scholarly journals Transcatheter arterial chemoembolization combined with radiofrequency ablation delays tumor progression and prolongs overall survival in patients with intermediate (BCLC B) hepatocellular carcinoma

BMC Cancer ◽  
2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Xin Yin ◽  
Lan Zhang ◽  
Yan-Hong Wang ◽  
Bo-Heng Zhang ◽  
Yu-Hong Gan ◽  
...  
2019 ◽  
Vol 47 (6) ◽  
pp. 2516-2523 ◽  
Author(s):  
Wang Haochen ◽  
Wang Jian ◽  
Song Li ◽  
Lv Tianshi ◽  
Tong Xiaoqiang ◽  
...  

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.


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 4077-4077
Author(s):  
Xin Yin ◽  
Bei Tang ◽  
Yu-Hong Gan ◽  
Yan-hong Wang ◽  
Yi Chen ◽  
...  

4077 Background: To determine treatment efficacy and safety of transarterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) (hereafter, TACE+RFA) in patients with intermediate stage (BCLC stage B) hepatocellular carcinoma (HCC) beyond Milan criteria. Methods: In this randomized clinical trial, 110 patients with intermediate stage HCC beyond Milan criteria (single tumor with diameter 5-7cm, median; 3-5 multiple nodules with diameter less than 5cm) were included and randomly assigned to TACE+RFA group (n=55) and TACE group (n=55) at liver cancer institute, Zhongshan hospital. The primary endpoint was overall survival (OS). The secondary end point was progression-free survival (PFS) , time to progress (TTP) and best objective response (BOR). Results: The median OS in TACE+RFA and TACE group were 29 and 18 months, respectively. The median TTP and BOR were 15.7 months and 69.1 % in TACE+RFA group and 12.4 months and 40.0 % in TACE group (P=0.004). The 1-, 3-, and 4-year overall survivals for TACE+RFA group and TACE group were 97.2%, 67.9% and 59.4% versus 84.0%, 46.7% and 37.3% , respectively (P = 0.008). The corresponding PFS were 47.3%, 27.2% and 21.7% versus 35.6%,15.3% and 11.4% , respectively (P = 0.04).The incidences of major complications in TACE+RFA group were comparable to those in TACE group (P=0.14). Conclusions: TACE+RFA was superior to TACE in improving tumor response and overall survival for patients with intermediate stage (BCLC stage B) hepatocellular carcinoma beyond Milan criteria. Clinical trial information: NCT03636620.


2021 ◽  
Author(s):  
Xinxin Wang ◽  
Yang Che ◽  
Shiyong Chen ◽  
Biao Wu ◽  
Yu He ◽  
...  

Abstract Background To evaluate the curative effect and safety of compare radiofrequency ablation (RFA) with or without transcatheter arterial chemoembolization (TACE) in the treatment of hepatocellular carcinoma (HCC)with the help of a meta-analysis of randomized controlled trials (RCTs) . Materials and Methods RCTs comparing TACE combined with RFA and RFA alone were searched electronically using PubMed, The Cochrane Library, and EMBASE. Fixed and random-effects were used to measure pooled estimates. Research indicators included overall survival (OS), recurrence-free survival (RFA), tumor progression and complications. Results Overall, 6 RCTs were included in this meta-analysis, with a total of 527 patients (TACE-RFA: 271; RFA: 256). 3- and5-year OS rate was higher in the TACE-RFA group than in the RFA group (OR = 1.74; 95% CI: 1.17–2.59; p = 0.006; OR = 2.19; 95% CI: 1.49–3.22; p < 0.0001). The 3- and 5-year RFS rate in the TACE-RFA group was higher than that in the RFA group (OR = 1.92, 95% CI: 1.30 ~ 2.82, p = 0.0009; OR = 1.81, 95% CI: 1.21 ~ 2.70, p = 0.004, respectively). The rate of tumor progression was lower in the TACE-RFA group than in the RFA group (OR = 0.57; 95% CI: 0.38 ~ 0.85; p = 0.005). No significant differences in terms of 1-year OS rate and complications rate were observed between groups.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Chuang Jiang ◽  
Gong Cheng ◽  
Mingheng Liao ◽  
Jiwei Huang

Abstract Background There is still some debate as to whether transcatheter arterial chemoembolization (TACE) plus radiofrequency ablation (RFA) is better than TACE or RFA alone. This meta-analysis aimed to compare the efficacy and safety of TACE plus RFA for hepatocellular carcinoma (HCC) with RFA or TACE alone. Methods We searched PubMed, MEDLINE, Embase, Cochrane Library, and CNKI (China National Knowledge Infrastructure) for all relevant randomized controlled trials and retrospective studies reporting overall survival (OS), recurrence-free survival (RFS), and complications of TACE plus RFA for HCC, compared with RFA or TACE alone. Results Twenty-one studies involving 3413 patients were included. TACE combined with RFA was associated with better OS (hazard ratio [HR]=0.62, 95% confidence intervals [CI] = 0.55–0.71, P < 0.001) and RFS (HR = 0.52, 95% CI = 0.39–0.69, P < 0.001) than TACE alone; compared with RFA alone, TACE plus RFA resulted in longer OS (HR = 0.63, 95% CI = 0.53–0.75, P < 0.001) and RFS (HR = 0.60, 95% CI = 0.51–0.71, P < 0.001). Subgroup analyses by tumor size also showed that combined treatment resulted in better OS and RFS compared with RFA alone in patients with HCC larger than 3 cm. Combined treatment resulted in similar rate of major complications compared with TACE or RFA alone (OR = 1.78, 95% CI = 0.99–3.20, P = 0.05; OR = 1.00, 95% CI = 0.42–2.38, P = 1.00, respectively). Conclusions TACE combined with RFA was more effective for HCC than TACE alone. For patients with a tumor larger than 3 cm, the combined treatment also achieved a better effect than RFA alone.


