Combined radiofrequency ablation and ethanol injection versus repeat hepatectomy for elderly patients with recurrent hepatocellular carcinoma after initial hepatic surgery

Chen, Shu‐Ling; Peng, Zhenwei; Xiao, Han; Lin, Manxia; Chen, Zebin; Jiang, Chonghe; Hu, Wenjie; Xie, Xian-Jin; Liu, Longzhong; Peng, Baogang

doi:10.1080/02656736.2017.1387941

Cited by 20 publications

(18 citation statements)

References 37 publications

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“…In addition, TACE can also diminish the dissemination of HCC [29]. The combination of RFA and ethanol injection can also improve the efficiency of RFA and achieve comparable prognosis to hepatectomy for patients with small recurrent HCC [30]. Both MVI and early recurrence are adverse prognostic factors for HCC [16].…”

Section: Discussionmentioning

confidence: 99%

The guiding value of microvascular invasion for treating early recurrent small hepatocellular carcinoma

Sun

Yang

Mei

et al. 2021

International Journal of Hyperthermia

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Introduction: Hepatocellular carcinoma (HCC) patients with microvascular invasion (MVI) have worse survival. Whether the presence of MVI indicates the necessity of more aggressive locoregional treatments for recurrences remains to be elucidated. Methods: We reviewed patients who underwent curative hepatectomy for primary HCC in our institution, and 379 patients with recurrent HCC up to three nodules smaller than 3 cm were enrolled. The Kaplan-Meier method was adopted to compare the secondary recurrence-free survival (sRFS) and post-recurrence survival (PRS) among patients undergoing hepatectomy, RFA and transarterial chemoembolization plus RFA (TACE-RFA). Cox regression analyses were performed to identify independent prognostic factors. Results: Both the sRFS and PRS of the MVI (À) group were significantly longer than those of the MVI (þ) group (p ¼ 0.001 and 0.011). For patients with MVI (À), no significant difference was found in sRFS or PRS among recurrent HCC patients receiving hepatectomy, RFA or TACE-RFA (p ¼ 0.149 and 0.821). A similar trend was found in patients with MVI (þ) (p ¼ 0.851 and 0.960). Further analysis found that TACE-RFA provided better sRFS than hepatectomy or RFA alone in patients with MVI (þ) and early recurrence within two years (p ¼ 0.036 and 0.044). Conclusion:For HCC patients with MVI (þ) and early small recurrence, TACE-RFA could achieve better prognosis than hepatectomy or RFA alone, while RFA alone provided comparable survival benefits compared with hepatectomy or TACE-RFA in other HCC patients with small recurrence.

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Section: Discussionmentioning

confidence: 99%

The guiding value of microvascular invasion for treating early recurrent small hepatocellular carcinoma

Sun

Yang

Mei

et al. 2021

International Journal of Hyperthermia

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“…reported that the prognoses of recurrent HCC patients who underwent salvage transplantation and repeated hepatectomy were similar, while the prognosis of patients who underwent repeated RFA was worst among the three therapies, although the backgrounds of patients differed among the treatment approaches. Chen et al . reported that RFA and percutaneous ethanol injection therapy provided comparable overall and recurrence‐free survival rates to repeated hepatectomy for elderly patients (≥70 years of age) with small recurrent HCC after hepatectomy.…”

Section: Discussionmentioning

confidence: 99%

Outcome of a second hepatectomy in octogenarians with hepatocellular carcinoma recurrence: single centre's experience

Ochiai

Inoue

Watanabe

et al. 2019

ANZ Journal of Surgery

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Background: Physicians rarely select surgery a second time as the treatment for octogenarians with hepatocellular carcinoma (HCC) recurrence. Methods: We encountered eight male and three female octogenarians underwent surgery a second time as the treatment for HCC recurrence (octo group). We studied these cases clinically and compared them with 25 younger people underwent surgery a second time (young group). All patients of octo group have resectable HCC according to the Japanese guideline, that is HCC patients with Child-Pugh status A or B and who have solitary or only a few HCC nodules, in addition, no serious comorbidities, no serious dementia, a performance status of 0-1 and the will to receive hepatectomy. Results: The average maximum tumour size at the first hepatectomy was significantly larger than that at the second hepatectomy (P < 0.05). The extent of the first hepatectomy was significantly greater than that of the second one (P < 0.05). There were no mortalities at either hepatectomy. The morbidities of the first and the second hepatectomies were 9.1% and 18.2%, respectively. All complications were bile leakage. Furthermore, there were no significant differences in the clinical features, including the prognosis, between the octo and young groups. Conclusion: Selected octogenarians who received a second hepatectomy showed a relatively good post-operative course after the first and second hepatectomies. Repeated hepatectomy for octogenarians seems to have same positive influence on the prognosis in comparison to the young group. But on the data analysed, we have not shown repeated hepatectomy is superior to non-surgical treatments. MethodsFrom August 2008 through May 2017, we encountered eight male and three female octogenarians who underwent surgery a second time as the treatment for HCC recurrence at our institute

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“…Достоверного различия в уровнях общей и безрецидивной выживаемости в двух группах выявлено не было. Вместе с тем, частота осложнений и длительность пребывания в стационаре больных, получивших малоинвазивное лечение (РЧА+ЧИЭ) были существенно ниже [19].…”

Section: би долгушин вю косыревunclassified

The role of interventional radiology in the treatment of hepatocellular carcinoma

Долгушин¹,

Kosyrev²

2019

Practical oncology

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Combined radiofrequency ablation and ethanol injection versus repeat hepatectomy for elderly patients with recurrent hepatocellular carcinoma after initial hepatic surgery

Abstract: RFA-PEI provides comparable OS and RFS to repeat hepatectomy for elderly patients with small recurrent HCC after hepatectomy but with fewer non-tumour-related deaths, major complications and shorter hospital stays.

Cited by 20 publications

References 37 publications

The guiding value of microvascular invasion for treating early recurrent small hepatocellular carcinoma

The guiding value of microvascular invasion for treating early recurrent small hepatocellular carcinoma

Outcome of a second hepatectomy in octogenarians with hepatocellular carcinoma recurrence: single centre's experience

The role of interventional radiology in the treatment of hepatocellular carcinoma

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