Combination Therapy With Sorafenib and Radiofrequency Ablation for BCLC Stage 0–B1 Hepatocellular Carcinoma: A Multicenter Retrospective Cohort Study

Abstract

Combined therapy with Sorafenib-RFA was associated with a lower incidence of post-RFA recurrence and better OS than RFA alone in patients with BCLC Stage 0-B1 HCC. Although these findings suggest that Sorafenib and RFA is safe and effective for the treatment of early HCC, prospective and randomized controlled trials are needed to validate them.

Laparoscopic hepatectomy versus radiofrequency ablation for minimally invasive treatment of single, small hepatocellular carcinomas

“…The widespread popularity of endoscopic techniques may expand the indications of laparoscopic liver resection. However, RFA is also undergoing constant progress and development, and RFA combined with iodine-125 and sorafenib was recently reported to improve survival and reduce recurrence in patients with early HCC, suggesting that RF technology should not be ignored [28][29][30][31]. Overall, the trend in liver cancer treatment is toward multidisciplinary and minimally invasive methods, and many patients require treatment with a variety of treatment modalities.…”

A Recent Advance in Image-Guided Locoregional Therapy for Hepatocellular Carcinoma

“…Histologic studies performed with liver specimens from patients who underwent RFA as bridge treatment before transplantation showed that the presence of large (≥3 mm) abutting vessels results in a decrease of about 50% in the rate of complete tumor necrosis because of the heat loss due to perfusion-mediated tissue cooling in the area to be ablated [25]. The methods to overcome the heat sink effect include pharmacologically decreasing blood flow [26,27,28,29], temporary vascular balloon occlusion [30,31], and intra-arterial embolization [32,33]. A combination of TACE followed by RFA is the most widely used technique aiming to minimize heat loss due to the heat sink effect, and the effectiveness of this combination treatment has been confirmed by several investigators [34,35,36,37,38,39].…”

Management strategies for hepatocellular carcinoma: old certainties and new realities

“…The study involved 128 HCC patients: 64 patients were treated with Sorafenib plus RFA and 64 patients were treated with RFA alone; the primary endpoint of the study was the incidence of post-RFA HCC recurrence, whereas secondary end-points were overall survival (OS) and treatment toxicity. Combined therapy with Sorafenib and RFA was associated with a lower incidence of post-RFA recurrence and better OS than RFA alone, whereas no statically significant difference was evidenced in morbidity and mortality and the two groups had similar Dindo-Clavien class complications [108]. Besides, the final results of the START trial, a phase II, investigator-initiated, prospective single-arm multinational study that evaluated sorafenib in combination with doxorubicin-based transarterial TACE in patients with intermediate-stage, unresectable HCC, evidenced that TACE/sorafenib cycles repeated every 6-8 weeks were well tolerated, and 52.6 % of patients achieved complete response in target lesions; 16.8 % achieved partial response, and 5.8 % had progression of disease as their best response, assessed by modified response evaluation criteria in solid tumors (RECIST).…”

“…In particular, in a retrospective study, a therapeutic approach with curative intent for all detectable lesions in patients with BCLC stage 0-B1 HCC comprising of Sorafenib combined with RFA was evaluated for efficacy [108]. The study involved 128 HCC patients: 64 patients were treated with Sorafenib plus RFA and 64 patients were treated with RFA alone; the primary endpoint of the study was the incidence of post-RFA HCC recurrence, whereas secondary end-points were overall survival (OS) and treatment toxicity.…”