Safety and Efficacy of Radiofrequency Ablation for Solitary Hepatocellular Carcinoma (3–5 cm): a Propensity Score Matching Cohort Study

Qingwang, Ye; Pang, Shujie; Zhang, Haibin; Fu, Yong; Lin, Bingcheng; Yang, Guang-Shun

doi:10.1007/s11605-019-04229-6

Cited by 7 publications

(5 citation statements)

References 26 publications

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“…In these studies, with the exception of Ye et al. ‘s study ( 31 ) that did not report specific age information or follow-up time, the age (median or mean) range of the other included individuals was 47.0–73.0, and the follow-up time (months) range was 24.2–93.0. Almost all of the participants had good liver function, with Child–Pugh class A or B.…”

Section: Resultsmentioning

confidence: 99%

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Liver resection, radiofrequency ablation, and radiofrequency ablation combined with transcatheter arterial chemoembolization for very-early- and early-stage hepatocellular carcinoma: A systematic review and Bayesian network meta-analysis for comparison of efficacy

Zhang¹,

Qin²,

Dong³

et al. 2022

Front. Oncol.

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ObjectiveTo compare the efficacy of liver resection (LR), radiofrequency ablation (RFA), and radiofrequency ablation combined with transcatheter arterial chemoembolization (RFA+TACE) in the treatment of very-early- and early-stage hepatocellular carcinoma (HCC).MethodsWe systemically searched the PubMed, Embase, and Cochrane Library databases. Randomized controlled trials (RCTs) and observational analyses with propensity score-matched cohort analyses (PSMs) comparing any two of the three treatments were included in this study. The primary result was overall survival (OS) and the secondary result was recurrence-free survival (RFS), which were analyzed by calculating the hazard ratio (HR) and 95% confidence intervals (CI).ResultsA total of 25 studies (4249 patients), including 10 RCTs and 15 PSM observational studies, met the inclusion criteria. Although there was no significant difference between LR and RFA in terms of one-year OS, though LR showed superior performance for three- and five-year OS (at three years, HR: 0.74, 95% CI: 0.56-0.96; at five years, HR: 0.73, 95% CI: 0.55-0.94). In addition, significantly higher rates of RFS at one-, three- and five-year follow-up were found for LR than for RFA alone (at one year, HR: 0.68, 95% CI: 0.51-0.92; at three years, HR: 0.67, 95% CI: 0.55-0.81; at five years, HR: 0.61, 95% CI: 0.48-0.78). The combination of RFA+TACE was superior to RFA alone based on one-year RFS (HR: 0.57, 95% CI: 0.34-0.96), while there were no significant differences in OS at one, three, and five years, and in RFS at three and five years.ConclusionsFor very-early- and early-stage HCC, this systematic review and network meta-analysis showed that the efficacy of LR is superior to that of RFA alone, regardless of whether the evaluation is based on either OS or RFS. The advantages of RFA+TACE compared to RFA alone are limited, and further studies are needed to determine whether combination therapy is necessary, i.e., results in significantly improved outcomes. Systematic Review RegistrationThe study was registered with http://www.crd.york.ac.uk/PROSPERO, identifier: CRD42022299269

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Section: Resultsmentioning

confidence: 99%

“…We performed a subgroup analysis of studies that included only single tumors, all of which were less than 5cm in diameter (8,12,15,16,19,27,28,(31)(32)(33)(34)(35)37). For the outcome of OS at one year, LR had an HR of 1.12 (95% CI: 0.52-2.21), and RFA+TACE had an HR of 0.50 (95% CI: 0.07-3.11) compared with RFA.…”

Section: According To the Number Of Tumorsmentioning

confidence: 99%

Liver resection, radiofrequency ablation, and radiofrequency ablation combined with transcatheter arterial chemoembolization for very-early- and early-stage hepatocellular carcinoma: A systematic review and Bayesian network meta-analysis for comparison of efficacy

Zhang¹,

Qin²,

Dong³

et al. 2022

Front. Oncol.

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“…Our results support that SR treatment can provide survival benefits for elderly patients of < 5 cm single lesion HCC. In theory, RFA may have several advantages over SR ( 21 ). Compared with SR, it has lower morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

“…The discrepancy of these results may be partly due to improvements in perioperative management of modern surgery and refinements in ablation techniques. Scholars have repeatedly emphasized the standardization of RFA ( 21 ). Improper treatment, such as insufficient ablation scope and incomplete ablation process, will greatly increase the short-term recurrence rate.…”

Section: Discussionmentioning

confidence: 99%

Comparison of surgical resection and radiofrequency ablation for stages I and II elderly hepatocellular carcinoma patients (≥ 65 years): A SEER population-based propensity score matching’s study

Xie

Yang

et al. 2022

Front. Oncol.

