Early-Stage Hepatocellular Carcinoma in Patients with Cirrhosis: Long-term Results of Percutaneous Image-guided Radiofrequency Ablation

Lencioni, Riccardo; Cioni, Dania; Crocetti, Laura; Franchini, Chiara; Pina, Clotilde Della; Lera, José Miguel; Bartolozzi, Carlo

doi:10.1148/radiol.2343040350

Cited by 783 publications

(533 citation statements)

References 32 publications

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“…Additionally, survival rates were better after treatment in these patients. 8,22 This study demonstrated that there was no significant difference in survival rates between major vascular invasion, multiple tumors larger than 5 cm and lymph nodes metastasis. Therefore this study combined these 3 subgroups of primary 6th edition stage III into modified stage IIIB.…”

Section: Discussionmentioning

confidence: 72%

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Validation of clinical AJCC/UICC TNM staging system for hepatocellular carcinoma: Analysis of 5,613 cases from a medical center in southern Taiwan

Kee

Wang

Lee

et al. 2007

Intl Journal of Cancer

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This study was aimed to validate the 5th and 6th editions of tumor-node-metastasis (TNM) system for patients with hepatocellular carcinoma (HCC), and attempted to improve prognostic stratification by modifying the 6th edition according to vascular invasion and tumor size. From 1986 to 2002, a total of 5,613 HCC cases from Kaohsiung Chang Gung Memorial Hospital in southern Taiwan were enrolled. The 6th edition was modified by dividing stage I into stages IA (single tumor, £2cm) and IB (single tumor, >2cm), and by dividing stage II into IIA (multiple tumors, none >5cm) and IIB (tumor with segmental macro vascular invasion). The Akaike information criteria (AIC), within a Cox proportional hazard regression model were used; lower AIC value indicated a better discriminatory ability for staging system. The 1-, 3-, 5-, and 7-year overall survival rates were 45.6, 25.9, 17.9, and 13.4%, respectively. Significant differences in survival curve existed in the 5th, 6th, and modified 6th edition TNM systems. For the modified 6th edition TNM, survival differed significantly between stages IA and IB, and between stage IIA and IIB. The AIC values of 5th (72,328), 6th (72,188), modified 6th (71,991) edition TNM system were decreasing. This investigation demonstrated better prognostic stratifications for the 6th edition than the 5th edition TNM staging system. Moreover, the modified 6th edition staging system demonstrated better prognostic prediction than the former two. Pretreatment staging and simple classification of current modified 6th edition TNM staging can be applied to all HCC patients and are clinically useful. ' 2007 Wiley-Liss, Inc.

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Section: Discussionmentioning

confidence: 72%

“…For multiple tumors (none >5 cm) without vascular invasion having higher survival rates if compared with vascular invasion. 15,[21][22][23] Stage II was thus divided into stages IIA (multiple tumors, none >5 cm and without vascular invasion) and IIB (tumor with segmental macroscopic vascular invasion).…”

Section: Establishing a New Modified 6th Tnm Staging Systemmentioning

confidence: 99%

Validation of clinical AJCC/UICC TNM staging system for hepatocellular carcinoma: Analysis of 5,613 cases from a medical center in southern Taiwan

Kee

Wang

Lee

et al. 2007

Intl Journal of Cancer

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“…An RCT demonstrated that the number of treatment sessions was fewer with RFA than with microwave coagulation [298], although the rates of complete therapeutic effect, major complications, and local tumor progression were not statistically different between the two therapies. In RFA, survival rates have been reported to be 39.9-68.5% at 5 years [299][300][301][302][303][304] and local tumor progression rates to be 2.4-16.9% [299][300][301]304]. Mortality and morbidity rates of RFA have been reported to be 0.9-7.9% and 0-1.5%, respectively [300][301][302][303][304][305].…”

Section: Local Ablation Is a First-line Treatment Of Unresectable Smmentioning

confidence: 99%

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

et al. 2010

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Introduction The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party on the management of hepatocellular carcinoma (HCC) in December 2008 to develop consensus recommendations. Methods The working party consisted of expert hepatologist, hepatobiliary surgeon, radiologist, and oncologist from Asian-Pacific region, who were requested to make drafts prior to the consensus meeting held at Bali, Indonesia on 4 December 2008. The quality of existing evidence and strength of recommendations were ranked from 1 (highest) to 5 (lowest) and from A (strongest) to D (weakest), respectively, according to the Oxford system of evidence-based approach for developing the consensus statements. 123Hepatol Int (2010) 4: 439-474 DOI 10.1007/s12072-010-9165-7 Results Participants of the consensus meeting assessed the quality of cited studies and assigned grades to the recommendation statements. Finalized recommendations were presented at the fourth APASL single topic conference on viral-related HCC at Bali, Indonesia and approved by the participants of the conference.

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“…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

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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.

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Early-Stage Hepatocellular Carcinoma in Patients with Cirrhosis: Long-term Results of Percutaneous Image-guided Radiofrequency Ablation

Abstract: RF ablation is an effective first-line treatment for cirrhotic patients with early-stage HCC who were excluded from surgery.

Cited by 783 publications

References 32 publications

Validation of clinical AJCC/UICC TNM staging system for hepatocellular carcinoma: Analysis of 5,613 cases from a medical center in southern Taiwan

Validation of clinical AJCC/UICC TNM staging system for hepatocellular carcinoma: Analysis of 5,613 cases from a medical center in southern Taiwan

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

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

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