RFA Versus SBRT for Recurrent Small HCC

2019 ◽  
Author(s):  
Keyword(s):  
Small Hcc

Prediction of Recurrence after HCC Resection

1994 ◽  
Vol 35 (4) ◽  
pp. 329-334 ◽  
Author(s):  
M. Yamamoto ◽  
Y. Iimuro ◽  
M. Mogaki ◽  
K. Kachi ◽  
H. Fujii ◽  
...  
Keyword(s):  
Imaging Techniques ◽  
Tumor Vasculature ◽  
The Other ◽  
High Recurrence Rate ◽  
Small Hepatocellular Carcinoma ◽  
Conventional Imaging ◽  
Cumulative Survival ◽  
Preoperative Ct ◽  
Small Hcc ◽  
Better Than

In trying to clarify the high recurrence rate after removal of small hepatocellular carcinoma (HCC), we assessed the postoperative evolution of minute hepatic Lipiodol deposits which had been diagnosed as artifacts on the preoperative Lipiodol-CT. Of 27 patients with solitary HCC less than 5 cm in diameter, 14 had such Lipiodol deposits in the preoperative CT and 9 of them (64%) developed recurrent tumors. On the other hand, 6 of the 13 patients without deposits (46%) suffered recurrence, but in 5 of these 6 patients the HCC was metachronous multicentric. The cumulative survival rate of the non-deposit group was better than that of the deposit group (p < 0.1). The present study suggested that, even in patients with small HCC, minute concomitant tumors invisible by conventional imaging techniques may exist at the time of surgery. Some of these lesions without sufficient tumor vasculature showing a hypervascular blush on angiography appear to retain small, vague Lipiodol deposits.

Malignant progression of a small HCC nodule: Hypovascular ‘early HCC’ converted to hypervascular ‘small HCC’ within six months

2007 ◽  
Vol 39 (9) ◽  
pp. 883-890 ◽  
Author(s):  
R. Golfieri ◽  
F. Coppola ◽  
F. Fusco ◽  
S. Li Bassi ◽  
P. Caraceni ◽  
...  
Keyword(s):  
Malignant Progression ◽  
Early Hcc ◽  
Small Hcc

Indication for local ablation therapy for small HCC with reference to intrahepatic metastasis

2001 ◽  
Vol 120 (5) ◽  
pp. A556
Author(s):  
Takuji Okusaka ◽  
Shuichi Okada ◽  
Hideki Ueno ◽  
Masafumi Ikeda ◽  
Hitoshi Kuriyama ◽  
...  
Keyword(s):  
Intrahepatic Metastasis ◽  
Local Ablation ◽  
Ablation Therapy ◽  
Local Ablation Therapy ◽  
Small Hcc

Single hepatocellular carcinoma (HCC) ineligible for surgical resection (SR): High tumor control rate with conformal radiotherapy + transarterial chemoembolization (CRT + TACE).

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 433-433
Author(s):  
Philippe Merle ◽  
Agnes Rode ◽  
Anne-Frederique Manichon ◽  
Nadim Fares ◽  
Celia Prevost ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Proportional Hazards ◽  
Univariate Analysis ◽  
Cox Proportional Hazards ◽  
Tumor Control ◽  
Continuous Variables ◽  
Tumor Control Rate ◽  
Curative Therapy ◽  
Poor Outcome ◽  
Small Hcc

433 Background: SR is a curative therapy of single HCC. CRT is efficient for small HCC (≤ 5 cm), whereas its combination to TACE (CRT+TACE) is needed for large ( > 5 cm) HCC. However, SR remains the gold-standard in guidelines for large HCC. This work aims to compare these approaches. Methods: Retrospective analysis of prospectively collected data, on patients (pts) included at Lyon North Hepatobiliary Centre, Child-Pugh-A, single HCC. CRT+TACE was decided at the HCC board by ineligibility for SR, radiofrequency or liver transplantation. Outcome of pts was compared between CRT+TACE and SR. Continuous variables were assessed by the t-Student test, and survival analysis by the Cox proportional-hazards regression. Results: 178 pts (68 CRT+TACE, 110 SR), males 78%, cirrhosis 52%, etiology (alcohol 46%, HCV 17%, HBV 13%, NASH 30%), 103 small, 75 large HCC, median age 66 ys, tumor size 50 mm, AFP 8 ng/mL, albuminemia (ALB) 39 g/L, platelets (PLAT) 166 Giga/L, follow-up 33 months. CRT+TACE complete response rate: 92% small / 80% large HCC. Small HCC comparison: CRT+TACE vs SR: age (67 vs 64, P= NS), cirrhosis (94% vs 47%, P< 0.0001), ALB (36 vs 40, P= 0.0001), PLAT (150 vs 201, P= 0.02), AFP (381 vs 300, P= NS). CRT-TACE was a poor outcome factor in univariate analysis for overall survival (OS) (HR 2.32; P= 0.01), progression-free survival (PFS) (HR 1.90; P= 0.007), but did not remain independent in multivariate analysis due to combined factors: age > 70, cirrhosis, ALB < 35, PLAT < 100. Large HCC comparison: CRT+TACE vs SR: age (73 vs 62, P= 0.0008), cirrhosis (70% vs 25%, P= 0.0004), ALB (38 vs 39, P= NS), PLAT (173 vs 240, P= 0.01), AFP (5616 vs 3456, P= NS). CRT-TACE was a poor outcome factor only for OS (HR 3.01; P= 0.0007) in univariate analysis. After adjustment to other factors (age > 70, cirrhosis, PLAT < 100), CRT-TACE was not independent in multivariate analysis for OS ( P= 0.19). Conclusions: CRT+TACE induced an encouraging tumor control rate in a population of older pts, more deteriorated chronic hepatopathy than pts treated by SR. Especially for large HCC, SR was not better than CRT+TACE on the outcome. Prospective randomized trials are warranted to confirm these data.