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ObjectivesThe treatment for hepatocellular carcinoma (HCC) remains controversial and limited in elderly patients. Therefore, we aimed to explore treatment choices for the elderly patients (≥ 65years) following surgical resection (SR) versus radiofrequency ablation (RFA) with HCC (single lesion less than 5 cm).MethodsWe used SEER database to identify HCC patients who received treatment of SR/RFA. Kaplan–Meier method and Cox proportional hazards regression method were used to determine the prognostic factors associated with overall survival (OS) and disease-specific survival (DSS). In addition, RFA group and SR group patients were matched with 1:1 propensity score matching (PSM) for diagnosis age, sex, race, marital, American Joint Committee on Cancer (AJCC), grade, radiotherapy, and chemotherapy to decrease the possibility of selection bias. Conditional disease-specific survival (CS) was estimated using the life-table method.ResultsA total of 794 patients who underwent SR and 811 patients who underwent RFA were confirmed from the SEER database. Surgery type was an independent risk factor for HCC. Survival analysis indicated that SR, races, AJCC I, no chemotherapy treatment, and grade I were cumulative risk factors that can significantly improve median survival for HCC (P < 0.05). After PSM analysis, only surgery type was significantly improved median survival of HCC patients (SR vs. RFA, HR: 0.644, 95% CI: 0.482–0.86; P < 0.001). For RFA group, the 2-, 3-, and 5-year CS rates were approximately 71%, 65%, and 62%, respectively, and corresponding to 82%, 80%, and 78% in the SR group.ConclusionSR treatment can provide survival benefits for elderly patients of <5 cm single lesion HCC.

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“… 11 Thirdly, microvascular infiltration and satellite lesions are more common in larger tumors, lending to a higher incidence of residual and LTP. 12 , 13 Therefore, surgical resection is often considered the main treatment for liver cancers above 3 cm. 13 , 14 However, some patients with recurrent liver cancers or insufficient liver functional reserve cannot tolerate this procedure.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Microwave Ablation Assisted by Ultrasound Fusion Imaging for Primary and Secondary Liver Cancers with a Diameter of 3–7 Cm

Yang,

Liang,

Liu

et al. 2023

JHC

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Purpose To investigate the efficacy and safety of microwave ablation (MWA) assisted by ultrasound fusion imaging (FI) for primary and secondary liver cancers with a diameter of 3–7 cm. Patients and Methods A retrospective analysis was conducted on patients with primary and secondary liver cancers (3–7 cm) who underwent MWA with ultrasound FI assistance in our hospital from April 2020 to May 2022. Technical success, technique efficacy, local tumor progression (LTP), major complication, intrahepatic distant recurrence (IDR), and overall survival (OS) were assessed during the follow-up period. In addition, the ablation results of tumors between the medium-sized group (3.1–5.0 cm) and large-sized group (5.1–7.0 cm) were compared. Results 31 patients with 35 primary and secondary liver cancers were treated with MWA assisted by ultrasound FI. Complete ablation was achieved in 34 lesions with a technical success rate of 97.1%. Major complications occurred in 6.5% of patients (2/31), while no ablation-related deaths were reported. The median follow-up time of this study was 24 months (range:10 to 35 months). The technique efficacy rate was 97.1% (34/35), with LTP occurring in three lesions at a rate of 8.8% (3/34). The incidence of IDR was 38.7% (12/31) and the 2-year cumulative OS rate reached 96.7%. Moreover, there were no statistical differences in technique efficacy rate (p=0.286), LTP rate (p=0.328), major complication rate (p=0.503), IDR (p=0.857), and OS (p=0.118) between medium-sized group and large-sized group. Conclusion Ultrasound FI-assisted MWA has the potential to be an effective and safe therapeutic strategy for primary and secondary liver cancers ranging from 3–7 cm in size.

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Safety and Efficacy of Radiofrequency Ablation for Solitary Hepatocellular Carcinoma (3–5 cm): a Propensity Score Matching Cohort Study

Cited by 7 publications

References 26 publications

Liver resection, radiofrequency ablation, and radiofrequency ablation combined with transcatheter arterial chemoembolization for very-early- and early-stage hepatocellular carcinoma: A systematic review and Bayesian network meta-analysis for comparison of efficacy

Liver resection, radiofrequency ablation, and radiofrequency ablation combined with transcatheter arterial chemoembolization for very-early- and early-stage hepatocellular carcinoma: A systematic review and Bayesian network meta-analysis for comparison of efficacy

Comparison of surgical resection and radiofrequency ablation for stages I and II elderly hepatocellular carcinoma patients (≥ 65 years): A SEER population-based propensity score matching’s study

Efficacy and Safety of Microwave Ablation Assisted by Ultrasound Fusion Imaging for Primary and Secondary Liver Cancers with a Diameter of 3–7 Cm

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