Local recurrence of hepatocellular carcinoma in the tumor blood drainage area following radiofrequency ablation

Hirooka, Masashi; Ochi, Hironori; Terada, Yoshio; Hiraoka, Atsushi; Kumagi, Teru; Abe, Masanori; Tanaka, Hiroaki; Hiasa, Yoichi

doi:10.3892/mco.2013.229

Cited by 14 publications

(18 citation statements)

References 24 publications

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“…However, incomplete tumor ablation (20) and local tumor recurrence or progression remain problematic (21). In order to prevent local recurrence, Hirooka et al (22) reported that the safety margin for RFA should be defined as the blood drainage area, and ablation should aim at acquiring adequate safety margins. In the present study, CT during arterial portography (CTAP) and CT during arteriography (CTA) were performed on the patients with TACE.…”

Section: Discussionmentioning

confidence: 99%

Effect of treatment support on preventing local recurrence of hepatocellular carcinoma directly adjacent to the diaphragm

Ishikawa

Imai

et al. 2017

Molecular and Clinical Oncology

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Abstract. Treatment support is anticipated to improve the results of radiofrequency ablation (RFA) treatment in cases in which visualization of tumors using the conventional B-mode is unclear. In the present study, the effectiveness of treatment support for RFA reducing the local recurrence rate of hepatocellular carcinoma (HCC) that are located directly adjacent to the diaphragm, and which are difficult to visualize with B-mode ultrasound imaging, was investigated. A total of 103 HCC tumors measuring <5 cm, which were located abutting the diaphragm, and which were difficult to visualize using the B-mode, were treated using RFA. Thirty-three of those HCC tumors were treated using RFA without treatment support, whereas the remaining 70 HCC tumors were treated using RFA with treatment support, including artificial pleural effusion, contrast-enhanced ultrasonography (CEUS) with the contrasting agent, Sonazoid™, and fusion imaging, either alone or in combination to improve the visualization of the tumors. The rate of local recurrence, and factors affecting local recurrence, were analyzed. Local recurrences were confirmed in 17 of the 103 nodules (16.50%). The overall rate of local recurrence was 13.1% at 6 months, and 20.2% at 12 months. The rate of local recurrence using RFA with artificial pleural effusion was significantly lower compared with those cases of HCC tumors treated without artificial pleural effusion (P=0.008). Similarly, the rate of local recurrence for CEUS RFA with Sonazoid™ was significantly lower compared with those cases of HCC tumors treated without Sonazoid™ (P=0.00081). In a multivariate analysis, CEUS RFA with Sonazoid™ and artificial pleural effusion contributed to the decrease in the rate of local recurrence (hazard ratios, 0.075 and 0.143, respectively). Based on these results, it is possible to conclude that CEUS with Sonazoid™ as a treatment support was the most effective method for reducing the rate of local recurrences abutting the diaphragm that are difficult to visualize using B-mode ultrasonography. IntroductionHepatocellular carcinoma (HCC) is the fifth most common cancer in men, and the seventh most common cancer in women worldwide, and it is the most common cause of cancer-associated mortality (1). Radiofrequency ablation (RFA) was first described by Rossi et al (2) as a local thermal ablation therapy for HCC. It has been endorsed as a curative treatment modality by several clinical management guidelines for early-stage, unresectable HCC (3-9). However, to further improve the treatment outcomes of RFA for HCC, it is important to accurately identify the position of tumors on performing ultrasonography. Even in cases for which the visualization of tumors is difficult with the conventional B-mode ultrasound imaging, performing RFA using treatment support such as artificial pleural effusion, fusion imaging, and contrast-enhanced ultrasound with Sonazoid™ (Perflubutane; Daiichi Sankyo Co., Ltd., Tokyo, Japan), is expected to improve treatment outcomes in clinical settings (10).The aim...

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Section: Discussionmentioning

confidence: 99%

Effect of treatment support on preventing local recurrence of hepatocellular carcinoma directly adjacent to the diaphragm

Ishikawa

Imai

et al. 2017

Molecular and Clinical Oncology

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“…Radiofrequency ablation (RFA) has spread widely as a curative and minimally invasive method for early stage hepatocellular carcinoma (HCC) . If the ablation area covers the blood drainage area where satellite lesions of HCC often occur, local tumor progression is very rare …”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] If the ablation area covers the blood drainage area where satellite lesions of HCC often occur, local tumor progression is very rare. 4 A single puncture with monopolar RF technology as the conventional method shows limited ability to reliably create a volume of coagulation necrosis. The major problem for monopolar RFA is that the electrical current flows between the electrode and the grounding pads.…”

Section: Introductionmentioning

confidence: 99%

Prospective cohort trial to confirm the efficacy of no‐touch radio frequency ablation

Hirooka

Hiraoka

Ochi

et al. 2018

J of Gastro and Hepatol

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“…However, RFA using the monopolar applicator to pierce the tumor is reportedly associated with a local tumor progression rate of 3-19% [6,23,24,25,26]. In the case of lesions located deep inside the liver, a piercing of the tumor does not lead to local tumor progression, and a sufficient ablative safety margin is a significant factor related to the local tumor progression [24,26]. No-touch ablation could not be performed on large tumors in the present study due to limitations on the permitted needle distance, and it was only performed on tumors approximately ≤2 cm.…”

Section: Discussionmentioning

confidence: 99%

Short-Term Results of Laparoscopic Radiofrequency Ablation Using a Multipolar System for Localized Hepatocellular Carcinoma

et al. 2016

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Background and Aim: Multipolar radiofrequency ablation (RFA) is feasible for the treatment of hepatocellular carcinoma (HCC) for which a large ablative area is planned, and it imposes a light physical burden on patients. Multipolar RFA via the percutaneous approach is performed in the majority of cases, but the efficacy of multipolar RFA with a laparoscopic approach has rarely been studied. This study aimed to evaluate the efficacy and safety of multipolar laparoscopic RFA (LRA) for localized HCC over the short term. Methods: From January 2014 to January 2016, 77 consecutive patients with 130 HCCs treated by multipolar LRA were assessed. One to three bipolar needle applicators were inserted under laparoscopic ultrasonography guidance, regardless of tumor location. We intended to achieve parallel insertions and no-touch ablation as much as possible. Results: The median size of the main tumor was 22 mm (range, 10-42 mm). The median follow-up time was 13.6 months (range, 3.1-24.8 months). In all cases, a sufficient ablative area was obtained as planned, without thermal injury of adjacent organs. During the follow-up period, all patients were alive with no local tumor progression, while intrahepatic recurrence distant from the primary site occurred in 7 patients. The 2-year local tumor progression-free survival rate and overall cancer-free survival rate were 100 and 81.6%, respectively. There were no procedural major complications caused prolonging the hospitalization, and all patients were discharged without subjective symptoms 4-7 days after LRA. Conclusions: Multipolar LRA was efficacious in the treatment of localized HCCs by safely achieving a good ablative area.

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Local recurrence of hepatocellular carcinoma in the tumor blood drainage area following radiofrequency ablation

Cited by 14 publications

References 24 publications

Effect of treatment support on preventing local recurrence of hepatocellular carcinoma directly adjacent to the diaphragm

Effect of treatment support on preventing local recurrence of hepatocellular carcinoma directly adjacent to the diaphragm

Prospective cohort trial to confirm the efficacy of no‐touch radio frequency ablation

Short-Term Results of Laparoscopic Radiofrequency Ablation Using a Multipolar System for Localized Hepatocellular Carcinoma

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