scholarly journals Stereotactic Body Radiation Therapy vs. Radiofrequency Ablation for Single Small Hepatocellular Carcinoma: A Propensity-score Matching Analysis of Their Impact on Liver Function and Clinical Outcomes

2021 ◽  
Author(s):  
Masayuki Ueno ◽  
Hiroyuki Takabatake ◽  
Satoshi Itasaka ◽  
Takahisa Kayahara ◽  
Youichi Morimoto ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Radiation Therapy ◽  
Radiofrequency Ablation ◽  
Local Recurrence ◽  
Propensity Score ◽  
Liver Function ◽  
Stereotactic Body Radiation Therapy ◽  
Propensity Score Matching Analysis ◽  
Small Hcc

Abstract Background: Stereotactic body radiation therapy (SBRT) has high efficacy for early-stage hepatocellular carcinoma (HCC) and is expected as an accepted alternative to radiofrequency ablation (RFA). However, SBRT for HCC may cause subacute liver injury leading to negative clinical outcomes. In this study, we compared changes of liver function and prognosis after SBRT or RFA in patients with single, small HCC by using a propensity-score matching analysis.Methods: We reviewed medical records of 140 patients with single ≤3 cm HCC treated with SBRT or RFA at Kurashiki Central Hospital between January 2014 and February 2019. Changes of albumin-bilirubin (ALBI) score, local recurrence, and overall survival were compared between the propensity-score matched groups (31 patients treated with SBRT and 62 treated with RFA).Results: The ALBI score increased modestly but significantly after SBRT, while it was unchanged in the RFA group; the intergroup difference was statistically significant (p = 0.004). No local recurrence of tumor was identified in the SBRT group, whereas the cumulative recurrence incidence was 9.7% in the RFA group (p = 0.023). Overall survival was not significantly different between the two groups (hazard ratio 1.32, 95% confidence interval 0.60–2.89, p = 0.401).Conclusions: SBRT had modestly negative impact on liver function but better local control of HCC than did RFA. Although long-term follow-up of liver function is necessary with SBRT treatment especially in patients with impaired liver function, SBRT is a satisfactory alternative to RFA for treatment of single, small HCC.

scholarly journals Feasibility and safety of liver resection for huge hepatocellular carcinoma in cirrhotics

2021 ◽  
Vol 8 (8) ◽  
pp. 2294
Author(s):  
Ahmed Abdel Kahaar Aldardeer ◽  
Ashraf Mohammad El-Badry
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Group Versus ◽  
University Hospital ◽  
Risk Of Mortality ◽  
High Incidence ◽  
Complication Score ◽  
Small Hcc ◽  
Cirrhotic Patients ◽  
Huge Hepatocellular Carcinoma

Background: With the current high incidence of hepatocellular carcinoma (HCC), more patients even with large and huge HCC are considered for liver resection.Methods: Medical records of consecutive adult cirrhotic patients who underwent partial hepatectomy for huge HCC (≥10 cm, huge HCC group) versus small HCC (<5 cm, small HCC group) at Sohag university hospital (January 2016 to December 2020) were analyzed. Both groups were compared regarding postoperative morbidity and risk of mortality following post hepatectomy liver failure (PHLF) as defined by the 50-50 criteria (50% mortality occurs among patients who developed increased plasma bilirubin >50 μml/l and reduced prothrombin activity <50% on postoperative day 5 (POD-5).Results: Thirty two patients were enrolled (16 per group), with median age of 56 (range 38-81) years, 22 were males. In correlation with resection of more liver segments in the huge HCC group, post hepatectomy alteration of liver functions (bilirubin rise and reduction of albumin and prothrombin concentration) was significantly pronounced among patients who had resection for huge compared with small HCC (p<0.05). Huge HCC group exhibited significantly worse postoperative complication score (p< 0.05) and needed significantly prologed periods of hospital stay (p<0.05). Concurrent persistence of PHLF and thrombocytopenia until POD-5 occurred in 3 patients (2 with huge HCC and 1 with small HCC). Among those patients, only one from huge HCC group died (mortality 6%) postoperatively.Conclusions: Liver resection provides safe and effective treatment strategy for carefully selected cirrhotic patients with huge HCC. 

Diagnosis of Small HCC

2005 ◽  
Vol 129 (4) ◽  
pp. 1364 ◽  
Author(s):  
Jordi Bruix ◽  
Morris Sherman
Keyword(s):  
Small Hcc
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