Improved Clinical Outcome Using Transarterial Chemoembolization Combined with Radiofrequency Ablation for Patients in Barcelona Clinic Liver Cancer Stage A or B Hepatocellular Carcinoma Regardless of Tumor Size: Results of a Single-center Retrospective Case Control Study

Ren, Yanqiao; Cao, Yanyan; Ma, Hong; Kan, Xuefeng; Zhou, Chen; Liu, Jiacheng; Shi, Qin; Gao, Feng; Xiong, Bin; Zheng, Chuansheng

doi:10.21203/rs.2.10906/v2

Cited by 6 publications

(7 citation statements)

References 6 publications

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“…With the development of the imaging-guided location, artificial hydrothorax, and perioperative management, aggressive therapies (including but not limited to RFA and liver resection) are no longer contraindications but alternative treatment options in advanced HCC. Recently, a growing number of studies have indicated the application of RFA in patients with intermediate-and advanced-stage HCC, including patients with tumor thrombus (10,11).…”

Section: Introductionmentioning

confidence: 99%

Comparison of radiofrequency ablation combined with sorafenib or sorafenib alone in patients with ECOG performance score 1: identifying optimal candidates

Liu¹,

Zhang²,

Geng³

et al. 2020

Ann Transl Med

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Background: Sorafenib has been recommended as the first-line treatment and shown to prolong the median overall survival (OS) of patients with advanced unresectable hepatocellular carcinoma (HCC).Recently, a growing number of earlier studies showed the application of radiofrequency ablation (RFA) plus sorafenib in patients diagnosed at the advanced-stage HCC. This study aimed to compare the outcomes of RFA plus sorafenib versus sorafenib alone and identify prognostic factors related to OS for BCLC stage C patients with PS 1 but without vascular invasion or extrahepatic spread.Methods: A total of 276 consecutive patients in BCLC stage C with PS 1 but without vascular invasion or extrahepatic spread were enrolled in this retrospective study. Survival analyses were performed using the Kaplan-Meier analysis, and the log-rank test examined the statistical differences between the transarterial chemoembolization (TACE) and sorafenib groups. Univariate and multivariate Cox regression analyses were performed to investigate the prognostic factors for OS.Results: Based on the Kaplan-Meier curves, patients treated with RFA plus sorafenib showed better OS than those undergoing sorafenib, with respective OS at 1, 3 and 5 years (84.0%, 43.1%, 22.8% vs. 55.6%, 29.6%, 4.8%, Log-rank P<0.001). The univariate analysis and multivariate analysis showed that tumor size, tumor number, treatment method, albumin, bilirubin, and the Child-Pugh score were associated with OS.According to the subgroups analyses based on the tumor size and tumor number, there were significant differences in OS among overall subsets except in patients with tumor number ≥4 between RFA plus sorafenib and sorafenib therapy.Conclusions: RFA plus sorafenib provided better prognostic performance than sorafenib, which should be suggested as an alternative treatment modality compared with sorafenib for BCLC stage C patients with PS 1 but without vascular invasion or extrahepatic spread.

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Section: Introductionmentioning

confidence: 99%

Comparison of radiofrequency ablation combined with sorafenib or sorafenib alone in patients with ECOG performance score 1: identifying optimal candidates

Liu¹,

Zhang²,

Geng³

et al. 2020

Ann Transl Med

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“…Moreover, the extent of thermal ablation is generally limited, although this can be compensated for by repeated operations, but the possibility of omission exists [36]. Furthermore, after the arterial blood supply of tumor is destroyed by thermal coagulation, subsequent follow-up treatment, such as transcatheter arterial chemoembolization, is highly required [37,38]. We believe that these observations are the reasons tumors are more likely to recur after RFA treatment.…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency ablation versus laparoscopic hepatectomy for treatment of hepatocellular carcinoma: a systematic review and meta-analysis

et al. 2020

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Background: Several randomized controlled trials (RCTs) compared the effects of laparoscopic hepatectomy (LH) and radiofrequency ablation (RFA) for the treatment of hepatocellular carcinoma (HCC), but the results have remained inconsistent. Hence, a meta-analysis and a systematic review of these treatment modalities are necessary to evaluate their efficacy and safety for HCC treatment. Methods: From the inception of this meta-analysis and review until August 31, 2019, we searched Medline, PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, and China Biomedical Literature Database for RCTs involving LH and RFA treatments of patients with HCC. The studies were screened and the data from these articles were extracted independently by two authors. Summary odd ratios (OR) or mean differences (MD) with 95% confidence intervals (CI) were calculated for each outcome with a fixed-or random-effect model. The outcomes for effectiveness evaluations included duration of surgery, estimated bleeding volume, incidence of blood transfusion during surgery, duration of hospital stay, and the outcome for safety included the incidence of cancer recurrence. Results: Seven RCTs with a total of 615 patients were identified, 312 and 303 of which underwent RFA and LH treatments, respectively. The duration of surgery (MD = −99.04; 95% CI: −131.26-−66.82), estimated bleeding volume (MD = −241.97; 95% CI: −386.93-−97.02), incidence of blood transfusion during surgery (OR = 0.08; 95% CI: 0.02-0.37), and duration of hospital stay (MD = −3.4; 95% CI: −5.22-−1.57) in RFA treatment were significantly lower than those of LH treatment. However, the incidence of cancer recurrence was significantly higher for RFA treatment compared with LH treatment (OR = 2.68; 95% CI: 1.72-4.18). Conclusions: LH treatment is preferred over RFA treatment with a better radical effect, but RFA treatment is more beneficial with smaller trauma, development of less complications, and shorter operating time when compared with HCC treatment.

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“…A string of image-guided percutaneous ablations encompasses a great variety of techniques, including radiofrequency ablation (RFA), microwave ablation (MWA), ethanol injection, and cryoablation [62][63][64][65]. As RFA is the most frequently used ablation modality for HCC [66,67], the main topic addressed in this section is RFA.…”

Section: Local Ablationmentioning

confidence: 99%

Current updates in machine learning in the prediction of therapeutic outcome of hepatocellular carcinoma: what should we know?

et al. 2021

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With the development of machine learning (ML) algorithms, a growing number of predictive models have been established for predicting the therapeutic outcome of patients with hepatocellular carcinoma (HCC) after various treatment modalities. By using the different combinations of clinical and radiological variables, ML algorithms can simulate human learning to detect hidden patterns within the data and play a critical role in artificial intelligence techniques. Compared to traditional statistical methods, ML methods have greater predictive effects. ML algorithms are widely applied in nearly all steps of model establishment, such as imaging feature extraction, predictive factor classification, and model development. Therefore, this review presents the literature pertaining to ML algorithms and aims to summarize the strengths and limitations of ML, as well as its potential value in prognostic prediction, after various treatment modalities for HCC.

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Improved Clinical Outcome Using Transarterial Chemoembolization Combined with Radiofrequency Ablation for Patients in Barcelona Clinic Liver Cancer Stage A or B Hepatocellular Carcinoma Regardless of Tumor Size: Results of a Single-center Retrospective Case Control Study

Cited by 6 publications

References 6 publications

Comparison of radiofrequency ablation combined with sorafenib or sorafenib alone in patients with ECOG performance score 1: identifying optimal candidates

Comparison of radiofrequency ablation combined with sorafenib or sorafenib alone in patients with ECOG performance score 1: identifying optimal candidates

Radiofrequency ablation versus laparoscopic hepatectomy for treatment of hepatocellular carcinoma: a systematic review and meta-analysis

Current updates in machine learning in the prediction of therapeutic outcome of hepatocellular carcinoma: what should we know?

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