Radiofrequency ablation induces dedifferentiation of hepatocellular carcinoma

Tajima, Hidehiro; Ohta, Tetsuo; Okamoto, Koichi; Nakanuma, Shinichi; Hayashi, Hironori; Nakagawara, Hisatoshi; Onishi, Ichiro; Takamura, Hiroyuki; Kitagawa, Hirohisa; Fushida, Sachio; Tani, Takashi; Fujimura, Takashi; Kayahara, Masato; Arai, Kuniaki; Yamashita, Tatsuya; Kaneko, Shuichi; Zen, Yoh

doi:10.3892/ol_00000016

Cited by 25 publications

(19 citation statements)

References 22 publications

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“…RFA induces tumor necrosis with a low prevalence of complications, and is superior to percutaneous injection of ethanol in terms of tumor ablation [2]. However, several cases of rapid and aggressive recurrence of HCC after RFA have been reported [3][4][5][6]. Tajima et al reported that, in patients with local recurrence after RFA, tumors showed greater growth and invasion of vascular structures, and less differentiation compared with tumors of patients who did not undergo RFA [6].…”

Section: Introductionmentioning

confidence: 99%

“…However, several cases of rapid and aggressive recurrence of HCC after RFA have been reported [3][4][5][6]. Tajima et al reported that, in patients with local recurrence after RFA, tumors showed greater growth and invasion of vascular structures, and less differentiation compared with tumors of patients who did not undergo RFA [6]. Recently, we reported that local recurrence of HCC after RFA showed an aggressive tumor phenotype and poor prognosis through enhanced expression of hypoxia-inducible factor (HIF)-1 and epithelial cell adhesion molecule (EpCAM) [7].…”

Section: Introductionmentioning

confidence: 99%

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Epithelial–mesenchymal transition-related genes are linked to aggressive local recurrence of hepatocellular carcinoma after radiofrequency ablation

et al. 2016

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Epithelial–mesenchymal transition-related genes are linked to aggressive local recurrence of hepatocellular carcinoma after radiofrequency ablation

et al. 2016

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“…Some refractory cases are also unresponsive to locoregional treatment. In addition, recurrent HCC after RFA and/or TACE is a serious issue because such a pattern of recurrence is sometimes associated with aggressive malignancy [5][6][7][8]. Therefore, in such patients, salvage hepatectomy is thought to be important to improve prognosis.…”

Section: Introductionmentioning

confidence: 99%

Salvage Hepatectomy for Recurrent Hepatocellular Carcinoma after Radiofrequency Ablation and/or Transcatheter Arterial Chemoembolization: A Propensity Score-Matched Analysis

et al. 2017

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Aim: We aimed to evaluate the short- and long-term surgical outcomes of salvage hepatectomy for recurrent hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA) and/or transcatheter arterial chemoembolization (TACE). Methods: We reviewed the surgical outcomes of 90 recurrent HCC patients after RFA and/or TACE (salvage group) and 490 HCC patients without preoperative treatment (primary group). We performed 1:1 propensity score matching (PSM) between the 2 groups and matched 87 patients in each group. Results: Before PSM, the salvage group was pathologically more advanced than the primary group. After PSM, there were no significant differences in the clinicopathological features between the groups. The outcomes of propensity score-matched groups were compared and there was no statistically significant difference between the 2 groups regarding perioperative outcomes and survival. Univariate and multivariate analyses of propensity score-matched HCC patients revealed that stage, tumor size, differentiation, and portal vein invasion were independent prognostic factors for survival. Preoperative RFA and/or TACE was not a prognostic factor in a propensity score-matched cohort. Conclusions: The short- and long-term surgical outcomes of the primary and salvage groups were similar under the matched clinicopathological background. Salvage hepatectomy might be an acceptable treatment for recurrent HCC patients after RFA and/or TACE.

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“…These findings suggest that RFA might be related to the development of sarcomatous HCC. Moreover, locally recurrent HCC grows more invasively after RFA, including vascular invasion, and is less differentiated compared with recurrent HCC not treated with RFA . These findings provide important insights into the potential effects of RFA.…”

Section: Comparison Of Surgical Resection and Rfamentioning

confidence: 84%

Pathophysiology of recurrent hepatocellular carcinoma after radiofrequency ablation

Ikemoto

Shimada

Yamada

2016

Hepatology Research

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Radiofrequency ablation (RFA) is effective for the local control of hepatocellular carcinoma (HCC), particularly when a patient's liver functional reserve does not allow radical resection. There is controversy regarding the superiority of surgical resection compared with RFA for such patients, particularly those with three or fewer tumors with diameters ≤3 cm. Moreover, HCC often recurs after RFA, and the tumor cells show distinct phenotypic changes. Incomplete ablation accounts for tumor recurrence, and recent studies provide new insights into the biological mechanisms responsible for the pathological changes of HCC after RFA. This review focuses on the roles of epithelial-mesenchymal transition and cancer stemness that are driven by a mechanism that involves microRNA-mediated upregulation of hypoxia-inducible factor-1. The studies reviewed here provide compelling evidence that complete ablation of HCC is required to prevent recurrence and indicate that further research is urgently required to develop a new systematic strategy to prevent tumor recurrence by targeting hypoxia-inducible factor-1.

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Radiofrequency ablation induces dedifferentiation of hepatocellular carcinoma

Cited by 25 publications

References 22 publications

Epithelial–mesenchymal transition-related genes are linked to aggressive local recurrence of hepatocellular carcinoma after radiofrequency ablation

Epithelial–mesenchymal transition-related genes are linked to aggressive local recurrence of hepatocellular carcinoma after radiofrequency ablation

Salvage Hepatectomy for Recurrent Hepatocellular Carcinoma after Radiofrequency Ablation and/or Transcatheter Arterial Chemoembolization: A Propensity Score-Matched Analysis

Pathophysiology of recurrent hepatocellular carcinoma after radiofrequency ablation

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