scholarly journals Circulating Tumor Cell Is a Clinical Indicator of Pretransplant Radiofrequency Ablation for Patients with Hepatocellular Carcinoma

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Zhitao Chen ◽  
Tielong Wang ◽  
Chuanbao Chen ◽  
Xitao Hong ◽  
Jia Yu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Tumor Cell ◽  
San Francisco ◽  
Circulating Tumor Cell ◽  
University Of California ◽  
Clinical Indicator ◽  
Kaplan Meier ◽  
Tumor Number ◽  
Ucsf Criteria

Introduction. It is of great significance to confirm reliable indicators for the guidance of pretransplant radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC). In this study, we aim to investigate whether circulating tumor cell (CTC) status is a clinical indicator for RFA before liver transplantation (LT) in HCC patients. Method. CTC analyses were measured in 79 HCC patients. Clinical outcomes including progression-free (PFS) and overall survival (OS) were compared and analyzed between patients with and without pretransplant RFA. Result. Forty-two patients were detected as CTC-positive and 18 patients received pretransplant RFA. Recurrence was correlated with CTC count ( P = 0.024 ), tumor number ( P = 0.035 ), liver cirrhosis ( P = 0.001 ), Milan criteria ( P = 0.003 ), and University of California San Francisco (UCSF) criteria ( P = 0.001 ). Kaplan–Meier analysis revealed that patients with CTC-positive had a lower PFS rate ( P = 0.0257 ). For CTC-positive patients, the PFS rate of the pretransplant RFA group was significantly higher than the non-pretransplant RFA group (100% vs. 46.7%, P = 0.0236 ). For CTC-negative patients, both PFS rate and OS rate were similar and without significant differences. In multivariate analysis, pretransplant RFA was the independent factor for PFS ( P = 0.025 ). Conclusion. Pretransplant CTC status can guide the administration of pretransplant RFA in HCC patients which can improve PFS in CTC-positive HCC patients.

scholarly journals Circulating Tumor Cell is a Clinical Indicator of Pretransplant Radiofrequency Ablation for Patients with Hepatocellular Carcinoma

2021 ◽  
Author(s):  
Zhitao Chen ◽  
tielong Wang ◽  
Chuanbao Chen ◽  
Xitao Hong ◽  
Jia Yu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Tumor Cell ◽  
Recurrence Rate ◽  
San Francisco ◽  
Circulating Tumor Cell ◽  
Clinical Indicator ◽  
Kaplan Meier ◽  
Tumor Number ◽  
Ucsf Criteria

Abstract Introduction: It is of great significance to confirm reliable indicators for the guidance of pretransplant radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC). In this study, we aim to investigate whether circulating tumor cell (CTC) status is clinical indicator for RFA before liver transplantation (LT) in HCC patients. Method: 79 HCC patients with pretransplant CTC analysis were enrolled in this retrospective study. Clinical outcomes including recurrence and survival were compared and analyzed between patients with and without pretransplant RFA. Result Forty-two patients were detected as CTC- positive and 18 patients received pretransplant RFA. Recurrence was correlated with CTC count (P = 0.024), tumor number (P = 0.035), liver cirrhosis (P = 0.001), Milan criteria (P = 0.003) and University of California San Francisco (UCSF) criteria (P = 0.001). Kaplan-Meier analysis revealed that patients with CTC-positive had higher recurrence rate (P = 0.0257). For CTC-positive patients, the recurrence rate of pretransplant RFA group were significantly lower than non- pretransplant RFA group (0 vs. 46.7%, P = 0.0236). For CTC-negative patients, both recurrence rate and OS rate were similar and without significantly differences. In multivariate analysis, pretransplant RFA was the independent factor for recurrence (P = 0.025). Conclusion Pretransplant CTC status can guide the administration of pretransplant RFA in HCC patients which can reduce recurrence in CTC-positive HCC patients.

scholarly journals Clinical efficacy of locoregional therapy prior to living donor liver transplantation for hepatocellular carcinoma based on UCSF criteria

2019 ◽  
Author(s):  
Tsung-Han Wu ◽  
Chih-Hsien Cheng ◽  
Chen-Fang Lee ◽  
Ting-Jung Wu ◽  
Hong-Shiue Chou ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
San Francisco ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Locoregional Therapy ◽  
Donor Liver ◽  
Donor Liver Transplantation ◽  
Regional Therapy ◽  
Ucsf Criteria

