Risk factors for the local recurrence of hepatocellular carcinoma after a single session of percutaneous radiofrequency ablation

Hori, Takeshi; Nagata, Kenji; Hasuike, Satoru; Onaga, Masaaki; Motoda, Mizue; Moriuchi, Akihiro; Iwakiri, Hisayoshi; Uto, Hirofumi; Kato, Jien; Ido, Akio; Hayashi, Katsuhiro; Tsubouchi, Hirohito

doi:10.1007/s00535-003-1181-0

Cited by 211 publications

(150 citation statements)

References 22 publications

Supporting

Mentioning

139

Contrasting

Unclassified

Order By: Relevance

“…32,33 An important observation of our study is the fact that despite the tumor's size as a predictor of local recurrence, this parameter, whether considered as a continuous or discontinuous variable, and local recurrence itself, did not impact overall and tumor-free survival. Interestingly, similar results have been recently reported by Lam et al 4 The main explanations of these apparently paradoxical results are, first, that the local recurrence rate observed (11.5%) was quite low in comparison with results reported by earlier studies including medium-sized (Ͼ3-5 cm) HCCs, 22,34 presumably because RFA has improved technically 35 and technologically 23,36 over time; and second, that the majority of these local recurrences (59%) was sufficiently limited to be completely ab- lated by iterative RFA, highlighting the benefit of careful posttreatment follow-up to allow additional procedure as soon as possible. Converse to liver resection, which can only be repeated in a few distant recurrence cases, 25,26 our study clearly shows that iterative RFA is also effective to achieving complete and durable ablation in the majority of cases.…”

Section: Discussionsupporting

confidence: 82%

Radiofrequency ablation of hepatocellular carcinoma: Long-term results and prognostic factors in 235 Western patients with cirrhosis

N’Kontchou¹,

Mahamoudi²,

Aout³

et al. 2009

Hepatology

412

303

View full text Add to dashboard Cite

For the treatment of small hepatocellular carcinoma (HCC), radiofrequency ablation (RFA) is in some centers considered a first-line therapeutic option. However, such a strategy is still under debate with regard to tumor and patient characteristics. In this single-center study we assessed the 5-year survival and prognosis factors in 235 consecutive patients with cirrhosis (Child-Pugh A/B: 205/30) who received RFA as first-line treatment for up to three HCC <5 cm (307 tumors; mean diameter: 29 ؎ 10 mm; 53 multinodular forms). Among these patients, 67 satisfied the criteria for resection according to the Barcelona Clinic Liver Cancer. Complete ablation was obtained in 222 patients (94%). Overall, 337 RFA sessions were performed including iterative RFA for recurrence. Major complications occurred in three patients (0.9%), including one treatmentrelated death. After 27 ؎ 20 months of mean follow-up, local or distant, or both, tumor recurrence occurred in 16, 88, and 11 patients, respectively. Twenty-nine patients underwent transplantation and were removed from the study at this point. Overall 5-year, recurrence-free, and tumor-free (including results of iterative RFA) survival rates were, respectively, 40%, 17%, and 32%. The overall 5-year survival rate was 76% for operable patients. Factors associated with overall survival were prothrombin activity (hazard ratio [HR] ‫؍‬ 0.97, 0.96-0.98; P < 0.0001) and serum levels of ␣-fetoprotein (AFP) (HR ‫؍‬ 1.02, 1.02-1.02; P < 0.0001), and factors associated with tumor recurrence were multinodular forms (HR ‫؍‬ 2.34; 1.52-3.6; P ‫؍‬ 0.0001) and serum AFP levels (HR ‫؍‬ 1.015, 1.014-1.016; P ‫؍‬ 0.015). Tumor size was associated with local recurrence but not with overall and tumor-free survival. Conclusion: RFA is a safe and effective first-line treatment of HCC up to 5 cm in diameter, especially for patients with a single tumor, a low serum AFP level, and well-preserved liver function.

show abstract

Section: Discussionsupporting

confidence: 82%

Radiofrequency ablation of hepatocellular carcinoma: Long-term results and prognostic factors in 235 Western patients with cirrhosis

N’Kontchou¹,

Mahamoudi²,

Aout³

et al. 2009

Hepatology

412

303

View full text Add to dashboard Cite

show abstract

“…RFA is successful for achieving a one-session treatment for patients with small HCC using RFA with CT assistance, and RFA with CT assistance is effective for the treatment of patients with small HCC [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] . One of the advantages of RFA is that it can be repeatedly performed, can be combined with TACE, and can also be used according to the features of the disease and the response [7] .…”

Section: Discussionmentioning

confidence: 99%

“…The most important variable, which influences the local recurrence rate, is tumor size [14] . Patients who have more than two HCC nodules accompanied by HCV infection should be carefully followed because of a high incidence of new HCC lesions in the remnant liver, even if coagulation by microwave or ablation by radiofrequency is complete [11] .…”

