Percutaneous thermal ablation for primary hepatocellular carcinoma: A systematic review and meta‐analysis

Chinnaratha, Mohamed Asif; Chuang, Ming-yu (Anthony); Fraser, Robert; Woodman, Richard; Wigg, Alan

doi:10.1111/jgh.13028

Cited by 87 publications

(69 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This result is in close agreement with a previous study in which complete tumor necrosis has been correlated with reduced risk of posttransplantation tumor recurrence . Hence, complete tumor necrosis is the goal of any treatment modality, including emerging therapies such as microwave ablation and stereotactic body radiotherapy . In order to achieve the so‐called “holy grail” of complete necrosis, the treatment paradigm for RFA of liver tumors requires a sufficient ablation margin beyond the visible tumor margin to ensure ablation of infiltrative and/or microscopic disease that may not be visible by current imaging methods.…”

Section: Discussionsupporting

confidence: 89%

Radiofrequency ablation of hepatocellular carcinoma as bridge therapy to liver transplantation: A 10‐year intention‐to‐treat analysis

Lee

Raman²,

Asvadi³

et al. 2017

Hepatology

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 89%

Radiofrequency ablation of hepatocellular carcinoma as bridge therapy to liver transplantation: A 10‐year intention‐to‐treat analysis

Lee

Raman²,

Asvadi³

et al. 2017

Hepatology

View full text Add to dashboard Cite

show abstract

“…Current literature concerning complete ablation and LTP rates of MWA versus RFA are controversial [33, 34]. In our study, a lower incidence of LTP was observed in the MWA group compared with the RFA group.…”

Section: Discussionsupporting

confidence: 47%

Comparison of Laparoscopic Microwave to Radiofrequency Ablation of Small Hepatocellular Carcinoma (≤3 cm)

et al. 2016

View full text Add to dashboard Cite

show abstract

“…The two meta-analysis published so far in this field reported no difference 3-year OS with MWA outperforming RFA in terms of LR for treatment of larger tumours[99,100]. However, further RCTs are needed to verify whether MWA efficacy in determining broader ablation areas will translate into a real survival benefit.…”

Section: Other Thermal Ablation Techniquesmentioning

confidence: 99%

Local ablative treatments for hepatocellular carcinoma: An updated review

Facciorusso

Serviddio

Muscatiello

2016

WJGPT

108

View full text Add to dashboard Cite

Ablative treatments currently represent the first-line option for the treatment of early stage unresectable hepatocellular carcinoma (HCC). Furthermore, they are effective as bridging/downstaging therapies before orthotopic liver transplantation. Contraindications based on size, number, and location of nodules are quite variable in literature and strictly dependent on local expertise. Among ablative therapies, radiofrequency ablation (RFA) has gained a pivotal role due to its efficacy, with a reported 5-year survival rate of 40%-70%, and safety. Although survival outcomes are similar to percutaneous ethanol injection, the lower local recurrence rate stands for a wider application of RFA in hepato-oncology. Moreover, RFA seems to be even more cost-effective than liver resection for very early HCC (single nodule ≤ 2 cm) and in the presence of two or three nodules ≤ 3 cm. There is increasing evidence that combining RFA to transarterial chemoembolization may increase the therapeutic benefit in larger HCCs without increasing the major complication rate, but more robust prospective data is still needed to validate these pivotal findings. Among other thermal treatments, microwave ablation (MWA) uses high frequency electromagnetic energy to induce tissue death via coagulation necrosis. In comparison to RFA, MWA has several theoretical advantages such as a broader zone of active heating, higher temperatures within the targeted area in a shorter treatment time and the lack of heat-sink effect. The safety concerns raised on the risks of this procedure, due to the broader and less predictable necrosis areas, have been recently overcome. However, whether MWA ability to generate a larger ablation zone will translate into a survival gain remains unknown. Other treatments, such as high-intensity focused ultrasound ablation, laser ablation, and cryoablation, are less investigated but showed promising results in early HCC patients and could be a valuable therapeutic option in the next future.

show abstract

Percutaneous thermal ablation for primary hepatocellular carcinoma: A systematic review and meta‐analysis

Abstract: Overall, both RFA and MWA are equally effective and safe, but MWA may be more effective compared to RFA in preventing LTP when treating larger tumors. Well-designed, larger, multicentre RCTs are required to confirm these findings.

Cited by 87 publications

References 39 publications

Radiofrequency ablation of hepatocellular carcinoma as bridge therapy to liver transplantation: A 10‐year intention‐to‐treat analysis

Radiofrequency ablation of hepatocellular carcinoma as bridge therapy to liver transplantation: A 10‐year intention‐to‐treat analysis

Comparison of Laparoscopic Microwave to Radiofrequency Ablation of Small Hepatocellular Carcinoma (≤3 cm)

Local ablative treatments for hepatocellular carcinoma: An updated review

Contact Info

Product

Resources

About