HIFU for the treatment of gastric cancer with liver metastases with unsuitable indications for hepatectomy and radiofrequency ablation: a prospective and propensity score-matched study

Abstract

Background The purpose of this study was to explore the efficacy and safety of high intensity focused ultrasound (HIFU) in gastric cancer with liver metastasis (GCLM) patients who were contraindicated for either hepatectomy or radiofrequency ablation (RFA). Methods This is a prospective, observational study on GCLM patients with 1–3 liver metastases. The primary gastric lesions were thoroughly resected and any case that exhibited extra-hepatic metastasis was excluded. A 1:2:2 propensity score-matching analysis was performed using a logistic regression model on the HIFU group, best supportive care (BSC) group, and palliative chemotherapy (PC) group. The primary endpoints include progression-free survival (PFS) and overall survival (OS). Results Forty patients were finally included, there were 8 cases in HIFU group, 16 cases in BSC group, and 16 cases in PC group. The median follow-up time for the entire cohort was 10 months. The median PFS was 16.5 months in HIFU group, 2 months in BSC group, and 5 months in PC group. The median OS was 27.5 months in the HIFU group, 7 months in the BSC group, and 11.5 months in the PC group. Additionally, no grade 3 or higher adverse events occurred in the HIFU group. Conclusion The results of this study showed that HIFU treatment could improve the long-term prognosis of GCLM patients without a significant increase in the occurrence of adverse events. Compared with PC and BSC, HIFU is the preferred treatment option when GCLM patients without extra-hepatic metastasis are unable to undergo either surgery or RFA.

Ultra‐high‐performance liquid chromatography‐tandem mass spectrometry‐based metabolomics unveils the metabolic alterations in colon cancer mice during CT‐guided radiofrequency ablation

“…Radiofrequency ablation is now considered the most frequently adopted method for treating cancer locally (Zhou et al, 2019). Its efficacy is equivalent to or even superior to that of surgical excision for treating cancer (Zhou, He, et al, 2021). In addition, RFA not only can ablate the tumor but also is effective in sealing bile ducts and vessels, which can promote the bloodless resection of the tumor (Jiang, Luo, et al, 2020).…”

Systematic review and meta-analysis of the efficacy and safety of high-intensity focused ultrasound combined with transarterial chemoembolization and transarterial chemoembolization alone in the treatment of liver cancer

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A review of high-intensity focused ultrasound as a novel and non-invasive interventional radiology technique

“…HIFU can converge high-power ultrasound with a wave length of 0.2–0.3 ​mm onto tissue with a volume of 9 ​× ​2 ​× ​2 ​mm 3 . 12 Histology reveals a sharp edge between live and dead cells. HIFU can provide an absolutely non-invasive treatment without causing destruction to the non-targeted tissues.…”