Rate of local tumor progression following radiofrequency ablation of pathologically early hepatocellular carcinoma

Abstract

AIMTo evaluate whether pathologically early hepatocellular carcinoma (HCC) exhibited local tumor progression after radiofrequency ablation (RFA) less often than typical HCC.METHODSFifty pathologically early HCCs [tumor diameter (mm): mean, 15.8; range, 10-23; follow-up days after RFA: median, 1213; range, 216-2137] and 187 typical HCCs [tumor diameter (mm): mean, 15.6; range, 6-30; follow-up days after RFA: median, 1116; range, 190-2328] were enrolled in this retrospective study. The presence of stromal invasion (namely, tumor cell invasion into the intratumoral portal tracts) was considered to be the most important pathologic finding for the diagnosis of early HCCs. Typical HCC was defined as the presence of a hyper-vascular lesion accompanied by delayed washout using contrast-enhanced computed tomography or contrast-enhanced magnetic resonance imaging. Follow-up examinations were performed at 3-mo intervals to monitor for signs of local tumor progression. The local tumor progression rates of pathologically early HCCs and typical HCCs were then determined using the Kaplan-Meier method.RESULTSDuring the follow-up period for the 50 pathologically early HCCs, 49 (98%) of the nodules did not exhibit local tumor progression. However, 1 nodule (2%) was associated with a local tumor progression found 636 d after RFA. For the 187 typical HCCs, 46 (24.6%) of the nodules exhibited local recurrence after RFA. The follow-up period until the local tumor progression of typical HCC was a median of 605 d, ranging from 181 to 1741 d. Among the cases with typical HCCs, local tumor progression had occurred in 7.0% (7/187), 16.0% (30/187), 21.9% (41/187) and 24.6% (46/187) of the cases at 1, 2, 3 and 4 years, respectively. Pathologically early HCC was statistically associated with a lower rate of local tumor progression, compared with typical HCC, when evaluated using a log-rank test (P = 0.002).CONCLUSIONThe rate of local tumor progression for pathologically early HCCs after RFA was significantly lower than that for typical HCCs.

Radiotherapy for Hepatocellular Carcinoma Results in Comparable Survival to Radiofrequency Ablation: A Propensity Score Analysis

“…We previously described our RFA methods in detail . RFA procedures were performed percutaneously under ultrasound guidance.…”

“…We previously described our RFA methods in detail. (14) RFA procedures were performed percutaneously under ultrasound guidance. One to three insertions were performed to achieve complete ablation, requiring a 5-mm ablative safety margin for each tumor.…”

Intraprocedural contrast-enhanced ultrasound-CT/MR fusion imaging assessment in HCC thermal ablation to reduce local tumor progression: compared with routine contrast-enhanced ultrasound

“…What's more, it is difficult to assess ablative margin (AM) using routine CEUS as both the ablated index tumor and the ablated liver tissue appear as perfusion defects on CEUS images. According to the previous reports, there is a 3.2%-24.6% probability that local tumor progression (LTP) will occur even after complete ablation of the lesion [11][12][13][14], and failure to establish a sufficient AM was believed an important independent risk factor for LTP [15][16][17][18][19]. Thus, to reduce the incidence of LTP, an intraprocedural imaging assessment method with the ability to quickly and accurately evaluate AM is necessary.…”

Microvascular invasion predicts a poor prognosis of solitary hepatocellular carcinoma up to 2 cm based on propensity score matching analysis

“…Additionally, percutaneous ablation therapies, such as radiofrequency ablation (RFA) and hepatic resection, are equally recommended for HCCs up to 2 cm . However, a recent study showed that the rate of local tumor progression for pathologically early HCCs after RFA was significantly lower than that for typical HCCs . MVI is a histological feature of HCC, and is related to aggressive biological behavior .…”

“…15 However, a recent study showed that the rate of local tumor progression for pathologically early HCCs after RFA was significantly lower than that for typical HCCs. 16 MVI is a histological feature of HCC, and is related to aggressive biological behavior. 17 Therefore, it is important to evaluate the predictors of MVI to refine the clinical treatment choice.…”