scholarly journals Comparing the Safety and Efficacy of Microwave Ablation Using ThermosphereTM Technology versus Radiofrequency Ablation for Hepatocellular Carcinoma: A Propensity Score-Matched Analysis

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1295
Author(s):  
Hidekatsu Kuroda ◽  
Tomoaki Nagasawa ◽  
Yudai Fujiwara ◽  
Hiroki Sato ◽  
Tamami Abe ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Radiofrequency Ablation ◽  
Propensity Score ◽  
Microwave Ablation ◽  
Survival Rates ◽  
Survival Outcomes ◽  
Recurrence Free Survival ◽  
Limited Information ◽  
Free Survival

There is limited information regarding the oncological benefits of microwave ablation using ThermosphereTM technology for hepatocellular carcinoma. This study compared the overall survival and recurrence-free survival outcomes among patients with hepatocellular carcinoma after microwave ablation using ThermosphereTM technology and after radiofrequency ablation. Between December 2017 and August 2020, 410 patients with hepatocellular carcinoma (a single lesion that was ≤5 cm or ≤3 lesions that were ≤3 cm) underwent ablation at our institution. Propensity score matching identified 150 matched pairs of patients with well-balanced characteristics. The microwave ablation and radiofrequency ablation groups had similar overall survival rates at 1 year (99.3% vs. 98.2%) and at 2 years (88.4% vs. 87.5%) (p = 0.728), as well as similar recurrence-free survival rates at 1 year (81.1% vs. 76.2%) and at 2 years (60.5% vs. 62.1%) (p = 0.492). However, the microwave ablation group had a significantly lower mean number of total insertions (1.22 ± 0.49 vs. 1.59 ± 0.94; p < 0.0001). This retrospective study revealed no significant differences in the overall survival and recurrence-free survival outcomes after microwave ablation or radiofrequency ablation. However, we recommend microwave ablation for hepatocellular carcinoma tumors with a diameter of >2 cm based on the lower number of insertions.

Combination therapy with PD-1 blockade and radiofrequency ablation for recurrent hepatocellular carcinoma：A retrospective study

2021 ◽  
Author(s):  
Xiaofei Wang ◽  
Shu Chen ◽  
Huaqiang Bi ◽  
Feng Xia ◽  
Kai Feng ◽  
...  
Keyword(s):  
Overall Survival ◽  
Retrospective Study ◽  
Radiofrequency Ablation ◽  
Survival Rate ◽  
Combination Therapy ◽  
Multivariate Analyses ◽  
Survival Rates ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Tumor Number

Abstract Background: The aim of this study was to evaluate whether combined therapy with PD-1 blockade (anti-PD-1) and radiofrequency ablation (RFA) was superior to RFA monotherapy for recurrent hepatocellular carcinoma (HCC).METHODS: A total of 127 patients who underwent anti-PD-1 plus RFA treatment (n = 41) or RFA alone treatment (n = 86) for recurrent HCC were enrolled in this retrospective study. Clinical data including post-RFA HCC recurrence (the primary end point), overall survival (OS) (the secondary end point), adverse events and toxic effects were retrospectively analyzed.RESULTS: The 1-year recurrence-free survival rates for the anti-PD-1 plus RFA and RFA groups were 36.6% and 16.3%, respectively. The corresponding overall survival rates for the two groups were 95.1% and 74.4%, respectively. There were statistically significant differences between the two groups in recurrence-free survival rate (P = 0.002) or overall survival rate (P = 0.008). Tumor number, TNM stage and anti-PD-1 treatment were demonstrated to be important factors associated with 1-year recurrence-free survival probability by univariate and multivariate analyses. Univariate and multivariate analyses demonstrated that tumor number, TNM stage and anti-PD-1 treatment were significant prognostic factors for OS. RFA treatment-related adverse events were pleural effusion requiring drainage and mild or moderate increase in body temperature. Grade 3 or higher events related to anti-PD-1 treatment occurred in 12.8% (6) patients and were infrequent.CONCLUSIONS: Combination therapy of anti-PD-1 plus RFA was superior to RFA alone in improving survival for recurrent HCC.

