Intrahepatic dissemination of hepatocellular carcinoma after local ablation therapy

Abstract

LAT for HCCs (even those less than 3 cm in diameter) adjacent less than 5 mm to the main or sectional portal vein possibly promotes intrahepatic dissemination.

β-catenin plays a key role in metastasis of human hepatocellular carcinoma

“…survival of optimal candidates may exceed 60-70% at 5 years, the main drawback being the high rate of disease recurrence during follow-up (>50% at 3 years). After surgical ablation, numerous cases are susceptible to metastasis (22). therefore, controlling the molecular factor of metastasis may be the suitable strategy after clinical surgery.…”

Preoperative prediction of poorly differentiated components in small‐sized hepatocellular carcinoma for safe local ablation therapy

“…Some investigators reported the risk factors of tumor seeding to be related to poor differentiation [14,17], the serum AFP level [17,20], subcapsular tumor location [17], preoperative biopsies [16], and the location of a tumor near the portal vein branches [20]. In our previous study, eight resected HCCs with intrahepatic dissemination were investigated after local ablation therapy, and five patients (62.5%) had an unsatisfactory safety margin, two (25%) had a prior needle biopsy, and four (50%) contained a poorly differentiated component in the tumor [19].…”

“…However, several investigators have reported adverse effects and unusual patterns of recurrence after thermal ablation therapy [12][13][14][15][16][17][18][19][20]. Recently, some cases of treatment-related tumor seeding, especially needle tract tumor seeding [15][16][17] and intrahepatic dissemination have been reported [18][19][20]. Some investigators reported the risk factors of tumor seeding to be related to poor differentiation [14,17], the serum AFP level [17,20], subcapsular tumor location [17], preoperative biopsies [16], and the location of a tumor near the portal vein branches [20].…”

Does Surgical Resection Provide Better Outcomes Than Radiofrequency Ablation in Patients With BCLC Very Early-stage Hepatocellular Carcinoma?

“…During the thermal ablation, the intratumoral pressure will increase which could promote tumor cells flow into the adjacent portal vein, and as a result, dissemination may occur throughout the liver. 8 Seki et al 9 also reported that some patients suffered from rapid tumor progression after RFA. Mulier et al 7 suggested RFA should achieve at least 1 cm ablative margin.…”