Microvascular Invasion as a Predictor of Response to Treatment with Sorafenib and Transarterial Chemoembolization for Recurrent Intermediate-Stage Hepatocellular Carcinoma

Peng, Zhenwei; Chen, Shuling; Xiao, Han; Wang, Yu; Li, Jiaping; Mei, Jie; Chen, Zebin; Zhou, Qian; Feng, Shi‐Ting; Chen, Minshan; Gao, Qian; Peng, Sui; Kuang, Ming

doi:10.1148/radiol.2019181818

Cited by 58 publications

(43 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Third, the ablative tissue reacting to heat stimulation might present abnormal blood perfusion on contrast-enhanced images, occasionally influenced the determination of reactive hyperemia, and residual or viable tumor (Chan et al, 2015). IVTT positive in the primary tumor at microscopy represented more obvious aggressive behavior with tumor growth, invasion, and metastasis than those with IVTT negative lesion (Peng et al, 2019). Similarly, when R0 resection or complete ablation was achieved, the LPFS in the ablation group was shorter than that in the resection group when IVTT was positive, although no statistical difference was shown.…”

Section: Figurementioning

confidence: 85%

Resection vs. ablation for lesions characterized as resectable-ablative within the colorectal liver oligometastases criteria: a propensity score matching from retrospective study

Luo

Chen

et al. 2020

PeerJ

View full text Add to dashboard Cite

Background. There has been no prospective or retrospective studies reporting the comparison outcome between surgery and ablation for resectable-ablative (lesions could be treated by resection or complete ablation) colorectal liver oligometastases (CLOM). The purpose of this study was to compare the efficacy and prognostic difference in patients who underwent R0 resection vs. complete ablation within the resectable-ablative CLOM criteria. Methods. From January 2008 to May 2018, a total of 2,367 patients diagnosed with colorectal liver metastases were included in this observational study. The metastasis was characterized by only limited to liver with number ≤5, size ≤5 cm, and resectableablative (lesions could be treated by resection or complete ablation). The evaluated indications, including liver progression-free survival (LPFS), overall survival (OS), survival rates, pattern and number of recurrences, and complications, were compared by using propensity score matching (PSM). The Kaplan−Meier curves were generated, and a log-rank test was performed. The Cox regression model was used for univariate and multivariate analyses to identify predictors of outcomes. Results. A total of 421 consecutive patients were eligible for this study, with 250 and 171 undergoing R0 resection and complete ablation, respectively. PSM identified 145 patients from each group. The 1-, 3-, 5-and 8-year OS rates in the resection group and the ablation group were 95.8% vs. 95.0%, 69.8% vs. 60.1%, 53.6% vs. 42.5%, and 45.1% vs. 32.9% (p = 0.075), respectively. The median LPFS in the resection group was significantly longer than that in the ablation group (35 months vs. 15 months, p = 0.011). No statistical difference was found in LPFS between the two groups when comparing ≤3 cm liver metastases. For liver metastasis >3 cm, the median LPFS in the resection group and ablation group was 11 months and 5 months, respectively (p = 0.001). In terms of high risk of clinical risk score (CRS), the resection group showed longer LPFS than the ablation group (median 18 months vs. 10 months, p = 0.043). Conclusion. For patients within the CLOM criteria suggesting that liver metastases were resectable as well as ablative, resection could result in longer liver recurrence-free How to cite this article Luo M, Chen S-L, Chen J, Yan H, Qiu Z, Chen G, Lu L, Zhang F. 2020. Resection vs. ablation for lesions characterized as resectable-ablative within the colorectal liver oligometastases criteria: a propensity score matching from retrospective study. PeerJ 8:e8398 http://doi.org/10.7717/peerj.8398 survival than ablation in cases with size >3 cm or high risk of CRS. But for ≤3 cm liver metastases, their treatment efficacies were comparable. SA. 2004. Recurrence and outcomes following hepatic resection, radiofrequency ablation, and combined resection/ablation for colorectal liver metastases. Annals of Surgery 239:818-825 AC. 2015. The role of contrast-enhanced ultrasound in guiding radiofrequency ablation of hepatocellular carcinoma: a retrospective study. WY. 2006...

show abstract

Section: Figurementioning

confidence: 85%

Resection vs. ablation for lesions characterized as resectable-ablative within the colorectal liver oligometastases criteria: a propensity score matching from retrospective study

Luo

Chen

et al. 2020

PeerJ

View full text Add to dashboard Cite

show abstract

“…IVTT positive in the primary tumor at microscopy represented more obvious aggressive behavior with tumor growth, invasion, and metastasis than those with IVTT negative lesion (Peng et al 2019). Similarly, when R0 resection or complete ablation was achieved, the LPFS in the ablation group was shorter than that in the resection group when IVTT was positive, although no statistical difference was shown.…”

Section: Discussionmentioning

confidence: 85%

Peer Review #1 of "Resection vs. ablation for lesions characterized as resectable-ablative within the colorectal liver oligometastases criteria: a propensity score matching from retrospective study (v0.1)"

