Intrahepatic recurrence after percutaneous radiofrequency ablation of hepatocellular carcinoma: Analysis of the pattern and risk factors

Kim, Youngsun; Rhim, Hyunchul; Cho, On Koo; Koh, Byung-Hee; Kim, Yongsoo

doi:10.1016/j.ejrad.2006.03.007

Cited by 227 publications

(185 citation statements)

References 21 publications

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“…One possible reason is that the deterioration of liver function to death is much faster than tumour progression. The reported 1-year local recurrence rate of HCC in patients treated by local ablation therapy was low (2 -18%) (Lin et al, 2005;Tateishi et al, 2006;Kim et al, 2006b), whereas the 1-year survival rate of Child C patients treated by local ablation therapy was 69.1%, indicating that many patients died without recurrence of HCC. Although no effect of local ablation therapy was observed, therapy including RFA could be used for decompensated liver cirrhosis (Kim et al, 2006a) and it is possible that it might be beneficial in special circumstances, such as when minute growth of the tumour immediately results in the occlusion of major critical vessels.…”

Section: Discussionmentioning

confidence: 94%

Prognostic factors and treatment effects for hepatocellular carcinoma in Child C cirrhosis

Nouso¹,

Ito

Kuwaki

et al. 2008

Br J Cancer

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The aim of this study is to elucidate the prognostic factors and the treatment effect on survival in hepatocellular carcinoma (HCC) patients with Child C cirrhosis. Out of 3330 newly discovered HCC patients, 157 consecutive HCC individuals with Child C cirrhosis were enrolled. The prognostic factors were examined by Cox proportional hazards regression analysis and their survival was compared by propensity score-matched analysis. Multivariate analysis revealed that high serum bilirubin (43 mg dl À1 ), the presence of uncontrollable ascites, and a high platelet count (48 Â 10 4 mm À3 ), so-called background liver factors, as well as multiple tumours, large tumours (43 cm), high alpha-fetoprotein (4400 ng ml À1 ), and the presence of portal vein thrombus, so-called tumour factors, were factors of poor prognosis. While transcatheter arterial chemoembolisation (TACE) was a factor of good prognosis (relative risk ¼ 0.50, 95%CI ¼ 0.27 -0.89, P ¼ 0.019), local ablation therapy and transcatheter arterial chemoinfusion (TAI) were not significant prognostic factors. The survival of patients who received TACE was superior to matched patients without active treatment (P ¼ 0.009); however, we did not observe survival benefit after local ablation therapy or TAI. These results suggested that tumour factors as well as background liver factors are prognostic factors of HCC even in patients with Child C cirrhosis, and selective use of TACE in these patients provides survival benefit.

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Section: Discussionmentioning

confidence: 94%

Prognostic factors and treatment effects for hepatocellular carcinoma in Child C cirrhosis

Nouso¹,

Ito

Kuwaki

et al. 2008

Br J Cancer

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“…RFA has recently gained wide acceptance worldwide, mainly due to its relatively low level of invasiveness, ease of use and effectiveness (9,10). The incidence of local tumor progression of HCC reportedly ranges between 0.9 and 31.3% (5,9,(11)(12)(13)(14)(15)(16)(17)(18). Local tumor recurrence may occur due to untreated satellite lesions, which are too small to detect on imaging prior to RFA (19).…”

Section: Introductionmentioning

confidence: 99%

Local recurrence of hepatocellular carcinoma in the tumor blood drainage area following radiofrequency ablation

Hirooka

Ochi

Terada

et al. 2013

Molecular and Clinical Oncology

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Abstract. Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide. HCC is generally considered to spread via the bloodstream and local recurrence often occurs in the blood drainage area determined by computed tomography during hepatic arteriography (CTHA), despite complete ablation of the primary nodule. This study was conducted in order to prospectively assess the rate of local recurrence in the blood drainage area depicted by delayed-phase CTHA. The participants comprised 364 consecutive patients (260 men and 104 women; mean age, 67.4±8.6 years), enrolled between April, 2002 and December, 2011. The participants were divided into two groups, according to whether the ablation area covered the entire blood drainage area as defined by delayed-phase CTHA (group A) or not (group B). Local tumor progression was compared between the two groups. The median time to recurrence was significantly shorter for group B (434 days) compared to that for group A (1,474 days; P=0.0037). The cumulative local recurrence rates for group A were 0, 0 and 1.5% at 1, 3 and 5 years postoperatively, respectively, whereas the recurrence rates for group B were 3.8, 17.0 and 22.8% at 1, 3 and 5 years, respectively (P<0.0001). In conclusion, the safety margin for radiofrequency ablation should be defined as the blood drainage area and ablation should aim at acquiring adequate safety margins.

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“…[4][5][6] Post-operative tumour residue and intrahepatic reoccurrence are the main factors affecting the curative effect of RFA. 7 Scholars 8,9 think that because the residual tumours are not accurately found within short term following RFA treatment, the residues progressed to local recurrence focuses. Early detection and treatment of the residue lesions can substantially raise the complete coagulated rate from 77% to 99.7% by radiofrequency coagulation.…”

Section: Introductionmentioning

confidence: 99%

Contrast-enhanced ultrasonography used for post-treatment responses evaluation of radiofrequency ablations for hepatocellular carcinoma: a meta-analysis

Shi

Ding

et al. 2016

BJR

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Weixiang Shi and Ying He should both be regarded as first authors.Objective: This meta-analysis aims to analyze the usefulness of contrast-enhanced ultrasonography (CEUS) for posttreatment responses evaluation of radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) management. Methods: Literature retrieval in three databases PubMed, Embase and Cochrane Library was conducted up to September 2015, with pre-defined criteria. The technical success rate, local tumour recurrence and local tumour progression were the measurement indexes. Cochran's Q test and I 2 were used for heterogeneity detection. Subgroup analyses were performed for complete ablation rate stratified by study designs, contrast agents and post-operative testing time points. Statistical analyses were conducted using Stata® 12.0 software (Stata Corporation, College Station, TX). Results: 12 studies consisting of 772 patients were included in this study. The CEUS-evaluated success rate of RFA for HCCs was 91%. The proportion of ablative margin ,5 mm was 53%. The local tumour recurrence rate and local tumour progression rate were 4% and 8%, respectively. Subgroup analysis indicated that the CEUS-assessed technical success rate with Sonazoid™ (Daiichi-Sankyo, Tokyo, Japan) as the contrast agent was higher (95%) than those with other agents [SH U 508A (Schering AG, Berlin, Germany) 86%; SonoVue (Bracco SpA, Milan, Italy) 87%]. The success rate assessed within 24 h (94%) after treatment was higher than longer time (1-3 days 86%; 1 month 91%). Conclusion:The meta-analysis showed that the CEUSevaluated success rate of RFA for HCCs was 91%. The local tumour recurrence rate and local tumour progression rate were 4% and 8%, respectively. Advances in knowledge: Using meta-analysis, the study provided more reliable assessment of usefulness of CEUS, which could provide guidelines for HCC treatment.

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Intrahepatic recurrence after percutaneous radiofrequency ablation of hepatocellular carcinoma: Analysis of the pattern and risk factors

Cited by 227 publications

References 21 publications

Prognostic factors and treatment effects for hepatocellular carcinoma in Child C cirrhosis

Prognostic factors and treatment effects for hepatocellular carcinoma in Child C cirrhosis

Local recurrence of hepatocellular carcinoma in the tumor blood drainage area following radiofrequency ablation

Contrast-enhanced ultrasonography used for post-treatment responses evaluation of radiofrequency ablations for hepatocellular carcinoma: a meta-analysis

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