External radiation or ablation for solitary hepatocellular carcinoma: A survival analysis of the SEER database

Berger, Nicholas G.; Tanious, M.; Hammad, Ahmed Mohammed Ali; Miura, John T.; Mogal, Harveshp; Clarke, Callisia N.; Christians, Kathleen K.; Tsai, Susan; Gamblin, T. Clark

doi:10.1002/jso.24661

Cited by 20 publications

(30 citation statements)

References 27 publications

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“…The titles and abstracts of 270 studies were then screened for inclusion. The full texts of 36 studies were read and, finally, we included 10 non-randomized controlled trial (Non-RCT) studies that met the present metaanalysis criteria (3,10,(13)(14)(15)(16)18,19,21,22). The details of PRISMA flow diagram of the literature for meta-analysis is shown in Supplementary Figure S1 (23).…”

Section: Search Results and Quality Assessmentmentioning

confidence: 99%

“…In present analysis, 3 studies were based on already existed database (13,15,19) and the remaining 7 studies were based on retrospective studies (3,10,(16)(17)(18)21,22). 2 studies conducted SBRT or RFA for transplant intent.…”

Section: Search Results and Quality Assessmentmentioning

confidence: 99%

“…2 studies conducted SBRT or RFA for transplant intent. 5 studies were performed in USA (10,13,15,18,19), 2 in Japan(12,16), 1 in Canada(3), 1 in South Korea (17), and 1 in China (22). Out of 2732 patients from the 10 included studies 859 patients were classified into the SBRT group, and the rest 1873 patients were classified into the RFA group.…”

Section: Search Results and Quality Assessmentmentioning

confidence: 99%

“…Recent publications have reported either comparable outcomes between the two treatment modalities or favorable outcomes for one to the other (3,10,(12)(13)(14)(15)(16)(17)(18)(19). However, the efficacy of these two treatments regarding disease control and long-term survival are ununified.…”

Section: Introductionmentioning

confidence: 99%

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Stereotactic body radiotherapy vs radiofrequency ablation in the treatment of hepatocellular carcinoma: a meta-analysis

Pan

Qian

et al. 2019

Preprint

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Background Both stereotactic body radiotherapy (SBRT) and radiofrequency ablation (RFA) are effective local treatments for hepatocellular carcinoma (HCC), but whether RFA is superior to SBRT is still controversial. Therefore, we performed a meta-analysis to compare the treatment outcomes of SBRT with RFA as curable or bridge intention.Methods We searched online databases for studies that compared treatment outcome for SBRT and RFA. Eligibility criteria included evaluation of local control, overall survival (OS), transplant rate, and post-transplant pathological necrosis.Results 10 retrospective studies with a total of 2732 patients were included. 2 studies were in favor of SBRT in local control, 2 studies preferred RFA in OS and others reported comparable outcomes for both. SBRT demonstrated significantly higher 1- and 3-year local control than RFA (OR 0.42, 95% CI 0.24 to 0.74, P =0.003; OR 0.54, 95% CI 0.37 to 0.80, P =0.002, respectively). However, SBRT reported significantly shorter 1- and 2-year OS (OR 1.52, 95% CI 1.21 to 1.90, P =0.0003; OR 1.66, 95% CI 1.38 to 2.01, P <0.00001, respectively). As bridge treatment, no significant difference was shown in transplant rate and post-transplant pathological necrosis rate (OR 0.57, 95% CI 0.32 to 1.03, P =0.060; OR 0.49, 95% CI 0.13 to 1.82, P =0.290, respectively).Conclusions This study demonstrates SBRT is able to complete a better local control for HCC than RFA, though the OS is inferior to RFA because of tumor burden or liver profiles of the enrolled studies. Well-designed, randomized, multicenter trials will be required to further investigate the conclusion.