2013 ◽  
Vol 31 (4) ◽  
pp. 426-432 ◽  
Author(s):  
Zhen-Wei Peng ◽  
Yao-Jun Zhang ◽  
Min-Shan Chen ◽  
Li Xu ◽  
Hui-Hong Liang ◽  
...  

Purpose To compare radiofrequency ablation (RFA) with or without transcatheter arterial chemoembolization (TACE) in the treatment of hepatocellular carcinoma (HCC). Patients and Methods A randomized controlled trial was conducted on 189 patients with HCC less than 7 cm at a single tertiary referral center between October 2006 and June 2009. Patients were randomly asssigned to receive TACE combined with RFA (TACE-RFA; n = 94) or RFA alone (n = 95). The primary end point was overall survival. The secondary end point was recurrence-free survival, and the tertiary end point was adverse effects. Results At a follow-up of 7 to 62 months, 34 patients in the TACE-RFA group and 48 patients in the RFA group had died. Thirty-three patients and 52 patients had developed recurrence in the TACE-RFA group and RFA group, respectively. The 1-, 3-, and 4-year overall survivals for the TACE-RFA group and the RFA group were 92.6%, 66.6%, and 61.8% and 85.3%, 59%, and 45.0%, respectively. The corresponding recurrence-free survivals were 79.4%, 60.6%, and 54.8% and 66.7%, 44.2%, and 38.9%, respectively. Patients in the TACE-RFA group had better overall survival and recurrence-free survival than patients in the RFA group (hazard ratio, 0.525; 95% CI, 0.335 to 0.822; P = .002; hazard ratio, 0.575; 95% CI, 0.374 to 0.897; P = .009, respectively). There were no treatment-related deaths. On logistic regression analyses, treatment allocation, tumor size, and tumor number were significant prognostic factors for overall survival, whereas treatment allocation and tumor number were significant prognostic factors for recurrence-free survival. Conclusion TACE-RFA was superior to RFA alone in improving survival for patients with HCC less than 7 cm.


2020 ◽  
Vol 9 (4) ◽  
pp. 936
Author(s):  
Takumi Kawaguchi ◽  
Sachiyo Yoshio ◽  
Yuzuru Sakamoto ◽  
Ryuki Hashida ◽  
Shunji Koya ◽  
...  

The outcome of patients with hepatocellular carcinoma (HCC) is still poor. Decorin is a small leucine-rich proteoglycan, which exerts antiproliferative and antiangiogenic properties in vitro. We aimed to investigate the associations of decorin with physical function and prognosis in patients with HCC. We enrolled 65 patients with HCC treated with transcatheter arterial chemoembolization (median age, 75 years; female/male, 25/40). Serum decorin levels were measured using enzyme-linked immunosorbent assays; patients were classified into the High or Low decorin groups by median levels. Associations of decorin with physical function and prognosis were evaluated by multivariate correlation and Cox regression analyses, respectively. Age and skeletal muscle indices were not significantly different between the High and Low decorin groups. In the High decorin group, the 6-min walking distance was significantly longer than the Low decorin group and was significantly correlated with serum decorin levels (r = 0.2927, p = 0.0353). In multivariate analysis, the High decorin group was independently associated with overall survival (hazard ratio 2.808, 95% confidence interval 1.016–8.018, p = 0.0498). In the High decorin group, overall survival rate was significantly higher than in the Low decorin group (median 732 days vs. 463 days, p = 0.010). In conclusion, decorin may be associated with physical function and prognosis in patients with HCC.


2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Shiying Wang ◽  
Liping Zhuang ◽  
Zhiqiang Meng

Objective. To identify the efficiency and safety of transcatheter arterial chemoembolization (TACE) combined with percutaneous ethanol (PEI) for patients with hepatocellular carcinoma (HCC) more than 3 cm in diameter in comparison with those of transcatheter arterial chemoembolization monotherapy. Methods. All databases were searched up to February 22, 2013. The literature retrieval was conducted through Pubmed, Web of Science, and Cochrane Library. We also searched Chinese databases, including Chinese National Knowledge Infrastructure (CNKI), Chinese Biology Medicine (CBM), Wanfang database, and VIP Database for Chinese Technical Periodicals without language limitations. Results. Based on the criteria, we found 12 RCTs including 825 patients. Our results showed that TACE combined with PEI therapy compared with TACE monotherapy improved overall survival and tumor response. Conclusion. The combination of TACE and PEI compared with TACE monotherapy improved overall survival rates and tumor response of patients with large HCC. Besides, larger and more methodologically rigorous clinical trials are needed to confirm this outcome.


Sign in / Sign up

Export Citation Format

Share Document