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

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.

scholarly journals Radiofrequency ablation versus repeat hepatectomy in the treatment of recurrent hepatocellular carcinoma in subcapsular location: a retrospective cohort study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Fuqun Wei ◽  
Qizhen Huang ◽  
Yang Zhou ◽  
Liuping Luo ◽  
Yongyi Zeng
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Repeat Hepatectomy ◽  
Free Survival ◽  
Recurrent Hepatocellular Carcinoma ◽  
Primary Endpoints ◽  
Grade 3 ◽  
Optimal Treatment Strategy ◽  
Hepatectomy Group

Abstract Background Repeat hepatectomy and radiofrequency ablation (RFA) are widely used to treat early recurrent hepatocellular carcinoma (RHCC) located in the subcapsular region, but the optimal treatment strategy remains to be controversial. Methods A total of 126 RHCC patients in the subcapsular location after initial radical hepatectomy were included in this study between Dec 2014 and Jan 2018. These patients were divided into the RFA group (46 cases) and the repeat hepatectomy group (80 cases). The primary endpoints include repeat recurrence-free survival (rRFS) and overall survival (OS), and the secondary endpoint was complications. The propensity-score matching (PSM) was conducted to minimize the bias. Complications were evaluated using the Clavien-Dindo classification, and severe complications were defined as classification of complications of ≥grade 3. Results There were no significant differences in the incidence of severe complications were observed between RFA group and repeat hepatectomy group in rRFS and OS both before (1-, 2-, and 3-year rRFS rates were 65.2%, 47.5%, and 33.3% vs 72.5%, 51.2%, and 39.2%, respectively, P = 0.48; 1-, 2-, and 3-year OS rates were 93.5%, 80.2%, and 67.9% vs 93.7%, 75.8%, and 64.2%, respectively, P = 0.92) and after PSM (1-, 2-, and 3-year rRFS rates were 68.6%, 51.0%, and 34.0% vs 71.4%, 42.9%, and 32.3%, respectively, P = 0.78; 1-, 2-, and 3-year OS rates were 94.3%, 82.9%, and 71.4% vs 88.6%, 73.8%, and 59.0%, respectively, P = 0.36). Moreover, no significant differences in the incidence of severe complications were observed between the RFA group and repeat hepatectomy group. Conclusion Both repeat hepatectomy and RFA are shown to be effective and safe for the treatment of RHCC located in the subcapsular region.

scholarly journals Transarterial Chemoembolization Combined with Iodine 125 Seeds Versus Transarterial Chemoembolization Combined with Radiofrequency Ablation in the Treatment of Early and Intermediate Hepatocellular Carcinoma

2020 ◽  
Author(s):  
chen lei ◽  
Xuefeng Kan ◽  
Tao Sun ◽  
Yanqiao Ren ◽  
Yanyan Cao ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Transarterial Chemoembolization ◽  
Objective Response ◽  
Progression Free Survival ◽  
Free Survival ◽  
Risk Of Death ◽  
Significant Difference ◽  
Pugh Class ◽  
Iodine 125

Abstract Background To compare the efficacy of the combination of transarterial chemoembolization (TACE) and iodine 125 seeds implantation (TACE-Iodine 125) with the combination of TACE and radiofrequency ablation (RFA) in the treatment of patients with early and intermediate hepatocellular carcinoma (HCC). Methods The study included 134 patients diagnosed with early and intermediate HCC from January 1, 2014, to May 31, 2018. Among them, 47 patients were treated with TACE-Iodine 125, and 87 with TACE-RFA and the efficacy of both treatments was analyzed. To reduced selective bias, propensity score matching (PSM) was used to compare the outcomes of the treatments. Results In the absence of PSM, the median overall survival (OS) and progression-free survival (PFS) of the TACE-RFA group were slightly longer than those of the TACE-Iodine 125 group (OS: 42 months vs. 37 months; PFS: 18 months vs. 15 months). However, there was no significant difference in median OS, PFS, and the objective response rate (ORR) between the two groups (P>0.05). After adjusted for age, gender, liver resection, Child-Pugh class, Barcelona Clinic Liver Cancer (BCLC) stage and Alpha-fetoprotein (AFP), TACE-Iodine 125 treatment was not associated with a significant increasing in risk of death (HR: 0.725; 95%CI: 0.423,1.241, P=0.241) and recurrence (HR: 1.008; 95%CI: 0.666,1.526, P=0.969). After PSM, 47 patient pairs were generated, and there was no significant difference in median OS and PFS between the two groups. Conclusions The combination of TACE and iodine 125 seeds implantation may represent an effective treatment for patients with early and intermediate HCC.

