medigraphic.com
Órgano Oficial de la Asociación Mexicana de Hepatología

2016, Number 1

<< Back Next >>

Ann Hepatol 2016; 15 (1)

Hepatocellular carcinoma ≤ 4 cm treated with radiofrequency ablation with or without percutaneous ethanol injection

Shi F, Tan Z, An H, Wang X, Xu Y, Wang S

Language: English
References: 33
Page: 61-70
PDF size: 172.08 Kb.


ABSTRACT

Background. To compare the survival of Chinese cirrhotic patients with hepatocellular carcinoma (HCC) ≤ 4 cm who underwent radiofrequency ablation (RFA) alone or a combination of RFA with percutaneous ethanol injection (PEI). Material and methods. Retrospective analysis was performed for 681 cases with HCC ≤ 4 cm who were treated with RFA alone or RFA combined with PEI (RFA + PEI) between 2004 and 2011. Results. As a result, 180 patients in each group were selected after propensity score matching (PSM). Higher overall survival (OS) and recurrence-free survival (RFS) rates were achieved by RFA + PEI compared with RFA alone (P = 0.019 and 0.009, respectively). The 1-, 3-, and 5-year cumulative OS rates were 78.0, 44.4, and 30.1% for patients in RFA group and 88.2, 58.0, and 41.1% for patients in RFA + PEI group, respectively. Besides, the 1-, 3-, and 5-year cumulative RFS rates were 77.0, 43.8, and 29.2% in RFA group, and 87.9, 57.6, and 38.4% in RFA + PEI group, respectively. The local recurrence, complete ablation and five-year mortality showed no distinct differences between RFA and RFA + PEI groups in three subgroups classified with tumor size. Moreover, Cox regression multivariate analysis results showed that sex and treatment approach were significantly related to OS, whereas sex, status of HBsAg, local recurrence, and number of tumor nodule were related to RFS. Conclusion. Therefore, the combination of RFA and PEI yielded better OS and RFS rates than RFA alone for Chinese patients with HCC ≤ 4 cm.


REFERENCES

  1. Amarapurkar D, Han KH, Chan HLY, Ueno Y. Application of surveillance programs for hepatocellular carcinoma in the Asia- Pacific region. J Gastroenterol Hepatol 2009; 24: 955-61.

  2. Ferenci P, Fried M, Labrecque D, Bruix J, Sherman M, Omata M, Heathcote J, et al. Hepatocellular carcinoma (HCC): a global perspective. J Clin Gastroenterol 2010; 44: 239-45.

  3. Bosch FX, Ribes J, Díaz M, Cléries R. Primary liver cancer: worldwide incidence and trends. Gastroenterology 2004; 127: S5-S16.

  4. Bruix J, Sherman M, Llovet JM, Beaugrand M, Lencioni R, Burroughs AK, Christensen E, et al. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona- 2000 EASL conference. J Hepatol 2001; 35: 421-30.

  5. Kurokohchi K, Watanabe S, Masaki T, Hosomi N, Miyauchi Y, Himoto T, Kimura Y, et al. Comparation between combination therapy of percutaneous ethanol injection and radiofrequency ablation and radiofrequency ablation alone for patients with hepatocellular carcinoma. World J Gastroenterol 2005; 11: 1426-32.

  6. Kim Y-s, Lim HK, Rhim H, Lee MW. Ablation of hepatocellular carcinoma. Best Practice & Research Clinical Gastroenterology 2014; 28: 897-908.

  7. Yamamoto J, Okada S, Shimada K, Okusaka T, Yamasaki S, Ueno H, Kosuge T. Treatment strategy for small hepatocellular carcinoma: Comparison of long-term results after percutaneous ethanol injection therapy and surgical resection. Hepatology 2001; 34: 707-13.

  8. Azab M, Zaki S, El-Shetey AG, Abdel-Moty MF, Alnoomani NM, Gomaa AA, Abdel-Fatah S, et al. Radiofrequency ablation combined with percutaneous ethanol injection in patients with hepatocellular carcinoma. Arab J Gastroenterol 2011; 12: 113-8.

  9. Minami Y, Kudo M. Radiofrequency ablation of hepatocellular carcinoma: current status. World J Radiol 2010; 2: 417-24.

  10. Yamakado K, Takaki H, Nakatsuka A, Yamaknaka T, Fujimori M, Hasegawa T, Uraki J. Radiofrequency ablation for hepatocellular carcinoma. Gastrointestinal Intervention 2014; 3: 35-9.

  11. Curley SA, Izzo F. Radiofrequency ablation of hepatocellular carcinoma. In: Radiofrequency Ablation for Cancer. Springer; 2004, p. 89-106.

  12. Lin S-M, Lin C-J, Lin C-C, Hsu C-W, Chen Y-C. Radiofrequency ablation improves prognosis compared with ethanol injection for hepatocellular carcinoma ≤ 4 cm. Gastroenterology 2004; 127: 1714-23.

  13. Kurokohchi K, Watanabe S, Masaki T, Hosomi N, Funaki T, Arima K, Yoshida S, et al. Combined use of percutaneous ethanol injection and radiofrequency ablation for the effective treatment of hepatocelluar carcinoma. Int J Oncol 2002; 21: 841-6.

  14. Lin J-W, Lin C-C, Chen W-T, Lin S-M. Combining radiofrequency ablation and ethanol injection may achieve comparable long-term outcomes in larger hepatocellular carcinoma (3.1–4 cm) and in high-risk locations. The Kaohsiung Journal of Medical Sciences 2014; 30: 396-401.