Nicosia¹

2020

View full text Add to dashboard Cite

Background There has been no prospective or retrospective studies reporting the comparison outcome between surgery and ablation for resectable-ablative (lesions could be treated by resection or complete ablation) colorectal liver oligometastases (CLOM). The purpose of this study was to compare the efficacy and prognostic difference in patients who underwent R0 resection vs. complete ablation within the resectable-ablative CLOM criteria. Methods From January 2008 to May 2018, a total of 2367 patients diagnosed with colorectal liver metastases were included in this observational study. The metastasis was characterized by only limited to liver with number ≤5, size ≤5 cm, and resectable-ablative (lesions could be treated by resection or complete ablation). The evaluated indications, including liver progression-free survival (LPFS), overall survival (OS), survival rates, pattern and number of recurrences, and complications, were compared by using propensity score matching (PSM). The Kaplan−Meier curves were generated, and a log-rank test was performed. The Cox regression model was used for univariate and multivariate analyses to identify predictors of outcomes. Results 421 consecutive patients were eligible for this study, with 250 and 171 undergoing R0 resection and complete ablation, respectively. PSM identified 145 patients from each group. The 1-, 3-, 5-and 8year OS rates in the resection group and the ablation group were 95.8% vs. 95.0%, 69.8% vs. 60.1%, 53.6% vs. 42.5%, and 45.1% vs. 32.9% (p=0.075), respectively. The median LPFS in the resection group was significantly longer than that in the ablation group (35 months vs. 15 months, p=0.011). No statistical difference was found in LPFS between the two groups when comparing ≤3 cm liver metastases. For liver metastasis >3 cm, the median LPFS in the resection group and ablation group was 11 months and 5 months, respectively (p=0.001). In terms of high risk of clinical risk score (CRS), the resection group showed longer LPFS than the ablation group (median 18 months vs. 10 months, p=0.043). Conclusion For patients within the CLOM criteria suggesting that liver metastases were resectable as well as ablative, resection could result in longer liver recurrence-free survival than ablation in cases with size >3 cm or high risk of CRS. But for ≤3 cm liver metastases, their treatment efficacies were comparable.

show abstract

“…The meta-analysis included a total of 15 [ 7 , 9 – 22 ] studies on comparison of TACE + Sorafenib and TACE in treating primary hepatocellular carcinoma, including 5 RCT and 10 NRCT. According to the Jadad score, RCT had 4 articles with scores of at least 3 and 1 articles with low scores.…”

Section: Resultsmentioning

confidence: 99%

“…[ 6 ] It is because of the complementary effect of Sorafenib and TACE that the combination of them has become a hot spot in treating advanced HCC. Peng et al [ 7 ] obtained a retrospective multicenter study of 260 patients in order to observe the outcomes of TACE combined with Sorafenib in treating HCC, in which they found that the objective response rate (ORR), disease control rate (DCR), 1-year overall survival rate (OS), 3-year OS, and 5-year OS were 72.3%, 87.3%, 73.9%, 39.9%, and 25.3%, respectively, which were significantly higher than the 50.0%, 80.6%, 50.3%, 28.5%, and 16.9% in the control group (TACE). So Peng et al proposed TACE combined with Sorafenib has a high clinical efficacy compared with TACE alone.…”

Section: Introductionmentioning

confidence: 99%

Trans-catheter arterial chemoembolization plus Sorafenib, an unsuccessful therapy in the treatment of hepatocellular carcinoma?

2020

View full text Add to dashboard Cite

Background: Trans-catheter arterial chemoembolization (TACE) plus Sorafenib is recommended as one of the primary means for treating hepatocellular carcinoma (HCC). This updated meta-analysis focuses on identifying the efficacy and safety of TACE plus Sorafenib versus TACE, which remains controversial despite years of exploration. Method: PubMed, Medline, Embase, China Journal Full-text Database, Wanfang Database, and Weipu Database were used to retrieve the studies which are about comparing the clinical efficacy and safety of TACE+Sorafenib with TACE alone. The Review Manager (Version 5. 3) software was used to perform a meta-analysis of the results of studies which met the inclusion criteria recommended by the Cochrane Collaboration. Result: Compared with TACE for treating primary HCC, TACE combined with Sorafenib can improve the 1 year, 2 years, 3 years, and 5 years overall survival rate (OS) of patients, respectively, and also improve disease control rate (DCR) and objective response rate (ORR). In terms of adverse reactions, the treatment group can lead to more complications significantly, such as hand-foot skin reaction, hypertension, diarrhea, rash, hair loss, and so on, most of which are relevant to Sorafenib related adverse reactions, but most patients have a good prognosis after symptomatic treatment. Conclusion: The clinical efficacy of TACE combined with Sorafenib in treating primary hepatocellular carcinoma is better than TACE, and the safety is acceptable.

show abstract

Microvascular Invasion as a Predictor of Response to Treatment with Sorafenib and Transarterial Chemoembolization for Recurrent Intermediate-Stage Hepatocellular Carcinoma

Cited by 58 publications

References 34 publications

Resection vs. ablation for lesions characterized as resectable-ablative within the colorectal liver oligometastases criteria: a propensity score matching from retrospective study

Resection vs. ablation for lesions characterized as resectable-ablative within the colorectal liver oligometastases criteria: a propensity score matching from retrospective study

Peer Review #1 of "Resection vs. ablation for lesions characterized as resectable-ablative within the colorectal liver oligometastases criteria: a propensity score matching from retrospective study (v0.1)"

Trans-catheter arterial chemoembolization plus Sorafenib, an unsuccessful therapy in the treatment of hepatocellular carcinoma?

Contact Info

Product

Resources

About