Comparing the Outcomes of Radiofrequency Ablation and Surgery in Patients With a Single Small Hepatocellular Carcinoma and Well-Preserved Hepatic Function

Hong, Sung Noh; Lee, Sun-Young; Choi, Moon Seok; Lee, Joon Hyeok; Koh, Kwang Cheol; Paik, Seung Woon; Yoo, Byung Chul; Rhee, Jong Chul; Choi, Dongil; Lim, Hyo Keun; Lee, Kwang‐Woong; Joh, Jae‐Won

doi:10.1097/01.mcg.0000152746.72149.31

Cited by 216 publications

(166 citation statements)

References 36 publications

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“…Surgical resection is considered to be the only potentially curative therapy for HCC (6), but it is a highly invasive procedure. In contrast, the less-invasive percutaneous RFA is a standardized and widely used treatment method, which has equal efficacy to liver resection in terms of localized control (7). However, RFA monotherapy may increase the risk of relapse in cases where the HCC is comparatively large, when it exists near the surface of the liver or near vessels that are hard to treat due to the risk of coagulation necrosis (8).…”

Section: Introductionmentioning

confidence: 99%

Utility of percutaneous radiofrequency ablation alone or combined with transarterial chemoembolization for early hepatocellular carcinoma

et al. 2017

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Abstract. Percutaneous radiofrequency ablation (RFA) combined with transarterial chemoembolization (TACE) is an effective, standard therapy against small hepatocellular carcinoma (HCC). However, there is debate regarding the effectiveness of RFA combined with TACE (RFA/TACE) compared with RFA alone. These two approaches were compared for the treatment of early HCC. The present study examined 83 HCC tumors in 83 patients treated with RFA between April 2007 and August 2014 at three medical institutions. All HCCs were single hypervascular tumors, with a median diameter of 16 mm (range, 6-30 mm). The overall survival (OS) rate of all patients (n=83) was 97.5% at 1 year, 82.8% at 3 years and 48.6% at 5 years, and the local recurrence rate of all patients was 14.3% at 1 year, 32.3% at 3 years and 36.5% at 5 years. The tumor-free survival (TFS) rate of all patients was 95.1% at 1 year, 56.3% at 3 years and 23.4% at 5 years. Compared with RFA alone, RFA/TACE significantly improved OS (P<0.001), intrahepatic distant recurrence (IDR; P=0.038) and TFS (P=0.010). A univariate analysis of prognostic indicators revealed that age <70 years (P=0.008), aspartate transaminase <40 IU/l (P=0.003), alanine aminotransferase <40 IU/l (P=0.006) and platelet count >10x10 4 /µl (P=0.05) were associated with a high survival rate. Multivariate analysis identified RFA/TACE [hazard ratio (HR), 0.108; P=0.001] as an independent prognostic indicator. RFA/TACE was identified as the only independent indicator of IDR (HR: 0.467; P=0.042) and TFS (HR: 0.452; P=0.012). RFA/TACE improved OS rate, IDR and TFS compared with RFA alone. The data suggested that RFA/TACE should be considered for the treatment of single hypervascular HCC.

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Section: Introductionmentioning

confidence: 99%

Utility of percutaneous radiofrequency ablation alone or combined with transarterial chemoembolization for early hepatocellular carcinoma

et al. 2017

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“…In both the surgical and RFA group, >90% of the patients had underlying hepatitis B and/or C. Patients were enrolled in the RFA branch of the study based on their refusal of surgery and other minor The Oncologist ® criteria. Local recurrence rates were higher in the RFA group, but a statistically significant difference was not seen in the overall survival rate or remote recurrence rate [32]. Another study compared 58 patients who underwent laparoscopic RFA (LRFA) with 40 patients who underwent segmental resection [33].…”

Section: Resection Versus Rfamentioning

confidence: 99%

RFA for Liver Tumors: Does It Really Work?

Higgins

Berger

2006

The Oncologist

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The use of radiofrequency ablation (RFA) is increasing in the treatment of both primary and metastatic hepatic tumors. However, the role of RFA has yet to be clearly defined in patients who are still considered amenable to surgical intervention. Future prospective studies are needed to define whether RFA can be used as an alternative to surgery in certain patient populations. In the interim, radiofrequency ablation technology will continue to advance and serve as both a palliative and potentially curative intervention for individuals with hepatic tumors. The Oncologist 2006;11:801-808

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“…The local tumor progression rate following RFA combined with chemoembolization (combination therapy) was lower than the rates in previous studies that used RFA alone (10)(11)(12). Despite good control of treated lesions, new tumors frequently occur, resulting in high distant recurrence rates (4,6).…”

Section: Introductionmentioning

confidence: 52%

Clinical significance of tumor markers in detection of recurrent hepatocellular carcinoma after radiofrequency ablation

Beppu

Sugimoto²,

Shiraki³

et al. 2010

Int J Mol Med

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Abstract. The aim of this study was to elucidate the importance of three tumor markers, ·-fetoprotein (AFP), Lens culinaris agglutinin A-reactive fraction of AFP (AFP-L3), and des-Á-carboxy prothrombin (DCP), for detecting and predicting the recurrence of hepatocellular carcinomas (HCCs). A total of 108 patients with initial non-advanced HCC who underwent curative radiofrequency ablation (RFA) in our hospital were enrolled in this study. The effectiveness of the three tumor markers for detecting recurrence and recurrence-free survival was analyzed. Positivity of these three makers was not markedly increased at the first or second recurrence. In addition, there was no significant correlation between the initial and recurrent levels of each tumor marker. The tumor marker that was positive at the time of initial HCC was not necessarily positive at recurrence. The tumor marker levels at recurrence were not correlated with pre-ablation levels. No significant correlation was found in the tumor marker values between pre-ablation and the time of recurrence. On multivariate analysis, high AFP-L3 levels (≥10%) were significantly predictive of recurrence-free survival. All three tumor markers should be routinely measured to detect recurrence during follow-up after RFA. Especially high AFP-L3 levels should be followed closely.

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Comparing the Outcomes of Radiofrequency Ablation and Surgery in Patients With a Single Small Hepatocellular Carcinoma and Well-Preserved Hepatic Function

Cited by 216 publications

References 36 publications

Utility of percutaneous radiofrequency ablation alone or combined with transarterial chemoembolization for early hepatocellular carcinoma

Utility of percutaneous radiofrequency ablation alone or combined with transarterial chemoembolization for early hepatocellular carcinoma

RFA for Liver Tumors: Does It Really Work?

Clinical significance of tumor markers in detection of recurrent hepatocellular carcinoma after radiofrequency ablation

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