Local Recurrence After Hepatic Radiofrequency Coagulation

Mulier, Stefaan; Ni, Yicheng; Jamart, Jacques; Ruers, Theo J.M.; Marchal, Guy; Michel, Luc

doi:10.1097/01.sla.0000171032.99149.fe

Cited by 621 publications

(173 citation statements)

References 130 publications

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“…Along with the selection of appropriate patients, choice of treatment modality is just as important. Various factors, such as timing of metastasis, metastatic features, and technical limitations of a procedure, should be considered when deciding on a particular treatment [29,30]. Additionally, a patient's performance status should also be taken into consideration when selecting a surgical or nonsurgical modality.…”

Section: Discussionmentioning

confidence: 99%

Liver-directed treatments for liver metastasis from gastric adenocarcinoma: comparison between liver resection and radiofrequency ablation

et al. 2015

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Background Although various liver-directed treatment modalities, such as liver resection and radiofrequency ablation (RFA), have been applied to treat liver metastases from gastric cancer, optimal management of them remains controversial. In patients with liver metastasis from gastric cancer, we investigated the short-and long-term outcomes of liver resection and RFA and analyzed factors influencing survival. Methods A total of 98 gastric cancer patients with liver metastasis and no extrahepatic disease were treated by liver resection (n = 68) or RFA (n = 30). Short-and long-term outcomes were evaluated retrospectively for each of the liver-directed treatments. Results Severe complication rates did not differ between liver resection (18 %) and RFA (10 %) (p = 0.333). Only one treatment-related mortality occurred in the liver resection group. No statistically significant difference in survival was noted between the treatment groups. Median overall survival after liver resection was 24 months, with 3-year overall and progression-free survival rates of 40.6 % and 30.4 %, respectively. Median overall survival after RFA was 23 months, with 3-year overall and progression-free survival rates of 43.0 % and 37.4 %, respectively. Only the size of the metastases was shown to be an independent prognostic factor for gastric cancer patients with liver metastasis. Conclusions In select patients with liver metastasis from gastric cancer, liver resection and RFA showed satisfactory and comparable short-and long-term results. Thus, systemic chemotherapy may not be the only therapeutic option for patients with liver metastasis, and possible liver-directed treatment options for such patients should be considered on an individual basis.

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Section: Discussionmentioning

confidence: 99%

Liver-directed treatments for liver metastasis from gastric adenocarcinoma: comparison between liver resection and radiofrequency ablation

et al. 2015

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“…Given the evidence that vascular clamping during thermal destruction therapy is an essential part of the procedure for obtaining a safer margin around the ablated tumour [50], particularly in larger tumours and tumours located near large vessels [50, 51], it is surprising that more than half of all responders never clamp during ablation. This may partly be explained by the fact that some surgeons do not treat patients with tumours >4 cm.…”

Section: Discussionmentioning

confidence: 99%

European Survey on the Application of Vascular Clamping in Liver Surgery

et al. 2007

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Background: This study evaluated the frequency, the indications and techniques of vascular clamping during liver resection and during thermal destruction therapies, as currently used by hepatic surgeons throughout Europe. Methods: A web-based questionnaire was distributed among 621 physicians, including all members of the European Hepato-Pancreato-Biliary Association and the European Surgical Association. Results: The overall response rate was 50%. During liver resection, vascular clamping is never applied by 10%, on indication by 71%, and routinely by 19%. Routine clamping is particularly performed by high-volume and senior surgeons and appears to be associated with longer ischaemia times. Intermittent inflow occlusion is the clamping method of choice for more than 65% of surgeons and total ischaemia times are usually limited to 15–30 min. During thermal ablation, vascular clamping is never used by 57%, on indication by 37%, and routinely by 7%; it is particularly applied for large tumours and for tumours close to large vessels, and ischaemia times are shorter. Conclusions: Vascular clamping during liver resection is frequently used; during thermal ablation it is preserved for larger tumours or tumours in the vicinity of large vessels. Complete inflow occlusion is the most frequently used technique, with a distinct preference for intermittent clamping.

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“…Standard treatments for localized HCC include surgical resection, liver transplantation,1, 2 radiofrequency ablation (RFA),3, 4 and transcatheter arterial chemoembolization (TACE) 5, 6, 7. Treatment eligibility is dependent on patient and tumor conditions.…”

Section: Introductionmentioning

confidence: 99%

Progressive hypofractionated carbon‐ion radiotherapy for hepatocellular carcinoma: Combined analyses of 2 prospective trials

Kasuya

Kato²,

Yasuda

et al. 2017

Cancer

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BACKGROUNDThe objective of this study was to evaluate the safety and efficacy of carbon‐ion radiotherapy (CIRT) in patients with hepatocellular carcinoma (HCC) with stepwise dose escalation and hypofractionation in 2 combined prospective trials.METHODSSequential phase 1/2 (protocol 9603) and phase 2 (protocol 0004) trials were conducted for patients with histologically proven HCC. The phase 1 component of protocol 9603 was a dose‐escalation study; CIRT was delivered in 12, 8, or 4 fractions. After determination of the recommended dose, 2 phase 2 trials were performed in an expanded cohort, and the data were pooled to analyze toxicity, local control, and overall survival.RESULTSIn the phase 1 component of protocol 9603, 69.6, 58.0, and 52.8 Gy (relative biological effectiveness [RBE]) in 12, 8, and 4 fractions, respectively, constituted the maximum tolerated doses, and 52.8 Gy (RBE) in 4 fractions was established as the recommended dose regimen for the 2 phase 2 studies. In 124 patients with a total of 133 lesions, few severe adverse effects occurred, and local‐control and overall survival rates at 1, 3, and 5 years were 94.7% and 90.3%, 91.4% and 50.0%, and 90.0% and 25.0%, respectively; this included 1‐, 3‐, and 5‐year local‐control rates of 97.8%, 95.5%, and 91.6%, respectively, in the phase 2 study. In a multivariate analysis, Child‐Pugh class B and the presence of a tumor thrombus were significant factors for mortality.CONCLUSIONSThe safety and efficacy of CIRT in 12, 8, and 4 fractions were confirmed, with 52.8 Gy (RBE) in 4 fractions established as the recommended treatment course for eligible HCC patients. Cancer 2017;123:3955‐65. © 2017 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

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Local Recurrence After Hepatic Radiofrequency Coagulation

Cited by 621 publications

References 130 publications

Liver-directed treatments for liver metastasis from gastric adenocarcinoma: comparison between liver resection and radiofrequency ablation

Liver-directed treatments for liver metastasis from gastric adenocarcinoma: comparison between liver resection and radiofrequency ablation

European Survey on the Application of Vascular Clamping in Liver Surgery

Progressive hypofractionated carbon‐ion radiotherapy for hepatocellular carcinoma: Combined analyses of 2 prospective trials

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