Abstract Background The study analyzed the loco-regional therapy outcomes prior to living donor liver transplantation (LDLT), to provide additional information for decision-making regarding therapeutic strategy for hepatocellular carcinoma (HCC) patients. Methods A total of 308 consecutive patients undergoing LDLTs for HCC between August 2004 and December 2018 were retrospectively analyzed. Patients subjected to loco-regional therapy prior to LT were grouped and the outcomes were compared. Results Overall, HCC recurrence after LDLT were detected in 38 patients (12.3%) during the follow-up period. By the end of the study, 205 patients, 6 of whom with recurrent HCC, were alive. Patients who had radiological imaging beyond the University of California at San Francisco (UCSF) criteria had significant inferior outcomes for both recurrence-free survival (RFS, p = 0.0005) and overall survival (OS, p = 0.0462) despite receiving loco-regional therapy as down-staging intention. Moreover, patients with profound tumor necrosis (TN) had a superior RFS at 3 and 5 years (97.4% and 93.8%, respectively), compared with others. Conclusion LDLT gains a satisfactory result based on the expanded UCSF criteria for HCC. However, the loco-regional therapy prior to LDLT does not seem to provide benefit unless a profound TN is noted.

scholarly journals Outcomes of Liver Transplantation for Hepatocellular Carcinoma Beyond the University of California San Francisco Criteria

2020 ◽  
Vol 104 (1) ◽  
pp. 113-121 ◽  
Author(s):  
David W. Victor ◽  
Howard P. Monsour ◽  
Maha Boktour ◽  
Keri Lunsford ◽  
Julius Balogh ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
San Francisco ◽  
University Of California ◽  
The University

scholarly journals A Comparison between Three-Dimensional Visualization Guided Hepatectomy and Ultrasonography Guided Radiofrequency Ablation in the Treatment of Small Hepatocellular Carcinoma within the Milan Criteria

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Tian-pei Guan ◽  
Chi-hua Fang ◽  
Jian Yang ◽  
Nan Xiang ◽  
Qing-shan Chen ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Cox Regression ◽  
Alternative Therapy ◽  
Three Dimensional ◽  
Primary Treatment ◽  
Small Hepatocellular Carcinoma ◽  
Visualization System ◽  
Tumor Number ◽  
Serum Alpha Fetoprotein

Background. Treatment selection for small hepatocellular carcinoma (sHCC) is controversial. We aimed to compare the outcomes of medical imaging three-dimensional visualization system (MI-3DVS) guided surgical resection (SR) and ultrasonography guided radiofrequency ablation (RFA) for sHCC.Methods. In total, 194 patients who underwent SR or RFA in our hospital between January 2006 and May 2010 were retrospectively enrolled. Overall survival (OS), recurrence-free survival (RFS), and postoperative complications were compared. Cox regression was used to estimate the benefits of MI-3DVS-guided SR on OS and RFS.Results. Ninety-two patients underwent SR and 102 underwent RFA. The SR group experienced more complications (41.3% versus 19.6%) and longer hospital stay (18.04±7.11versus13.06±5.59) (bothp<0.05). The 1-, 2-, 3-, 4-, and 5-year OS was 96.7%, 95.7%, 93.5%, 83.5%, and 61.1% in the SR group and 95.0%, 88.1%, 72.7%, 56.9%, and 39.5% in the RFA group. Corresponding RFS was 95.7%, 94.6%, 84.7%, 59.8%, and 40.2% in SR group and 91.2%, 80.3%, 60.5%, 32.3%, and 22.3% in RFA group. The 5-year OS and RFS were higher in SR group (bothp<0.001). Interestingly, there was no significance in OS and RFS among subgroups aged >60 years. Independent predictors of OS and RFS, respectively, were intervention (HR, 2.769 and 1.933), tumor number (HR, 5.128 and 3.903), and serum alpha-fetoprotein (AFP) (HR, 1.871 and 1.474) (allp<0.05).Conclusions. MI-3DVS based hepatectomy should be considered primary treatment while RFA can be treated as alternative therapy for older patients. Intervention, tumor number, and AFP are independent predictors for both survival and recurrence.

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