scholarly journals Comparison of Ablation Area and Change in Functional Liver Reserve after Radiofrequency Ablation for Hepatocellular Carcinoma Using the arfa® and VIVA® Systems

2022 ◽  
Vol 11 (2) ◽  
pp. 434
Author(s):  
Hiroaki Takaya ◽  
Tadashi Namisaki ◽  
Kazusuke Matsumoto ◽  
Junya Suzuki ◽  
Koji Murata ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Observational Study ◽  
Total Bilirubin ◽  
Retrospective Observational Study ◽  
Ablation Area ◽  
Hepatocellular Carcinomas ◽  
The Difference ◽  
Clinical Problems

Radiofrequency ablation (RFA) is recommended in Japan for patients with hepatocellular carcinomas (HCCs) one to three in number and ≤3 cm in size. The arfa® and VIVA® RFA systems are widely used for patients with HCC and this retrospective observational study aims to compare their performances. The study included 365 patients with HCCs one to three in number and ≤3 cm in size who underwent RFA using the arfa® system (arfa® group) or the VIVA® system (VIVA® group). The total bilirubin (T-Bil) level after RFA was higher in the arfa® group than in the VIVA® group. With a 3-cm electrode needle, the longest diameter (Dmax) and the shortest diameter were analyzed and found to be greater in the arfa® group than in the VIVA® group. Furthermore, Dmax with the 2.5-cm electrode needle was greater in the arfa® group than in the VIVA® group. Statistically significant differences in the ablation area and in the T-Bil value after RFA were observed between the groups; however, these differences are not considered clinical problems because the difference in the ablation area was only slight and the Child–Pugh score was the same between the groups. Thus, hepatologists can use either of the RFA systems based on their preference.

A multicenter nonrandomized controlled trial to evaluate the efficacy of surgery versus radiofrequency ablation for small hepatocellular carcinoma (SURF cohort trial).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 4581-4581
Author(s):  
Ryosuke Tateishi ◽  
Kiyoshi Hasegawa ◽  
Yoshikuni Kawaguchi ◽  
Tadatoshi Takayama ◽  
Namiki Izumi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Early Stage ◽  
Controlled Trial ◽  
Patient Characteristics ◽  
Small Hepatocellular Carcinoma ◽  
Multicenter Randomized Controlled Trial ◽  
Early Hcc ◽  
The Difference

4581 Background: In parallel with a multicenter randomized controlled trial that reported an equal recurrence-free survival (RFS) of early-stage hepatocellular carcinoma (HCC) patients who underwent either surgery (SUR) or radiofrequency ablation (RFA), we also enrolled HCC patients who fulfilled the enrollment criteria but did not give consent to participate in the RCT. Methods: All patients gave informed consent to participate in this study. Inclusion criteria were as follows: primary HCC with less than or equal to 3 tumors, each measuring 3 cm or smaller; without vascular invasion or extrahepatic metastasis; Child-Pugh score of 7 or less; and ages between 20 and 79 years. The feasibility for both treatments was confirmed by a joint chart review by surgeons and hepatologists. The primary endpoint was RFS and overall survival. A pre-specified interim analysis was performed to compare RFS. Results: Between April 2009 and August 2015, 740 patients (371 in SUR, 369 in RFA) were enrolled from 49 participating hospitals in Japan. The SUR group had significantly fewer patients with chronic hepatitis C (56.6% vs. 69.4%), higher median value of platelet count (145 vs. 120 × 109/L), and more patients with > 2 cm tumors (49.9% vs. 27.9%); most patients had a single tumor (91.1% vs. 88.3%). During the median follow-up period of 5 years, tumor recurrence was observed in 192 of SUR and 218 of RFA with 3-year RFS being 66.0% and 61.7%, respectively ( P = 0.091). In subgroup analysis, RFS was significantly better in SUR in patients with ≤ 2 cm tumors (62.9% vs. 51.7% in 3 years; hazard ratio [HR] 0.72, 95% confidence interval [CI] 0.56-0.93; P = 0.014), whereas the difference was not significant in those with > 2 cm tumors (52.7% vs. 46.4%; HR 0.85, 95% CI 0.63-1.18; P = 0.34). The adjusted HR for RFS using inversed probability of treatment weighting was 0.89 (95% CI, 0.72-1.10; P = 0.287). Conclusions: The imbalance in patient characteristics reflected a real-world practice. Factors related to background liver disease rather than tumor characteristics might have a larger impact on the recurrence in early HCC. Clinical trial information: C000001796 .

