Incomplete Ablation After Radiofrequency Ablation of Hepatocellular Carcinoma: Analysis of Risk Factors and Prognostic Factors

Lam, Vincent Wai-To; Ng, Kelvin K. C.; Chok, Kenneth S. H.; Cheung, Tan–To; Yuen, Jimmy; Tung, Helen; Tso, WK; Fan, Sheung‐Tat; Poon, Ronnie T. P.

doi:10.1245/s10434-007-9733-9

Cited by 77 publications

(58 citation statements)

References 47 publications

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“…For example, Lam et al . prospectively treated 298 HCC patients using RFA and demonstrated a significantly shorter survival time for 25 patients whose tumors had been incompletely ablated33.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Irreversible Electroporation: Long-term survival analysis of 71 patients with inoperable malignant hepatic tumors

Niessen

Thumann

Beyer

et al. 2017

Sci Rep

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Aim of this retrospective analysis was to evaluate the survival times after percutaneous irreversible electroporation (IRE) in inoperable liver tumors not amenable to thermal ablation. 71 patients (14 females, 57 males, median age 63.5 ± 10.8 years) with 103 liver tumors were treated in 83 interventions using IRE (NanoKnife® system). The median tumor short-axis diameter was 1.9 cm (minimum 0.4 cm, maximum 4.5 cm). 35 patients had primary liver tumors and 36 patients had liver metastases. The Kaplan-Meier method was employed to calculate the survival rates, and the different groups were compared using multivariate log-rank and Wilcoxon tests. The overall median survival time was 26.3 months; the median survival of patients with primary land secondary liver cancer did not significantly differ (26.8 vs. 19.9 months; p = 0.41). Patients with a tumor diameter >3 cm (p < 0.001) or more than 2 lesions (p < 0.005) died significantly earlier than patients with smaller or fewer tumors. Patients with hepatocellular carcinoma and Child-Pugh class B or C cirrhosis died significantly earlier than patients with Child-Pugh class A (p < 0.05). Patients with very early stage HCC survived significantly longer than patients with early stage HCC with a median survival of 22.3 vs. 13.7 months (p < 0.05).

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Section: Discussionmentioning

confidence: 99%

Percutaneous Irreversible Electroporation: Long-term survival analysis of 71 patients with inoperable malignant hepatic tumors

Niessen

Thumann

Beyer

et al. 2017

Sci Rep

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“…This observation confirms other reports in literature in which the size and location near major vessels are factors associated with higher local recurrence rate. 26,27 A potential limitation of this study is the reduction of sample size after matching that can affect the accuracy of survival-estimated values. However, the one-to-one propensity matching technique allows to obtain highly selected samples that significantly improve the quality of univariate and multivariate analyses.…”

Section: Discussionmentioning

confidence: 99%

Surgical Resection Versus Local Ablation for HCC on Cirrhosis: Results from a Propensity Case-Matched Study

Ruzzenente

Guglielmi

Sandri

et al. 2012

Journal of Gastrointestinal Surgery

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“…5,[20][21][22][23][24][25][26][27] Surprisingly, a histological study in patients who underwent liver transplantation after an RFA procedure revealed residual tumor tissue in 37% and 71% of patients with HCC 3 cm and HCC >3 cm, respectively. 28 The combination with TACE is expected to reduce such microscopic local tumor progression.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter arterial chemoembolization plus radiofrequency ablation therapy for early stage hepatocellular carcinoma

Kagawa

Koizumi

Kojima

et al. 2010

Cancer

104

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the Tokai RFA Study Group BACKGROUND: Radiofrequency ablation (RFA) is becoming a well-known local therapy for hepatocellular carcinoma (HCC). Transcatheter arterial chemoembolization (TACE) is expected to enhance the effects of subsequent RFA by reducing arterial blood flow. However, the long-term efficacy of this combined therapy has not been elucidated. In this study, the survival rates of patients who received TACE combined with RFA (TACE þ RFA) were compared with those of patients treated surgically. METHODS: The study included consecutive patients who received TACE þ RFA or surgical resection as the initial curative treatment for HCC between 2000 and 2005 at Tokai University Hospital. Inclusion criteria were a single HCC 50 mm or up to 3 HCCs 30 mm, presence of cirrhosis classified as Child-Pugh class A, no vascular invasion, and no extrahepatic metastasis. RESULTS: Sixty-two patients (23 women, 39 men; aged 67.5 AE 8.4 years [mean AE standard deviation]) received TACE þ RFA, and 55 patients (15 women, 40 men; aged 66.1 AE 8.4 years) underwent surgical resection. Median follow-up periods were similar (50 months in the TACE þ RFA group vs 49 months in the resection group). The probabilities of overall survival at 1, 3, and 5 years in the TACE þ RFA group (100%, 94.8%, and 64.6%, respectively) were similar (P ¼ .788) to those in the resection group (92.5%, 82.7%, and 76.9%, respectively). Two major RFA-related complications were observed (1.5%). CONCLUSIONS: RFA combined with TACE is an efficient and safe treatment that provides overall survival rates similar to those achieved with surgical resection. Cancer 2010;116;3638-44.

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Incomplete Ablation After Radiofrequency Ablation of Hepatocellular Carcinoma: Analysis of Risk Factors and Prognostic Factors

Abstract: This study demonstrated that incomplete ablation after RFA of HCC was associated with tumor size > 3 cm. Our data also suggest that aggressive further treatment of tumors with incomplete ablation aiming at complete tumor response improves overall survival.

Cited by 77 publications

References 47 publications

Percutaneous Irreversible Electroporation: Long-term survival analysis of 71 patients with inoperable malignant hepatic tumors

Percutaneous Irreversible Electroporation: Long-term survival analysis of 71 patients with inoperable malignant hepatic tumors

Surgical Resection Versus Local Ablation for HCC on Cirrhosis: Results from a Propensity Case-Matched Study

Transcatheter arterial chemoembolization plus radiofrequency ablation therapy for early stage hepatocellular carcinoma

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