Radiofrequency ablation of subcapsular versus nonsubcapsular hepatocellular carcinomas ≤ 3 cm: analysis of long-term outcomes from two large-volume liver centers

Han, Kichang; Kim, Jin Hyoung; Kim, Gun Ha; Kim, Ji Hoon; Kim, So Yeon; Park, Seong Ho; Moon, Sungmo; Kwon, Joon Ho; Kim, Gyoung Min; Lee, So Jung; Won, Hyung Jin; Shin, Yong Moon

doi:10.1007/s00330-023-10165-6

Cited by 3 publications

(4 citation statements)

References 29 publications

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“…Due to the limited number of people who develop LTP and the large number of confounding factors that need to be included, this study did not explore any independent factors affecting LTP. The frequency of LTP was 17.7% (26/147) [occurred at 3-60 months (mean: 18.8, standard error: 3.0, 95% CI: 12.6-25.1)], which is similar to previously reported rates of 9.6 to 27.3% (8,9,14,(21)(22)(23)(24). Furthermore, the study found that the cumulative LRFS rates were 88.9% at 1 year, 80.5% at 2 years, 70.1% at 3 years, 66.8% at 4 years, and 30.0% at 5 years.…”

Section: B Asupporting

confidence: 86%

“…Several factors have been identified as potential predictors of LTP in HCC, including tumor size and location (e.g., perivascular, subcapsular, or subphrenic) ( 8 , 22 , 23 ). Understanding the factors associated with LTP is crucial for guiding treatment decisions and improving patient outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…During the follow-up period (20.6 months in median, range: 1-65 months), 61 (45%) of the 135 patients developed tumor progression or recurrence, including one patient who died. The median PFS after RFA for all patients was 23 months (95% CI: [19][20][21][22][23][24][25][26][27][28][29][30][31]. The cumulative 1-, 2-, 3-, and 4-year PFS rates were 74% (95% CI: 66-84), 47% (95% CI: 37-60), 30% (95% CI: 20-43), and 17% BCLC stage, n (%)…”

Section: Risk Factors For Pfs and Systemic Tumor Responsementioning

confidence: 99%

“…The discrepancy between these studies may be due to differences in the HCC patients enrolled. In other words, the inclusion of larger HCC, tumor location (8,22,23), and number of tumors (25) might have adversely affected the LTP rate. Lee et al confirmed that LTP is an independent risk factor for overall survival (8).…”

Section: B Amentioning

confidence: 99%

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Radiofrequency ablation with or without transarterial chemoembolization for hepatocellular carcinoma meeting Milan criteria: a focus on tumor progression and recurrence patterns

Xie,

Lyu,

Guan

et al. 2024

Front. Oncol.

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Background/objectiveThe aim of this study was to evaluate tumor progression and recurrence patterns of radiofrequency ablation (RFA) with or without transarterial chemoembolization (TACE) for treating hepatocellular carcinoma (HCC) that meets Milan criteria.MethodsThis retrospective study included consecutive HCC patients meeting Milan criteria who underwent percutaneous RFA with or without TACE as initial treatment at a tertiary academic center between December 2017 and 2022. Technical success rate, local recurrence-free survival (LRFS), progression-free survival (PFS) and recurrence patterns were recorded.ResultsA total of 135 HCC patients (109 male [80.7%]) with a mean age of 62 years and 147 target lesions were retrospectively enrolled. The technical success rate was 99.3%. The median LRFS was 60 months, and the cumulative 1-, 3-, and 5-year LRFS were 88.9%, 70.1%, and 30.0%, respectively. Additionally, the median PFS was 23 months, with cumulative 1-, 3-, and 5-year PFS of 74%, 30%, and 0%, respectively. Multivariate analysis confirmed that age > 60, alpha-fetoprotein (AFP) (> 10), and albumin were associated with PFS (2.34, p = 0.004; 1.96, p = 0.021; 0.94, p = 0.007, respectively). Six recurrence patterns were identified: local tumor progression (LTP) alone (n = 15, 25.0%), intrahepatic distant recurrence (IDR) alone (n = 34, 56.7%), extrahepatic recurrence (ER) alone (n = 2, 3.3%), IDR + ER (n = 2, 3.3%), LTP + IDR (n = 5, 8.8%), and LTP + IDR + ER (n = 2, 3.3%). IDR occurred most frequently as a sign of good local treatment.ConclusionsRFA in combination with TACE does not appear to provide an advantage over RFA alone in improving tumor progression in patients with HCC meeting the Milan criteria. However, further prospective studies are needed to confirm these findings and to determine the optimal treatment approach for this patient population.