scholarly journals Comparison of blood loss in endoscopic powered adenoidectomy and conventional curettage

2019 ◽  
Vol 5 (3) ◽  
pp. 577
Author(s):  
Nithya Krishnakumar ◽  
N. K. Bashir ◽  
Girish Raj
Keyword(s):  
Radiofrequency Ablation ◽  
Standard Deviation ◽  
Blood Loss ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Conventional Technique ◽  
Nasal Endoscope ◽  
Medical College ◽  
Lower Blood ◽  
The Difference

<p class="abstract"><strong>Background:</strong> Adenoidectomy is one of the most common surgeries done in children. Over the years many techniques have evolved like powered adenoidectomy, radiofrequency ablation, electro cautery etc. Use of endoscopes has enabled surgeons to perform adenoidectomy under direct vision. The objectives of the study were to compare blood loss of conventional and endoscopic assisted powered adenoidectomy.</p><p class="abstract"><strong>Methods:</strong> In this a prospective observational study of 30 children attending ENT department in MES Medical College was done. In the conventional technique, adenoidectomy was done using St Claire Thomson adenoid curette. In powered adenoidectomy technique, micro debrider was used under guidance of 0<sup>0</sup> nasal endoscope (2.7 mm). Intra operatively blood loss during surgery were looked for and noted in both groups.  </p><p class="abstract"><strong>Results:</strong> In the study of 30 children divided in to 2 groups who are comparable statistically. Average blood loss in patients who underwent CA was 38.53 ml and in patients who underwent EAA was 28.27 ml, with standard deviation of 4.704 and 3.863 respectively. The difference in mean blood loss was 10.26 ml.</p><p class="abstract"><strong>Conclusions:</strong> Endoscopic assisted powered adenoidectomy has lower blood loss as compared to conventional adenoidectomy.</p>

Radiofrequency Ablation Guided by Contrast-Enhanced Sonography versus B-Mode Sonography for Hepatocellular Carcinoma after Transcatheter Arterial Chemoembolization

2016 ◽  
Vol 34 (6) ◽  
pp. 692-695 ◽  
Author(s):  
Toshihiko Kawasaki ◽  
Kan-yun Hata ◽  
Daisuke Kinoshita ◽  
Masaki Takayama ◽  
Hideyuki Okuda ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Success Rate ◽  
Phase Contrast ◽  
Transcatheter Arterial Chemoembolization ◽  
Therapeutic Option ◽  
The Other ◽  
Contrast Enhanced ◽  
The Difference ◽  
Arterial Chemoembolization

Purpose: Contrast-enhanced sonography increases negative enhancement in the Kupffer phase after transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). We compared contrast-enhanced sonography with B-mode sonography for guidance of radiofrequency ablation (RFA) of HCC after TACE. Methods: After TACE was performed, 18 nodules in 12 patients were treated by B-mode sonography guided RFA, while 22 nodules in 18 patients were treated by contrast-enhanced sonography-guided RFA. Results: The success rate of initial RFA was 83.3% (15/18 nodules) in the B-mode sonography group. On the other hand, the success rate was 100% (22/22 nodules) in the contrast-enhanced sonography group and the difference was significant (p = 0.046). Conclusion: These findings suggest that RFA guided by Kupffer phase contrast-enhanced sonography after TACE is a promising therapeutic option for curing HCC.

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