scholarly journals Laparoscopic Microwave Ablation of Hepatocellular Carcinoma at Liver Surface: Technique Effectiveness and Long-Term Outcomes

2019 ◽  
Vol 18 ◽  
pp. 153303381882433 ◽  
Author(s):  
Tao Wang ◽  
Xiao-Yu Zhang ◽  
Xiaojie Lu ◽  
Bo Zhai
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Microwave Ablation ◽  
Recurrence Free Survival ◽  
Long Term Outcomes ◽  
First Line ◽  
Free Survival ◽  
Tumor Number ◽  
Liver Surface

Background and Aims: To evaluate long-term outcomes and prognostic factors of laparoscopic microwave ablation as a first-line treatment for hepatocellular carcinoma located at the liver surface not feasible for percutaneous ablation. Methods: 51 consecutive patients receiving laparoscopic microwave ablation in our center between January 11, 2012, and July 31, 2014, were enrolled. Technique effectiveness (complete ablation or incomplete ablation) was evaluated 1 month postprocedure. Procedure-related complications were recorded. The influences of patients’ baseline characteristics on recurrence-free survival and overall survival were analyzed after a median follow-up of 34.0 (ranging 19.0-49.0) months. Results: Complete ablation was gained in 47 (92.2%) of the 51 patients. No patients died within 30 days of microwave ablation procedure. A total of 3 (5.9%) cases of complications were observed. Tumor progression/recurrence were observed in 40 patients (78.4%). The median recurrence-free survival and median overall survival of the total cohort was 11.0 months (95% confidence interval: 7.573-14.427) and 34.0 months (95% confidence interval: 27.244-40.756), respectively. Multivariate analysis identified alanine transaminase level and tumor number as independent significant prognosticators of recurrence-free survival whereas α-fetoprotein level as significant prognosticators of overall survival. Conclusions: As a first-line treatment, laparoscopic microwave ablation provides high technique effectiveness rate and is well tolerated in patients with hepatocellular carcinoma located at liver surface. Alanine transaminase and tumor number were significant predictors of recurrence-free survival, whereas α-fetoprotein level was significant predictor of overall survival. Laparoscopic microwave ablation might serve as a rational treatment option for patients with hepatocellular carcinoma with tumors at the liver surface, which merits validation in future perspective studies.

scholarly journals Radiofrequency Ablation of hepatocellular carcinoma: a meta-analysis of overall survival and recurrence-free survival

2018 ◽  
Vol Volume 11 ◽  
pp. 6555-6567 ◽  
Author(s):  
Andrea Casadei Gardini ◽  
Giorgia Marisi ◽  
Matteo Canale ◽  
Francesco Giuseppe Foschi ◽  
Gabriele Donati ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Radiofrequency Ablation ◽  
Meta Analysis ◽  
Recurrence Free Survival ◽  
Free Survival

scholarly journals Long-term outcomes of synchronous splenectomy and hepatectomy or radiofrequency ablation for hepatocellular carcinoma and esophagogastric variceal bleeding

2021 ◽  
Author(s):  
Jia-li Ma ◽  
Li Jiang ◽  
Ping Li ◽  
Ling-ling He ◽  
Hong-shan Wei
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Variceal Bleeding ◽  
Survival Rates ◽  
Recurrence Free Survival ◽  
Long Term Outcomes ◽  
Survival Curves ◽  
Free Survival ◽  
Overall Survival Rates

