tip to the tumor. We then divided the minimum distance into two groups: <2 and ≥2 mm. Contrast-enhanced computed tomography was performed after treatment. The LTP rate was calculated 1 and 3 years after RFA. We performed multivariate analysis to identify independent prognostic factors for LTP. Results The cumulative 1-year LTP rates in the <2- and ≥2-mm groups were 82.7% and 4.3%, respectively, and the cumulative 3-year LTP rates in the two groups were 94.8% and 10.8%, respectively. The minimum distance from the needle tip to the tumor was an independent prognostic factor for LTP. Conclusions A minimum distance of 2 mm from the needle tip to the tumor should be completely ablated along with the tumor.

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