High-Intensity Focused Ultrasound Ablation for Unresectable Primary and Metastatic Liver Cancer: Real-World Research in a Chinese Tertiary Center With 275 Cases

Abstract

This retrospective analysis was conducted to evaluate the feasibility and safety of highintensity focused ultrasound ablation for primary liver cancer and metastatic liver cancer. Patients with liver cancer who received high-intensity focused ultrasound were included in this analysis, including a primary liver cancer cohort (n=80) and a metastatic liver cancer cohort (n=195). The primary endpoint of our research was tumor response. The secondary endpoints included survival outcomes, visual analog scale pain scores, alpha-fetoprotein relief, and complications. Objective response rate and disease control rate were observed to be 71.8% and 81.2%, respectively, in patients with primary liver cancer and were 63.7% and 83.2% in cases with metastatic liver cancer. Alphafetoprotein levels and visual analogue scale levels significantly decreased after treatment compared with the baseline levels in patients with primary liver cancer (p<0.05). Median overall survival was estimated to be 13.0 and 12.0 months in the primary liver cancer and metastatic liver cancer cohorts. The 1-year survival rate was 70.69% and 48.00%, respectively. Multivariate regression analysis showed that visual analogue scale ≥ 5, longest diameter ≥ 5 cm, and portal vein invasion were the independent risk factors for poor survival in primary liver cancer. For patients with metastatic liver cancer, independent risk factors were identified as visual analogue scale ≥ 5, longest diameter ≥ 5 cm, existence of extrahepatic metastases, existence of portal vein invasion, and time to high-intensity focused ultrasound treatment from diagnosis < 3 months. Severe adverse events were rarely reported. In conclusion, high-intensity focused ultrasound might be an effective and safe option for patients with liver cancer regardless of primary and metastatic lesions.

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

“…It has been reported that a 35-year female patient with metachronous GCLM achieved CR after receiving HIFU combined with chemotherapy [ 48 ]. A recent retrospective study showed that HIFU therapy for metastatic liver cancer yielded better long-term results [ 49 ]. The one-year survival rate was 48.0%, and the median OS time was 12 months.…”

Hydralazine augmented ultrasound hyperthermia for the treatment of hepatocellular carcinoma

“…Likewise, hyperthermia induced by ultrasound has been demonstrated in efficient drug delivery in tumors 36 . Several earlier studies have established high-intensity focused ultrasound (HIFU)-induced hyperthermia as a technology for cancer therapy in humans 37 , 38 , including HCC 39 , 40 . The safety and feasibility of the focused ultrasound-triggered drug delivery in clinical trials have been extensively discussed 41 .…”

Advanced Techniques in the Percutaneous Ablation of Liver Tumours

“…HIFU uses focused ultrasound at high intensities, allowing the deposition of sufficient energy to cause a well-demarcated volume of coagulation necrosis, independent of soft tissue type, first described in 1994 [ 66 ]. It has been shown to be safe and effective in the liver, either as monotherapy or in combination with other modes of treatment such as trans-arterial chemoembolization (TACE) [ 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 ]. The main limitation of performing HIFU in the liver is the limited window and respiratory-induced liver motion, making it time consuming and technically challenging relative to other ablative modalities, impeding its widespread adoption.…”