Large Infiltrative Hepatocellular Carcinomas: Treatment with Percutaneous Intraarterial Ethanol Injection Alone or in Combination with Conventional Percutaneous Ethanol Injection

Séror, Olivier; N'Kontchou, Giselle; Haddar, D.; Dordea, Marius; Ajavon, Y.; Ganne, Nathalie; Trinchet, Jean Claude; Beaugrand, Michel; Sellier, N.

doi:10.1148/radiol.2341031008

Cited by 28 publications

(24 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Treatment failure was observed in 13/307 nodules (13 patients), including five nodules larger than 40 mm, four nodules associated with a serum AFP level Ͼ400 ng/mL, and four nodules located in areas difficult to reach. Among the 13 patients who had treatment failure after RFA, one patient was treated by resection, three patients by TACE, one patient by intra-arterial alcoholization, 28 and two patients were transplanted. The other six patients also had distant multinodular recurrences.…”

Section: Early Responsementioning

confidence: 99%

See 1 more Smart Citation

Radiofrequency ablation of hepatocellular carcinoma: Long-term results and prognostic factors in 235 Western patients with cirrhosis #

N’Kontchou¹,

Mahamoudi²,

Aout³

et al. 2009

Hepatology

Self Cite

418

303

View full text Add to dashboard Cite

For the treatment of small hepatocellular carcinoma (HCC), radiofrequency ablation (RFA) is in some centers considered a first-line therapeutic option. However, such a strategy is still under debate with regard to tumor and patient characteristics. In this single-center study we assessed the 5-year survival and prognosis factors in 235 consecutive patients with cirrhosis (Child-Pugh A/B: 205/30) who received RFA as first-line treatment for up to three HCC <5 cm (307 tumors; mean diameter: 29 ؎ 10 mm; 53 multinodular forms). Among these patients, 67 satisfied the criteria for resection according to the Barcelona Clinic Liver Cancer. Complete ablation was obtained in 222 patients (94%). Overall, 337 RFA sessions were performed including iterative RFA for recurrence. Major complications occurred in three patients (0.9%), including one treatmentrelated death. After 27 ؎ 20 months of mean follow-up, local or distant, or both, tumor recurrence occurred in 16, 88, and 11 patients, respectively. Twenty-nine patients underwent transplantation and were removed from the study at this point. Overall 5-year, recurrence-free, and tumor-free (including results of iterative RFA) survival rates were, respectively, 40%, 17%, and 32%. The overall 5-year survival rate was 76% for operable patients. Factors associated with overall survival were prothrombin activity (hazard ratio [HR] ‫؍‬ 0.97, 0.96-0.98; P < 0.0001) and serum levels of ␣-fetoprotein (AFP) (HR ‫؍‬ 1.02, 1.02-1.02; P < 0.0001), and factors associated with tumor recurrence were multinodular forms (HR ‫؍‬ 2.34; 1.52-3.6; P ‫؍‬ 0.0001) and serum AFP levels (HR ‫؍‬ 1.015, 1.014-1.016; P ‫؍‬ 0.015). Tumor size was associated with local recurrence but not with overall and tumor-free survival. Conclusion: RFA is a safe and effective first-line treatment of HCC up to 5 cm in diameter, especially for patients with a single tumor, a low serum AFP level, and well-preserved liver function.

show abstract

Section: Early Responsementioning

confidence: 99%

“…2). 28 The other patients were either included in clinical trials of systemic therapy (n ϭ 9) or treated by supportive cares (n ϭ 33). The cumulative rate of distant recurrence at 5 years was 73%.…”

Section: Survival and Recurrencementioning

confidence: 99%

Radiofrequency ablation of hepatocellular carcinoma: Long-term results and prognostic factors in 235 Western patients with cirrhosis #

N’Kontchou¹,

Mahamoudi²,

Aout³

et al. 2009

Hepatology

Self Cite

418

303

View full text Add to dashboard Cite

show abstract

“…A possible explanation in both cases is leakage of ethanol into the hepatic vasculature causing ethanol reflux into the pancreaticoduodenal artery [9]. Some authors suggest that the development of AP in this context could be favored by a concurrent treatment of PEI-associated pain with opioids [3].…”

Section: Discussionmentioning

confidence: 99%

Acute recurrent pancreatitis secondary to hepatocellular carcinoma invading the biliary tree

et al. 2015

View full text Add to dashboard Cite

“…Intravascular injection of ethanol in the main artery(ies) feeding the tumor is also possible in selected cases. This procedure induces an instant necrosis of all the area vascularized by the artery whatever its size and shape [12].…”

Section: Methods Alcoholizationmentioning

confidence: 99%

Transcutaneous Treatments of Hepatocellular Carcinoma in Patients with Cirrhosis: Present Status and Future Developments

Beaugrand

Séror²

2007

CPD

Self Cite

View full text Add to dashboard Cite

Hepatocellular carcinoma is in 90% of cases associated with cirrhosis and to preserve liver function while destroying the tumor is a main issue in these patients justifying the development of local percutaneous ablative therapies. Alcoholization and radiofrequency ablation are the most widely used techniques of percutaneous ablation. Both have in common limitations linked to the size of the tumor and its situation and contra indications such has advanced liver disease and unpaired hemostasis. Radiofrequency ablation despite specific contra indications such as a close vicinity of the colon has shown better results in term of tumor necrosis local recurrence and even survival. For tumors less than 3cm in diameter results are comparable to those of surgical resection with a lesser morbidity. Due to this equivalence and the multiple contra indications of surgical resection in patients with cirrhosis radiofrequency ablation is becoming an increasingly popular technique for treating small hepatocellular carcinoma detected by screening.

show abstract

Large Infiltrative Hepatocellular Carcinomas: Treatment with Percutaneous Intraarterial Ethanol Injection Alone or in Combination with Conventional Percutaneous Ethanol Injection

Abstract: For patients with advanced HCC who are ineligible for other curative options, PIAEI could be an effective treatment, despite the associated risk of severe complications.

Cited by 28 publications

References 38 publications

Radiofrequency ablation of hepatocellular carcinoma: Long-term results and prognostic factors in 235 Western patients with cirrhosis #

Radiofrequency ablation of hepatocellular carcinoma: Long-term results and prognostic factors in 235 Western patients with cirrhosis #

Acute recurrent pancreatitis secondary to hepatocellular carcinoma invading the biliary tree

Transcutaneous Treatments of Hepatocellular Carcinoma in Patients with Cirrhosis: Present Status and Future Developments

Contact Info

Product

Resources

About