  15. Bruix J, Sherman M. Management of hepatocellular carcinoma. Hepatology 2005; 42: 1208-36.

  16. Lim HK, Choi D, Lee WJ, Kim SH, Lee SJ, Jang H-J, Lee J-H, et al. Hepatocellular Carcinoma Treated with Percutaneous Radio-frequency Ablation: Evaluation with Follow-up Multiphase Helical CT 1. Radiology 2001; 221: 447-54.

  17. Higgins MC, Soulen MC. Combining locoregional therapies in the treatment of hepatocellular carcinoma. In: Seminars in interventional radiology. Volume 30. Thieme Medical Publishers 2013; 30: 74-81.

  18. Poggi G, Gatti C, Teragni C, Delmonte A, Bernardo G. Radiofrequency ablation combined with percutaneous ethanol injection in the treatment of hepatocellular carcinoma and portal vein neoplastic thrombosis. Anticancer Research 2004; 24: 2419-22.

  19. Giorgio A, Di Sarno A, De Stefano G, Scognamiglio U, Farella N, Mariniello A, Esposito V, et al. Percutaneous radiofrequency ablation of hepatocellular carcinoma compared to percutaneous ethanol injection in treatment of cirrhotic patients: an Italian randomized controlled trial. Anticancer Research 2011; 31: 2291-5.

  20. Austin PC. Generating survival times to simulate Cox proportional hazards models with time©varying covariates. Statistics in medicine 2012; 31: 3946-58.

  21. Wong SN, Lin C-J, Lin C-C, Chen W-T, Cua IHY, Lin S-M. Combined percutaneous radiofrequency ablation and ethanol injection for hepatocellular carcinoma in high-risk locations. AJR 2008; 190: W187-W195.

  22. Zhang Y-J, Liang H-H, Chen M-S, Guo R-P, Li J-Q, Zheng Y, Zhang Y-Q, et al. Hepatocellular Carcinoma Treated with Radiofrequency Ablation with or without Ethanol Injection: A Prospective Randomized Trial 1. Radiology 2007; 244: 599-607.

  23. Lin J-W, Lin C-C, Chen W-T, Lin S-M. Combining radiofrequency ablation and ethanol injection may achieve comparable long-term outcomes in larger hepatocellular carcinoma (3.1–4 cm) and in high-risk locations. The Kaohsiung Journal of Medical Sciences 2014; 30: 396-401.

  24. Shimada M, Takenaka K, Fujiwara Y, Gion T, Kajiyama K, Maeda T, Shirabe K, et al. Des-gamma-carboxy prothrombin and alpha-fetoprotein positive status as a new prognostic indicator after hepatic resection for hepatocellular carcinoma. Cancer 1996; 78: 2094-100.

  25. Schulze K, Gasch C, Staufer K, Nashan B, Lohse AW, Pantel K, Riethdorf S, et al. Presence of EpCAM-positive circulating tumor cells as biomarker for systemic disease strongly correlates to survival in patients with hepatocellular carcinoma. Int J Cancer 2013; 133: 2165-71.

  26. Jeng KS, Sheen IS, Tsai YC. Does the presence of circulating hepatocellular carcinoma cells indicate a risk of recurrence after resection? Am J Gastroenterol 2004; 99: 1503-09.

  27. Rossi S, Di Stasi M, Buscarini E, Quaretti P, Garbagnati F, Squassante L, Paties C, et al. Percutaneous RF interstitial thermal ablation in the treatment of hepatic cancer. AJR 1996; 167: 759-68.

  28. Zytoon AA, Ishii H, Murakami K, El-Kholy MR, Furuse J, El- Dorry A, El-Malah A. Recurrence-free survival after radiofrequency ablation of hepatocellular carcinoma. A registry report of the impact of risk factors on outcome. Japanese J Clin Oncol 2007; 37: 658-72.

  29. Kamiyama T, Yokoo H, Kakisaka T, Orimo T, Wakayama K, Kamachi H, Tsuruga Y, et al. Multiplication of alpha-fetoprotein and protein induced by vitamin K absence-II is a powerful predictor of prognosis and recurrence in hepatocellular carcinoma patients after a hepatectomy. Hepatology Research 2015 (article first published online).

  30. Vallone P, Catalano O, Izzo F, Siani A. Combined ethanol injection therapy and radiofrequency ablation therapy in percutaneous treatment of hepatocellular carcinoma larger than 4 cm. Cardiovasc Intervent Radiol 2006; 29: 544-51.

  31. Shankar S, vanSonnenberg E, Morrison PR, Tuncali K, Silverman SG. Combined radiofrequency and alcohol injection for percutaneous hepatic tumor ablation. AJR 2004; 183: 1425-9.

  32. Cammà C, Di Marco V, Orlando A, Sandonato L, Casaril A, Parisi P, Alizzi S, et al. Treatment of hepatocellular carcinoma in compensated cirrhosis with radio-frequency thermal ablation (RFTA): a prospective study. J Hepatol 2005; 42: 535-40.

  33. Salmi A, Turrini R, Lanzani G, Savio A, Anglani L. Efficacy of radiofrequency ablation of hepatocellular carcinoma associated with chronic liver disease without cirrhosis. International Journal of Medical Sciences 2008; 5: 327-332.




2020     |     www.medigraphic.com