Ablation for Recurrent Hepatocellular Carcinoma: A Systematic Review of Clinical Efficacy and Prognostic Factors

Thomasset, Sarah; Dennison, Ashley R.; Garcea, Giuseppe

doi:10.1007/s00268-015-2956-1

Cited by 31 publications

(17 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Improvements in technology for thermal ablation have led to increased ablation reproducibility and the emergence of RFA and MWA as safe and effective alternatives to tumor resection. 5,6,[21][22][23] From a technical and practical standpoint, MWA generates a more predictable ablation field than RFA due to the absence of electrical and thermal "sink" within the near-field ablation zone. However, with both MWA and RFA thermal damage remains indiscriminate, and in addition to killing tumor cells, widespread damage to the underlying hepatic architecture occurs within the ablated area.…”

Section: Discussionmentioning

confidence: 99%

High-Frequency Irreversible Electroporation: Safety and Efficacy of Next-Generation Irreversible Electroporation Adjacent to Critical Hepatic Structures

et al. 2017

View full text Add to dashboard Cite

Irreversible electroporation (IRE) is a nonthermal ablation modality employed to induce in situ tissue-cell death. This study sought to evaluate the efficacy of a novel high-frequency IRE (H-FIRE) system to perform hepatic ablations across, or adjacent to, critical vascular and biliary structures. Using ultrasound guidance H-FIRE electrodes were placed across, or adjacent to, portal pedicels, hepatic veins, or the gall bladder in a porcine model. H-FIRE pulses were delivered (2250 V, 2-5-2 pulse configuration) in the absence of cardiac synchronization or intraoperative paralytics. Six hours after H-FIRE the liver was resected and analyzed. Nine ablations were performed in 3 separate experimental groups (major vessels straddled by electrodes, electrodes placed adjacent to major vessels, electrodes placed adjacent to gall bladder). Average ablation time was 290 ± 63 seconds. No electrocardiogram abnormalities or changes in vital signs were observed during H-FIRE. At necropsy, no vascular damage, coagulated-thermally desiccated blood vessels, or perforated biliary structures were noted. Histologically, H-FIRE demonstrated effective tissue ablation and uniform induction of apoptotic cell death in the parenchyma independent of vascular or biliary structure location. Detailed microscopic analysis revealed minor endothelial damage within areas subjected to H-FIRE, particularly in regions proximal to electrode insertion. These data indicate H-FIRE is a novel means to perform rapid, reproducible IRE in liver tissue while preserving gross vascular/biliary architecture. These characteristics raise the potential for long-term survival studies to test the viability of this technology toward clinical use to target tumors not amenable to thermal ablation or resection.

show abstract

Section: Discussionmentioning

confidence: 99%

High-Frequency Irreversible Electroporation: Safety and Efficacy of Next-Generation Irreversible Electroporation Adjacent to Critical Hepatic Structures

et al. 2017

View full text Add to dashboard Cite

show abstract

“…[14][15][16][17] A recent systematic review of 19 retrospective series that focused on ablation for recurrent HCC revealed that 5-year survival rates after RFA for recurrent HCC was 40% (range 23-83%). 9 However, they also concluded that there was insufficient date to analyze survival outcomes after microwave ablation. In addition, there have been no studies comparing RFA and microwave ablation for recurrent HCC to date.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8] In addition to a large number of studies about local ablation therapy for primary HCC, a recent systematic review focused on local ablation therapy for recurrent HCC have reported that RFA was an effective option for patients with recurrent HCC. 9 However, little evidence is available regarding long-term outcomes after microwave ablation for recurrent HCC after curative hepatectomy.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of surgical microwave ablation for recurrent hepatocellular carcinoma after curative hepatectomy

