Comparison of Hepatic Resection with Percutaneous Ablation for Hepatocellular Carcinoma in the Caudate Lobe Within Milan Criteria

Xie, Wenlin; Tan, Junjie; Li, Bin; Chen, Shu‐Ling; Liu, Baoxian; Shen, Jingxian; Fu, Shunjun; Kuang, Ming; Sun, Ke; Zeng, Xuezhen

doi:10.1007/s11605-021-05111-0

Cited by 2 publications

(3 citation statements)

References 30 publications

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“…As previously described, 30 PA was performed by two experienced doctors with more than 10 years of tumor ablation experience. Ablation was performed using real-time ultrasound or computed tomography (CT) guidance.…”

Section: Methodsmentioning

confidence: 99%

Comparisons of Percutaneous Ablation, Open or Laparoscopic Liver Resection for Barcelona Clinic Liver Cancer Stage 0-A Hepatocellular Carcinoma: A Concurrent Generalized Propensity Score Analysis

Chen,

Zhou,

Chen

et al. 2024

JHC

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Purpose Liver resection and ablation remain the most common therapeutic options for Barcelona Clinic Liver Cancer (BCLC) stage 0-A hepatocellular carcinoma (HCC), but there is a lack of evidence to show which is the most suitable therapy. This study aimed to make concurrent multi-arm comparisons of the short-term and long-term outcomes of percutaneous ablation (PA), open (OLR) or laparoscopic liver resection (LLR) for these patients. Patients and Methods This was a retrospective observational cohort study. A series of generalized propensity score methods for multiple treatment groups were performed to concurrently compare the clinical outcomes of these three treatment options to balance potential confounders. Regression standardization was used to account for hazard of all-cause mortality and recurrence of intergroup differences. Results Of the 1778 patients included, 1237, 307 and 234 underwent OLR, LLR and PA, respectively. After overlap weighting, which was the optimal adjustment strategy, patients in the minimally invasive group (LLR and PA groups) had few postoperative complications and short postoperative hospital stays (both P < 0.001). The 5-year recurrence-free survival (RFS) rate and 5-year overall survival (OS) rate were significantly higher in the LLR group when compared with the OLR and PA groups (RFS: 55.6% vs 48.0% vs 30.2%, P < 0.001; OS: 89.1% vs 79.7% vs 84.0%, P = 0.020). Multivariable Cox analysis and regression standardization showed that LLR was an independent factor for better RFS when compared with OLR and PA. In subgroup analysis, the long-term outcomes of patients with BCLC stage A HCC were consistent with the whole population. Conclusion In the observational study using various covariate adjustment analysis with excellent balance, LLR is not only minimally invasive, but also provides better RFS and equivalent OS for patients with BCLC stage 0-A HCC when compared with OLR and PA.

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Section: Methodsmentioning

confidence: 99%

Comparisons of Percutaneous Ablation, Open or Laparoscopic Liver Resection for Barcelona Clinic Liver Cancer Stage 0-A Hepatocellular Carcinoma: A Concurrent Generalized Propensity Score Analysis

Chen,

Zhou,

Chen

et al. 2024

JHC

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show abstract

“…After guiding to complete ablation, it is still recommended to enhance CT to clarify residual lesions. (2) The 1-, 3-, and 5-year survival rates, and 1-, 3-, and 5-year disease-free survival (DFS) rates of stereo ultrasound guiding multi-needle RFA, 38 were roughly comparable with ultrasound-guided RFA 1 ; and the value and safety of its application needs to be further investigated. (3) Some scholars 39 found that the LTP rate of ultrasonography-guided ablation was significantly lower than that of ultrasound, and the application of ultrasonography also has great potential.…”

Section: Percutaneous Ablationmentioning

confidence: 99%

“…The independent portal venous supply and venous drainage of the caudate lobe allow hepatocellular carcinoma (HCC) in the caudate lobe to frequently invade vessels, such as the portal and inferior vena cava, and the frequent formation of cancer thrombi can result in early intra- or extra-hepatic metastases. For resectable hepatocellular carcinoma in the caudate lobe that meets Milan's criteria, surgical treatment has better recurrence-free survival and overall survival (OS) than radiofrequency ablation (RFA) 1 ; however, in some cases, surgical resection carries the risk of heavy bleeding and high early recurrence rates. In contrast, minimally invasive interventions, including endovascular and extravascular interventions, have the advantages of being safe and effective with minimal impact on liver function and are increasingly becoming the choice of treatment for unresectable caudate lobe HCC.…”

Section: Introductionmentioning

confidence: 99%

Advances in the interventional therapy of hepatocellular carcinoma originating from the caudate lobe

2022

Journal of Interventional Medicine

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Comparison of Hepatic Resection with Percutaneous Ablation for Hepatocellular Carcinoma in the Caudate Lobe Within Milan Criteria

Cited by 2 publications

References 30 publications

Comparisons of Percutaneous Ablation, Open or Laparoscopic Liver Resection for Barcelona Clinic Liver Cancer Stage 0-A Hepatocellular Carcinoma: A Concurrent Generalized Propensity Score Analysis

Comparisons of Percutaneous Ablation, Open or Laparoscopic Liver Resection for Barcelona Clinic Liver Cancer Stage 0-A Hepatocellular Carcinoma: A Concurrent Generalized Propensity Score Analysis

Advances in the interventional therapy of hepatocellular carcinoma originating from the caudate lobe

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