Abstract Aim: This study aimed to compare the long-term outcomes of hepatectomy and radiofrequency ablation (RFA) combined with pericardial devascularization (PCDV) plus splenectomy for patients with cirrhosis having hepatocellular carcinoma and esophagogastric variceal bleeding.Materials and Methods: Between October 2008 and March 2018, 46 patients with cirrhosis having hepatocellular carcinoma and esophagogastric variceal bleeding for portal hypertension were included in this study. The overall survival curves, recurrence-free survival curves, and rebleeding-free survival curves were plotted using Kaplan–Meier analysis. The log-rank test was used to compare time-to-event curves between groups.Results: The median follow-up time was 38 months. Among 20 patients undergoing RFA, the 1-, 3-, and 5-year overall survival rates were 95.00%,60.00%, and 35.00%, respectively. The 1-, 3- and 5-year recurrence-free survival rates were 35.00%, 25.00%, and 10.00%, respectively. The 1,3- and 5-year rebleeding-free survival rates were 85.00%, 60.00%, and 40.00%, respectively. Among 26 patients undergoing hepatectomy, the 1-, 3-, and 5-year overall survival rates were 96.15%,50.00%, and 34.62%, respectively. The 1-, 3-, and 5-year recurrence-free survival rates were 65.38%, 19.23%, and 11.54%, respectively. The 1-, 3-, and 5-year rebleeding-free survival rates were 73.08%, 42.31%, and 26.92%, respectively. No significant differences were found in overall, recurrence-free, and rebleeding-free survival rates.Conclusions: Hepatectomy or RFA with PCDV plus splenectomy might be a safe and effective treatment for patients with cirrhosis having hepatocellular carcinoma and esophagogastric variceal bleeding. “Hepatectomy first” strategy may be considered due to its lower and later recurrence. More attention should be paid to background liver diseases after surgery.

scholarly journals Extrapolating Prognostic Factors of Primary Curative Resection to Postresection Recurrences Hepatocellular Carcinoma Treatable by Radiofrequency Ablation

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Hui Ma ◽  
Zhongchen Li ◽  
Jia Yuan ◽  
Lan Zhang ◽  
Xiaoying Xie ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Radiofrequency Ablation ◽  
Curative Resection ◽  
Multivariate Analyses ◽  
Recurrence Free Survival ◽  
Primary Tumors ◽  
Free Survival

Objective. Recurrence after curative resection for hepatocellular carcinoma (HCC) is a major cause of death from this disease. Factors of primary curative resection are available and potential in the prognosis of follow-up treatment. Our aim was to assess the prognostic significance of primary curative resection factors in recurrent HCC patients undergoing radiofrequency ablation therapy (RFA). Methods. In this retrospective study, we assessed 235 patients who underwent limited RFA of HCC recurrences ( tumors ≤ 5   cm ; nodules ≤ 3 ) after primary curative resection. Factors of primary curative resection were collected, and overall survival and recurrence-free survival were evaluated by the Kaplan-Meier method. Univariate and multivariate analyses were used to identify significant prognostic factors. Results. After a median follow-up of 36 months, 54 patients died, and 128 patients had hepatic recurrence. On univariate analyses, patients whose primary tumors were less differentiated ( p = 0.032 and p = 0.048 ) and required less time to recur ( p = 0.013 and p = 0.001 ) after curative resection displayed poorer overall survival and higher recurrence rates following RFA. On multivariate analyses, the pathologic tumor grade ( p = 0.026 and p = 0.038 ) and recurrence-free survival after primary curative resection ( p = 0.028 and p < 0.001 ) emerged as independent risk factors of survival and HCC recurrence. Conclusions. Primary tumor differentiation and time to recurrence after curative resection are viable prognostic factors of overall survival and further recurrence risk in patients undergoing RFA of recurrent HCC.

Radiofrequency Ablation With or Without Transcatheter Arterial Chemoembolization in the Treatment of Hepatocellular Carcinoma: A Prospective Randomized Trial

2013 ◽  
Vol 31 (4) ◽  
pp. 426-432 ◽  
Author(s):  
Zhen-Wei Peng ◽  
Yao-Jun Zhang ◽  
Min-Shan Chen ◽  
Li Xu ◽  
Hui-Hong Liang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Transcatheter Arterial Chemoembolization ◽  
Recurrence Free Survival ◽  
Treatment Allocation ◽  
Free Survival ◽  
End Point ◽  
Tumor Number ◽  
Arterial Chemoembolization

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.

scholarly journals Surgical Resection Significantly Promotes the Overall Survival of Patients with Hepatocellular Carcinoma: A Propensity Score Matching Analysis

2021 ◽  
Author(s):  
Pei-Min Hsieh ◽  
Hung-Yu Lin ◽  
Chao-Ming Hung ◽  
Gin-Ho Lo ◽  
I-Cheng Lu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Surgical Resection ◽  
Cox Regression ◽  
Survival Rates ◽  
Hbv Infection ◽  
Cox Regression Analysis