Ryu

Takami

Wada

et al. 2020

HPB

View full text Add to dashboard Cite

Background: Little evidence exists regarding postrecurrence survival after microwave ablation for recurrent hepatocellular carcinoma (HCC) after curative hepatectomy; we aimed to evaluate the feasibility of surgical microwave ablation.Methods: In this retrospective review, we enrolled patients who underwent curative hepatectomy for primary HCC in our department and had intrahepatic recurrence. We analyzed overall survival according to treatment modality to clarify the prognostic factors for survival.Results: Of 257 patients, 119 had intrahepatic recurrence. Three patients underwent repeat hepatectomy; 75 patients underwent surgical microwave ablation, and 34 patients underwent transcatheter arterial chemoembolization or hepatic arterial infusion chemotherapy. The median postrecurrence survival time and 5-year postrecurrence survival after surgical microwave ablation were 37.4 months and 55.4%, respectively. The major complication rate (Clavien-Dindo classification IIIa or above) after surgical microwave ablation was 5.3% with no mortality. Multivariate analysis showed that microvascular invasion at primary tumors, and recurrent tumors within 3 cm and 3 nodules were independent prognostic factors for overall survival after surgical microwave ablation for recurrent HCC. Conclusion:Our results suggested that surgical microwave ablation is safe and feasible for recurrent intrahepatic HCC after curative hepatectomy. Close follow-up and further curative treatment could be important for improving postrecurrence survival.

show abstract

“…Even though better prognosis obtained in small tumor identified by screening might the result of “lead time bias,” there were still several treatments potential to improve prognosis or palliation. Cauchy et al [35–38] concluded 3 studies from Zhong et al [35] , Sasaki et al [37] , and Thomasset et al [36] in World Journal of Surgery and thought oncologic risk of isolated small lesion was underestimated. Only for patients without severe underlying parenchymal lesion, locoregional or resectional therapies and liver transplantation might be able to achieve similar outcomes.…”

Section: Discussionmentioning

confidence: 99%

Small hepatocellular carcinoma suppressed by chemotherapy for synchronous gastric carcinoma after laparoscopy-assisted radical distal gastrectomy

et al. 2018

View full text Add to dashboard Cite

Rationale:Synchronous gastric carcinoma and hepatocellular carcinoma (HCC) is rare. It is hard to distinguish synchronous HCC from metastatic liver cancer in this condition. The treatment and prognosis is quite different for synchronous HCC of gastric carcinoma and liver metastasis of gastric carcinoma.Patient concerns:A 68-year-old man with a chief complaint of epigastric pain for 1 year, accompanied by reflux and belching. The patient was diagnosed with gastric carcinoma (cT4NxM0) and laparoscopy-assisted radical distal gastrectomy was performed. This was followed by chemotherapy of FOLFOX regimen. However, a liver nodule growth was observed after postoperative systemic treatment.Diagnosis:The initial diagnosis was liver metastasis of gastric carcinoma. However after hepatectomy of segment VI and VII as well as thrombectomy of right hepatic vein, histology revealed intermediate to poor differentiated HCC. Hence this case was diagnosed as synchronous gastric carcinoma and HCC.Interventions:A preventive transcatheter arterial chemoembolization (TACE) was conducted at 4 weeks after hepatectomy. Another FOLFOX regimen was suggested, but was refused by the patient.Outcomes:The patient survived without tumor recurrence for 9 months after the second surgery.Lessons:Synchronous HCC should be routinely distinguished from gastric carcinoma liver metastasis, especially for patients with hepatitis B virus (HBV) infection. The FOLFOX4 regimen for treating gastric carcinoma liver metastasis may have inhibited the progression of primary HCC in this case. This patient with HCC benefited from liver resection, inspite of hepatic vein tumor thrombosis.

show abstract

Ablation for Recurrent Hepatocellular Carcinoma: A Systematic Review of Clinical Efficacy and Prognostic Factors

Cited by 31 publications

References 57 publications

High-Frequency Irreversible Electroporation: Safety and Efficacy of Next-Generation Irreversible Electroporation Adjacent to Critical Hepatic Structures

High-Frequency Irreversible Electroporation: Safety and Efficacy of Next-Generation Irreversible Electroporation Adjacent to Critical Hepatic Structures

Efficacy of surgical microwave ablation for recurrent hepatocellular carcinoma after curative hepatectomy

Small hepatocellular carcinoma suppressed by chemotherapy for synchronous gastric carcinoma after laparoscopy-assisted radical distal gastrectomy

Contact Info

Product

Resources

About