Section: Discussionmentioning

confidence: 99%

Risk factors for the recurrence of hepatocellular carcinoma after radiofrequency ablation of hepatocellular carcinoma in patients with hepatitis C

Yamanaka

Shiraki²,

Miyashita³

et al. 2005

WJG

View full text Add to dashboard Cite

AIM:To analyze the risk factors of hepatocellular carcinoma (HCC) recurrence after radiofrequency ablation (RFA) treatment with HCV-associated hepatitis. METHODS:Twenty-six patients with HCV-associated HCC who were followed-up for more than 12 mo were selected for this study. Risk factors for distant intrahepatic recurrences of HCC were evaluated for patients in whom complete coagulation was achieved without recurrence in the same subsegment as the primary nodule. Twelve clinical and tumoral factors were examined: Age, gender, nodule diameter, number of primary HCC nodule, Child-Pugh classification, serum platelet, serum albumin, serum AST, post RFA AST, serum ALT, post RFA ALT, post RFA treatment. RESULTS:Distant recurrences of HCC in remnant liver after RFA were observed in 14 cases and in the number of primary HCC nodules (P = 0.047), and the serum platelets (P = 0.030), the clear difference came out by the recurrence group and the non-recurrence group. The cumulative recurrence rates after 1 and 2 years were 30.8% and 86.8%, respectively for primary multinodular HCC, and 15.4% and 29.5% respectively, for primary uninodular HCC. In addition the 1-year recurrence rates for patients with serum albumin more than 3.4 g/dL and less than 3.4 g/dL were 23.1% for both, but the 2-years recurrence rates were 89.0% and 23.1%, respectively. The number of primary HCC nodules (relative risk, 6.970; P = 0.016) were found to be a statistically significant predictor for poor distant intrahepatic recurrence by univariate analysis. CONCLUSION:Patients who have multiple HCC nodules, low serum platelets and low serum albumin accompanied by HCV infection, should be carefully followed because of the high incidence of new HCC lesions in the remnant liver, even if coagulation RFA is complete.

show abstract

“…RFA has recently gained wide acceptance worldwide, mainly due to its relatively low level of invasiveness, ease of use and effectiveness (9,10). The incidence of local tumor progression of HCC reportedly ranges between 0.9 and 31.3% (5,9,(11)(12)(13)(14)(15)(16)(17)(18). Local tumor recurrence may occur due to untreated satellite lesions, which are too small to detect on imaging prior to RFA (19).…”

Section: Introductionmentioning

confidence: 99%

Local recurrence of hepatocellular carcinoma in the tumor blood drainage area following radiofrequency ablation

Hirooka

Ochi

Terada

et al. 2013

Molecular and Clinical Oncology

View full text Add to dashboard Cite

Abstract. Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide. HCC is generally considered to spread via the bloodstream and local recurrence often occurs in the blood drainage area determined by computed tomography during hepatic arteriography (CTHA), despite complete ablation of the primary nodule. This study was conducted in order to prospectively assess the rate of local recurrence in the blood drainage area depicted by delayed-phase CTHA. The participants comprised 364 consecutive patients (260 men and 104 women; mean age, 67.4±8.6 years), enrolled between April, 2002 and December, 2011. The participants were divided into two groups, according to whether the ablation area covered the entire blood drainage area as defined by delayed-phase CTHA (group A) or not (group B). Local tumor progression was compared between the two groups. The median time to recurrence was significantly shorter for group B (434 days) compared to that for group A (1,474 days; P=0.0037). The cumulative local recurrence rates for group A were 0, 0 and 1.5% at 1, 3 and 5 years postoperatively, respectively, whereas the recurrence rates for group B were 3.8, 17.0 and 22.8% at 1, 3 and 5 years, respectively (P<0.0001). In conclusion, the safety margin for radiofrequency ablation should be defined as the blood drainage area and ablation should aim at acquiring adequate safety margins.

show abstract

Risk factors for the local recurrence of hepatocellular carcinoma after a single session of percutaneous radiofrequency ablation

Cited by 211 publications

References 22 publications

Radiofrequency ablation of hepatocellular carcinoma: Long-term results and prognostic factors in 235 Western patients with cirrhosis

Radiofrequency ablation of hepatocellular carcinoma: Long-term results and prognostic factors in 235 Western patients with cirrhosis

Risk factors for the recurrence of hepatocellular carcinoma after radiofrequency ablation of hepatocellular carcinoma in patients with hepatitis C

Local recurrence of hepatocellular carcinoma in the tumor blood drainage area following radiofrequency ablation

Contact Info

Product

Resources

About