Abstract Background: The benefits of surgical resection (SR) for various Barcelona Clinic Liver Cancer (BCLC) stages of hepatocellular carcinoma (HCC) remain unclear. We investigated the risk factors of overall survival (OS) and survival benefits of SR over nonsurgical treatments in patients with HCC of various BCLC stages.Methods: Overall, 2316 HCC patients were included, and their clinicopathological data and OS were recorded. OS was analyzed by the Kaplan-Meier method and Cox regression analysis. Propensity score matching (PSM) analysis was performed.Results: In total, 66 (2.8%), 865 (37.4%), 575 (24.8%) and 870 (35.0%) patients had BCLC stage 0, A, B, and C disease, respectively. Furthermore, 1302 (56.2%) of all patients, and 37 (56.9%), 472 (54.6%), 313 (54.4%) and 480 (59.3%) of patients with BCLC stage 0, A, B, and C disease, respectively, died. The median follow-up duration time was 20 (range 0-96) months for the total cohort and was subdivided into 52 (8-96), 32 (1-96), 19 (0-84), and 12 (0-79) months for BCLC stages 0, A, B, and C cohorts, respectively. The risk factors for OS were 1) SR and cirrhosis; 2) SR, cirrhosis, and Child-Pugh (C-P) class; 3) SR, hepatitis B virus (HBV) infection, and C-P class; and 4) SR, HBV infection, and C-P class for the BCLC stage 0, A, B, and C cohorts, respectively. Compared to non-SR treatment, SR resulted in significantly higher survival rates in all cohorts. The 5-year OS rates for SR vs non-SR were 44.0% vs 28.7%, 72.2% vs 42.6%, 42.6% vs 36.2, 44.6% vs 23.5%, and 41.4% vs 15.3% (all p-values<0.05) in the total and BCLC stage 0, A, B, and C cohorts, respectively. After PSM, SR resulted in significantly higher survival rates compared to non-SR treatment in various BCLC stages.Conclusion: SR conferred significant survival benefits to patients with HCC of various BCLC stages and should be considered a recommended treatment for select HCC patients, especially patients with BCLC stage B and C disease.

scholarly journals Impact of postoperative complications on long-term survival of hepatocellular carcinoma patients after liver resection

2021 ◽  
Author(s):  
Susumu Mochizuki ◽  
Hisashi Nakayama ◽  
Yutaka Midorikawa ◽  
Tokio Higaki ◽  
Masamichi Moriguchi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Liver Resection ◽  
Pleural Effusion ◽  
Postoperative Complications ◽  
Recurrence Free Survival ◽  
Term Survival ◽  
Free Survival ◽  
Long Term Survival

Objective The effect of postoperative complications including red blood transfusion (BT) on long-term survival for hepatocellular carcinoma (HCC) is unknown. The purpose of this study was to define the relationship between postoperative complications and long-term survival in patients with HCC. Methods Postoperative complications of 1251 patients who underwent curative liver resection for HCC were classified, and their recurrence-free survival (RFS) and cumulative overall survival (OS) were investigated. Results Any complications occurred in 503 patients (40%). Five-year RFS and 5-year OS in the complication group were 21% and 56%, respectively, significantly lower than the respective values of 32% ( p &lt; 0.001) and 68% ( p &lt; 0.001) in the no-complication group (n=748). Complications related to RFS were postoperative BT [Hazard ratio (HR): 1.726, 95% confidence interval (CI): 1.338–2.228, p &lt; 0.001], pleural effusion [HR: 1.434, 95% CI: 1.200–1.713, p &lt; 0.001] using Cox-proportional hazard model. Complications related to OS were postoperative BT [HR: 1.843, 95%CI: 1.380-2.462, p &lt; 0.001], ascites [HR: 1.562, 95% CI: 1.066–2.290 p = 0.022], and pleural effusion [HR: 1.421, 95% CI: 1.150–1.755, p = 0.001). Conclusions Postoperative complications were factors associated with poor long-term survival. Postoperative BT and pleural effusion, were noticeable complications that were prognostic factors for both recurrence-free survival and overall survival.

Sign in / Sign up

Export Citation Format

Share Document