Percutaneous ablation therapy versus surgical resection in the treatment for early-stage hepatocellular carcinoma: a meta-analysis of 21,494 patients

Ni, Jingxian; Xu, Li; Sun, Hongzan; Zhou, Jian; Chen, Yaoting; Luo, Jun

doi:10.1007/s00432-013-1530-1

Cited by 38 publications

(36 citation statements)

References 30 publications

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“…FDA approval of the receptor tyrosine kinase inhibitor sorafenib was based on a 2.8-month improvement in survival (range 7.9-10.7 months) [2,3]. Despite ongoing evaluation of treatment options following progression on sorafenib [4], current therapeutic efforts are limited to palliative management involving surgical resection, percutaneous ethanol injection, transcatheter arterial chemoembolization, radiofrequency ablation, or selective internal radiation [3,5,6,7,8,9,10,11,12,13,14]. Systemic chemotherapy (i.e.…”

Section: Introductionmentioning

confidence: 99%

Summary of bi-shRNA<sup>furin</sup>/GM-CSF Augmented Autologous Tumor Cell Immunotherapy (FANG™) in Advanced Cancer of the Liver

et al. 2014

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Therapies for advanced hepatocellular carcinoma (HCC) are limited. We carried out a phase I trial of a novel autologous whole-cell tumor cell immunotherapy (FANG™), which incorporates a dual granulocyte macrophage colony-stimulating factor (GM-CSF) expressive/bifunctional small hairpin RNA interference (bi-shRNAi) vector. The bi-shRNAi DNA targets furin, which is a proconvertase of transforming growth factors beta (TGFβ) 1 and 2. Safety, mechanism, immunoeffectiveness, and suggested benefit were previously shown [Senzer et al.: Mol Ther 2012;20:679-689; Senzer et al.: J Vaccines Vaccin 2013;4:209]. We now provide further follow-up of a subset of 8 HCC patients. FANG manufacturing was successful in 7 of 8 attempts (one failure due to insufficient cell yield). Median GM-CSF expression was 144 pg/10⁶ cells, TGFβ₁ knockdown was 100%, and TGFβ₂ knockdown was 93% of the vector-transported cells. Five patients were vaccinated (1 or 2.5 × 10⁷ cells/intradermal injection, 6-11 vaccinations). No FANG toxicity was observed. Three of these patients demonstrated evidence of an immune response to the autologous tumor cell sample. Long-term follow-up demonstrated survival of 319, 729, 784, 931+, and 1,043+ days of the FANG-treated patients. In conclusion, evidence supports further assessment of the FANG immunotherapy in HCC.

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Section: Introductionmentioning

confidence: 99%

Summary of bi-shRNA<sup>furin</sup>/GM-CSF Augmented Autologous Tumor Cell Immunotherapy (FANG™) in Advanced Cancer of the Liver

et al. 2014

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“…This seemed to apply even for small cancers (tumour size ≤ 3 cm). Complication rates however significantly favoured ablative therapy [46] . Therefore one can conclude that in appropriately selected patients, surgical resection is the preferred management even for small cancers although ablative treatment had the advantage of lower morbidity.…”

Section: Liver Transplantationmentioning

confidence: 99%

Surgical management of hepatocellular carcinoma

Pang

Lam

2014

WJH

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Hepatocellular carcinoma (HCC) is the second most common cause of death from cancer worldwide. Standard potentially curative treatments are either resection or transplantation. The aim of this paper is to provide an overview of the surgical management of HCC, as well as highlight current issues in hepatic resection and transplantation. In summary, due to the relationship between HCC and chronic liver disease, the management of HCC depends both on tumourrelated and hepatic function-related considerations. As such, HCC is currently managed largely through nonsurgical means as the criteria, in relation to the above considerations, for surgical management is still largely

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“…When comparing liver resection vs RFA (for patients with stage A HCC who are not suitable for transplantation), there are several meta-analyses showing that hepatic resection is superior to RFA (or PEI) for HCC with regard to recurrence-free and overall survival [38,140,151,152] . Whereas this superiority of surgery is accepted especially for tumors with diameters > 3 cm, there are some contradictory results for small HCC with a diameter < 3 cm.…”

Section: Perspectivesmentioning

confidence: 99%

“…There is a recent meta-analysis with approximately 21000 patients which clearly demonstrates superiority of surgical resection over RFA and PEI in early stages of HCC [38] , which is according to the guidelines a domain of transplantation or RFA. These findings are confirmed by a meta-analysis by Xu et al [140] also showing a significantly improved survival benefit for patients with early stages of HCC undergoing surgery instead of RFA.…”

Section: Surgical Approach Vs Interventional Tumor Therapymentioning

confidence: 99%

“…It is recommended by the EASL-EORTC guidelines for early-stages of HCC in patients who are not eligible for surgery or transplantation. According to an actual systematic Cochrane Database review [35] , there is moderate evidence, that RFA is superior to percutaneous ethanol injection [36] , but inferior to hepatic resection of HCC [37,38] with regard to recurrence-free and overall survival. In contrast, RFA is superior to hepatic resection with regard to procedure-related complications due to the less invasive character of the procedure [39] .…”

Section: Rfamentioning

confidence: 99%

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Hepatocellular carcinoma: Surgeon's view on latest findings and future perspectives

Slotta

Kollmar

Ellenrieder

et al. 2015

WJH

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Hepatocellular carcinoma (HCC) is the most common liver-derived malignancy with a high fatality rate. Risk factors for the development of HCC have been identified and are clearly described. However, due to the lack of tumor-specific symptoms, HCC are diagnosed at progressed tumor stages in most patients, and thus curative therapeutic options are limited. The focus of this review is on surgical therapeutic options which can be offered to patients with HCC with special regard to recent findings, not exclusively focused on surgical therapy, but also to other treatment modalities. Further, potential promising future perspectives for the treatment of HCC are discussed. EPIDEMIOLOGYHepatocellular carcinoma (HCC) is a very common malignant disease with more than 700000 new patients diagnosed per year. Interestingly, the incidence of HCC varies relevantly throughout the world. Whereas HCC is a very common malignant disease in sub-Saharan Africa, and central and south-east Asia with incidence rates of 20-47/100000 habitants, the incidence of REVIEW Submit a

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Percutaneous ablation therapy versus surgical resection in the treatment for early-stage hepatocellular carcinoma: a meta-analysis of 21,494 patients

Abstract: Although SR was associated with more complications, SR was superior to RFA and PEI for treatment of patients with early-stage HCC.

Cited by 38 publications

References 30 publications

Summary of bi-shRNA<sup>furin</sup>/GM-CSF Augmented Autologous Tumor Cell Immunotherapy (FANG™) in Advanced Cancer of the Liver

Summary of bi-shRNA<sup>furin</sup>/GM-CSF Augmented Autologous Tumor Cell Immunotherapy (FANG™) in Advanced Cancer of the Liver

Surgical management of hepatocellular carcinoma

Hepatocellular carcinoma: Surgeon's view on latest findings and future perspectives

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