Factors that predict intrahepatic recurrence of hepatocellular carcinoma in 81 patients initially treated by percutaneous ethanol injection

Hasegawa, Susumu; Yamasaki, Naruhiro; Hiwaki, Takuya; Sako, Katsumi; Komorizono, Yasuji; Baba, Yoshirou; Imamura, Yasushi; Kubozono, Osamu; Yoshida, Aichi; Arima, Terukatsu

doi:10.1002/(sici)1097-0142(19991101)86:9<1682::aid-cncr9>3.0.co;2-6

Cited by 78 publications

(58 citation statements)

References 42 publications

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“…Previous studies have reported intra-hepatic distant recurrence rates of 18.7-22.5%, 62.1-67% and 81-81.7% at 1, 3 and 5 years, respectively, after percutaneous ethanol injection therapy (PEIT) (31-33), 38 and 60% at 1 and 2 years, respectively, after RFA (34), and 18 and 52% at 1 and 2 years, respectively, after RFA or microwave coagulation therapy (35). In the present subjects, distant recurrence occurred in 8.3, 19.3 and 66.3% at 1, 3 and 5 years, respectively, after the combination of TACE and RFA; these rates were comparable to those reported previously (31)(32)(33)(34)(35). The recurrences of HCC decrease liver function and worsen prognosis.…”

Section: Discussionsupporting

confidence: 88%

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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Section: Discussionsupporting

confidence: 88%

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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show abstract

“…Furthermore, a recent report of PEI in HCC patients with tumors less than 3 cm diameter found a local recurrence rate of 38% [44]. After a three-year follow-up Radiofrequency Ablation of Liver Tumors of all patients, HCC had recurred locally or at other intrahepatic sites in 81% of the patients [44]. Because PEI required multiple treatment sessions and was associated with a high local recurrence rate, the authors recommended that PEI only be considered for tumors less than 1.5 cm in diameter and that all other patients with small HCC be treated with resection or other definitive, single-treatment ablation techniques, like RFA.…”

Section: Greatest Diametermentioning

confidence: 99%

“…Most reports mention that local recurrence is common in tumors greater than 5 cm in diameter and recommend that PEI not be used to treat such large HCCs [41][42][43]. Furthermore, a recent report of PEI in HCC patients with tumors less than 3 cm diameter found a local recurrence rate of 38% [44]. After a three-year follow-up Radiofrequency Ablation of Liver Tumors of all patients, HCC had recurred locally or at other intrahepatic sites in 81% of the patients [44].…”

Section: Greatest Diametermentioning

confidence: 99%

Radiofrequency Ablation of Malignant Liver Tumors

2001

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The majority of patients with primary or metastatic hepatic tumors are not candidates for resection because of tumor size, location near major intrahepatic blood vessels precluding a margin-negative resection, multifocality, or inadequate hepatic function related to coexistent cirrhosis. Radiofrequency ablation (RFA) is an evolving technology being used to treat patients with unresectable primary and metastatic hepatic cancers. RFA produces coagulative necrosis of tumor through local tissue heating. Liver tumors are treated percutaneously, laparoscopically, or during laparotomy using ultrasonography to identify tumors and guide placement of the RFA needle electrode. For tumors smaller than 2.0 cm in diameter, one or two deployments of the monopolar multiple array needle electrode are sufficient to produce complete coagulative necrosis of the tumor. However, with increasing size of the tumor, there is a concomitant increase in the number of deployments of the needle electrode and the overall time necessary to produce complete coagulative necrosis of the tumor. In general, RFA is a safe, well-tolerated, effective treatment for unresectable hepatic malignancies less than 6.0 cm in diameter. Effective treatment of larger tumors awaits the development of more powerful, larger array monopolar and bipolar RFA technologies.

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“…22 For tumors between 2-4 cm, the efficacy of PEI falls off; beyond 4 cm, it is not useful. Because of its simplicity and effectiveness, it is the preferred method at many centers to treat small, solitary lesions.…”

Section: Tumor Management While Awaiting Transplantationmentioning

confidence: 99%

Liver transplantation in patients with hepatocellular carcinoma

Schwartz

2004

Liver Transpl

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Factors that predict intrahepatic recurrence of hepatocellular carcinoma in 81 patients initially treated by percutaneous ethanol injection

Cited by 78 publications

References 42 publications

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

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

Radiofrequency Ablation of Malignant Liver Tumors

Liver transplantation in patients with hepatocellular carcinoma

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