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Section: B Asupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Risk Factors For Pfs and Systemic Tumor Responsementioning

confidence: 99%

Section: B Amentioning

confidence: 99%

See 2 more Smart Citations

Radiofrequency ablation with or without transarterial chemoembolization for hepatocellular carcinoma meeting Milan criteria: a focus on tumor progression and recurrence patterns

Xie,

Lyu,

Guan

et al. 2024

Front. Oncol.

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Percutaneous radiofrequency ablation of liver metastases from colorectal cancer: Development of a prognostic score to predict overall survival

Ho Chu,

Hyoung Kim,

Ha Kim

et al. 2024

European Journal of Radiology

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Outcomes and Complications of Image-Guided Percutaneous Tumour Ablation for Hepatocellular Carcinoma at the Irish National Liver Transplant Centre

Tee,

Hughes,

Ryan

et al. 2024

Can Assoc Radiol J

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Background: Image-guided tumour ablation is a minimally invasive treatment for early stage hepatocellular carcinoma (HCC). Our study reviews the complications and long term outcomes in patients treated at a tertiary referral centre. Methods: Retrospective study. All patients with HCC who underwent microwave ablation (MWA) or radiofrequency ablation (RFA) from 1st January 2014 to 31st December 2022 were identified. Treatment response of target lesion, complications, and survival were recorded. Results: One hundred seventy ablations were performed in 118 patients; 70% MWA, 30% RFA. Median radiological follow-up 21 months (range 3-107). Follow-up imaging was reported using LI-RADS and mRECIST. At first follow-up imaging, 94 patients had complete response (primary efficacy rate 80.3%) while 19.7% (n = 23) had residual disease. Fifteen of these had repeat ablation; 10 had complete response (secondary efficacy rate 85.6%). By end of study duration, 70.5% (n = 79) achieved sustained local complete response from single ablation without documented recurrence. 14.3% (n = 16) required more than one ablation of target lesion. Overall, 84.8% (n = 95) demonstrated long term local complete response to ablation. Complication occurred in 5.9% (n = 10); 40.0% Grade I, 40.0% Grade II, 10.0% Grade III, 10.0% Grade IV as per the CIRSE Classification. 1-, 3-, and 5-year overall survival (OS) rate was 97%, 68%, and 61% respectively. Mean OS was 5.3 years (median 4.7). No difference in OS ( P = .7) or local progression free survival ( P = .5) between patients treated with MWA versus RFA. Conclusion: This study demonstrates excellent long-term response to TA, with acceptable complication profile. No difference in survival between RFA versus MWA.

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Radiofrequency ablation of subcapsular versus nonsubcapsular hepatocellular carcinomas ≤ 3 cm: analysis of long-term outcomes from two large-volume liver centers

Cited by 3 publications

References 29 publications

Radiofrequency ablation with or without transarterial chemoembolization for hepatocellular carcinoma meeting Milan criteria: a focus on tumor progression and recurrence patterns

Radiofrequency ablation with or without transarterial chemoembolization for hepatocellular carcinoma meeting Milan criteria: a focus on tumor progression and recurrence patterns

Percutaneous radiofrequency ablation of liver metastases from colorectal cancer: Development of a prognostic score to predict overall survival

Outcomes and Complications of Image-Guided Percutaneous Tumour Ablation for Hepatocellular Carcinoma at the Irish National Liver Transplant Centre

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