scholarly journals Radiofrequency ablation versus hepatic resection for recurrent hepatocellular carcinoma: an updated meta-analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Daopeng Yang ◽  
Bowen Zhuang ◽  
Yan Wang ◽  
Xiaoyan Xie ◽  
Xiaohua Xie
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Hepatic Resection ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Recurrent Hepatocellular Carcinoma ◽  
Major Complications ◽  
Alternative Treatment Option ◽  
Significant Difference

Abstract Background The clinical benefits of treatment with radiofrequency ablation (RFA) and repeat hepatic resection (RHR) for recurrent hepatocellular carcinoma (RHCC) remain controversial. This meta-analysis aims to evaluate the outcomes and major complications of RFA versus RHR in patients with early-stage RHCC. Methods PubMed, Embase, Web of Science and the Cochrane Library were systematically searched for comparative studies on the evaluation of RHR versus RFA for RHCC. The primary outcome was overall survival (OS), and the secondary outcomes were progression-free survival (PFS) and major complications. Meta-analysis was performed using a random-effects model or fixed-effects model, and heterogeneity was tested by the Cochran Q statistic. Results Ten studies with 1612 patients (RHR = 654, RFA = 958) were included in the meta-analysis. The meta-analysis showed that RHR had superior OS (HR 0.77, 95% CI =0.65–0.92, P = 0.004) and PFS (HR 0.81, 95% CI =0.67–0.98, P = 0.027) compared to RFA, whereas major complications may be less frequent in the RFA group (OR 0.15, 95% CI = 0.06–0.39, P < 0.001). In the subgroup analysis of patients with single RHCC ≤3 cm, OS (HR 1.03, 95% CI =0.69–1.52, P = 0.897) and PFS (HR 0.99, 95% CI = 0.71–1.37, P = 0.929) showed no significant differences in the comparison of RHR and RFA. In single RHCC> 3 cm and ≤ 5 cm, RFA showed an increased mortality in terms of OS (HR 0.57, 95% CI = 0.37–0.89, P = 0.014). Conclusion RHR offers a longer OS and PFS than RFA for patients with RHCC, but no statistically significant difference was observed for single RHCC ≤3 cm. The advantages of fewer major complications may render RFA an alternative treatment option for selected patients.

scholarly journals Transarterial Chemoembolization Combined with Radiofrequency Ablation in the Treatment of Stage B1 Intermediate Hepatocellular Carcinoma

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Furong Liu ◽  
Minshan Chen ◽  
Jie Mei ◽  
Li Xu ◽  
Rongping Guo ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Transarterial Chemoembolization ◽  
Progression Free Survival ◽  
Intermediate Stage ◽  
Multivariate Regression Analysis ◽  
Rank Test ◽  
Free Survival ◽  
Kaplan Meier ◽  
Tace Group

Background. Due to the heterogeneity of patients with Barcelona clinic liver cancer (BCLC) intermediate-stage hepatocellular carcinoma (HCC), Bolondi criteria were proposed and patients were divided into four substages. The purpose of this study was to compare the survival of substage B1 patients who were initially treated with a combination of transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) (TACE-RFA) or TACE alone. Methods. 404 patients with stage B1 HCC were retrospectively analyzed from January 2005 to December 2012. 209 patients received TACE-RFA, and 195 received TACE alone as initial treatment. The overall survival (OS) and progression-free survival (PFS) rates were estimated by the Kaplan–Meier method and compared by the log-rank test. Results. 1-, 3-, and 5-year OS rates were 83.7%, 45.8%, and 24.8% in the TACE-RFA group and 80.7%, 26.4%, and 16.7% in the TACE group, respectively (P=0.003). The corresponding PFS rates were 71.8%, 26.6%, and 13.0% and 59.1%, 11.0%, and 2.2% in the TACE-RFA group and TACE group, respectively (P<0.001). Multivariate regression analysis indicated that tumor size (OS: hazard ratio (HR) = 0.683, P=0.001; PFS: HR = 0.761, P=0.013), along with treatment allocation (OS: HR = 0.701, P=0.003; PFS: HR = 0.620, P<0.001), was the independent prognostic factor for both OS and PFS. Conclusions. Combination TACE and RFA treatment yielded better survival than TACE alone for patients with stage B1 HCC according to the Bolondi criteria.

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