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Section: Search Results and Quality Assessmentmentioning

confidence: 99%

Section: Search Results and Quality Assessmentmentioning

confidence: 99%

Section: Search Results and Quality Assessmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Stereotactic body radiotherapy vs radiofrequency ablation in the treatment of hepatocellular carcinoma: a meta-analysis

Pan

Qian

et al. 2019

Preprint

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“…Radiation therapy has grown in popularity for its potential uses in loco-regional management of HCC. Few retrospective studies have evaluated radiation vs. ablation; a propensity matched analysis based on SEER database (2004-2012) found that ablation was associated with improved survival compared to EBRT in patients with tumors greater than 3 cm, while EBRT and ablation were equivalent in patients with tumors less than 3 cm [70] . A separate retrospective study of SBRT vs. RFA also showed no significant difference in survival between SBRT and RFA, nor time to progression for tumors less than 2 cm [71] .…”

Section: Radiation Therapy Vs Other Loco-regional Treatmentsmentioning

confidence: 99%

Minimally invasive therapies for hepatocellular carcinoma: narrowing the gaps

Sullivan¹,

Yeung²

2018

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With increasing awareness of the HCC epidemic around the globe, early diagnosis of tumors provides a greater opportunity to benefit patients from liver-directed treatments including surgical resection, ablation, catheter-based therapies and external beam radiation. Development of new approaches and refinement of existing techniques have improved our capabilities to provide efficacious and safe means of local disease control. The choice of treatment for individual patients hinges heavily on factors related to the tumor, underlying hepatic function, and existing co-morbidities. Recent advances in minimally invasive therapies across all disciplines have augmented our ability to eradicate the tumor while preserving liver parenchyma. In this review, we discuss and summarize current minimally invasive options that are available to treat HCCs that are confirmed to the liver, especially in their early stages. Emerging evidence suggest that resection, ablation and radiation can all provide excellent local control, and this opens more options for patients to best suit their needs.

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CT‐guided liver beacon transponder implantation

Zhang

Guo

et al. 2021

Precision Medical Sciences

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Objective: To investigate the method of CT-guided beacon transponder implantation and precautions after implantation for liver malignant tumor. Methods: CT-guided beacon transponder implantation in three patients with liver malignancies was the first time in China. The operations were performed using Siemens's 16-row large-aperture spiral CT and 17-G guide needles were using for percutaneous liver puncture. Results: All three operations were successfully completed. During the operations, the beacon transponders were successfully implanted at predetermined targets next to the lesion in the liver parenchyma, and there was no obvious bleeding, pain or discomfort. All patients underwent localized CT examination on the fifth day after operations. Only one beacon transponder moved slightly, the remaining eight beacon transponders did not move, and the CT images did not have obvious metal artifacts. After the completion of radiotherapy in three patients, the follow-up CT examination showed no movement of the beacon transponders, and the liver lesions shrank well. However, 3.0 T MRI of the liver showed that the magnetic sensitive artifacts at beacon transponders were more obvious, which affected the observation of local liver tissue. Conclusion: CT-guided liver beacon transponder implantation is safe and feasible. Beacon transponders may move in the liver parenchyma within a short period of time after implantation. Therefore, localized CT examination is recommended to be performed 4 days after the implantation. CT scans after beacon transponder implantation have no obvious metal artifacts. So CT is recommended for follow-up. However, magnetic resonance sensitive artifacts are more obvious when MRI is performed, which will affect the evaluation of local efficacy and detect new small lesions.

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External radiation or ablation for solitary hepatocellular carcinoma: A survival analysis of the SEER database

Abstract: Similar survival for solitary HCC lesions <3 cm exists between XRT and AT. However, AT demonstrates improved survival rates compared to XRT for lesions >3 cm. This 3 cm reference point may serve as a valuable metric to guide treatment decisions and future investigations.

Cited by 20 publications

References 27 publications

Stereotactic body radiotherapy vs radiofrequency ablation in the treatment of hepatocellular carcinoma: a meta-analysis

Stereotactic body radiotherapy vs radiofrequency ablation in the treatment of hepatocellular carcinoma: a meta-analysis

Minimally invasive therapies for hepatocellular carcinoma: narrowing the gaps

CT‐guided liver beacon transponder implantation

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