Percutaneous CT-guided radiofrequency ablation for patients with extrahepatic oligometastases of hepatocellular carcinoma: long-term results

Mu, Luwen; Sun, Lin; Lyu, Ning; Li, Shaolong; Li, Xishan; Wang, Jianpeng; Xie, Qiankun; Deng, Haijing; Zheng, Lie; Peng, Jianhong; Shen, Lujun; Fan, Weijun; Wu, Peihong; Zhao, Ming

doi:10.1080/02656736.2017.1318332

Cited by 25 publications

(18 citation statements)

References 40 publications

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“…In our study, ethanol was injected to displace abutted important structures. Besides, previous studies also showed that artificial ascites can be applied to separate adjacent structures from the tumour and the ablation zone without deputy injury [30]. In our study, no patient suffered electrode puncture related injury and thermal injury of adjacent tissues.…”

Section: Discussionsupporting

confidence: 59%

Percutaneous radiofrequency ablation of adrenal metastases from hepatocellular carcinoma: a single-center experience

et al. 2019

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Background The prognosis of adrenal metastases (AM) from hepatocellular carcinoma (HCC) with surgical contraindication was poor. This study evaluated the feasibility, safety and treatment efficacy of percutaneous ultrasound (US)-guided radiofrequency ablation (RFA) for the local treatment of AM originated from HCC. Methods A retrospective study was carried out on 22 patients (21 male and 1 female, mean age, 53.0 ± 13.0 years) who had single AM (mean diameter, 4.0 ± 1.8 cm, range, 1.7–8.0 cm) originated from HCC and received US-guided percutaneous RFA at our institution. The diagnosis was established on typical radiologic findings. The primary technical success was defined as the tumour being completely ablated in the first RFA session. The secondary technical success was defined as tumour residual left from the first ablation was completely ablated by a second ablation session. Local tumour progression (LTP) and overall survival (OS) were estimated by using Kaplan-Meier analysis. Results A total of 25 ablation sessions were performed. The primary technical success and the secondary technical success were 77.3% (17 of 22) and 86.4% (19 of 22), respectively, with the major complication rate at 4.5% (1 of 22). The median follow-up period after RFA was 10 months (3–55 months). During the follow-up period, five patients were detected LTP. The LTP at 3, 6, and 12 months were 15.8, 26.3, and 26.3%, respectively. Nine patients died of distant extra-adrenal metastases and another five of liver failure due to HCC. The OS at 6, 12, 24 months after RFA for AM were at 79.7, 52.6, and 32.9%, respectively. Conclusion Percutaneous US-guided RFA in the treatment of AM originated from HCC is feasible, safe and effective.

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Section: Discussionsupporting

confidence: 59%

Percutaneous radiofrequency ablation of adrenal metastases from hepatocellular carcinoma: a single-center experience

et al. 2019

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“…However, these data were only descriptive, and no statistical analyses were performed. Two other studies evaluating the outcomes of CT-guided ablation for oligometastases in the lungs and lymph nodes documented a 1-year survival rate of 58%-91%, which was consistent with the rate in the present study (66.7%) [15,16]. Although these studies did not include cases of adrenal oligometastases, the results can serve as meaningful references.…”

Section: Discussionsupporting

confidence: 90%

“…Percutaneous computed tomography (CT)-guided thermal ablation is considered a curative treatment for small HCCs and has been shown to be clinically useful for the treatment of various tumors, such as those involving the lungs, kidneys, and prostate glands [12][13][14]. Some studies also reported effective local control of EHM by ablation; however, these studies mainly focused on the lungs and lymph nodes, which are the most common sites of EHM [15,16]. To our knowledge, adrenal metastases have been documented only in case reports and a few studies with very small sample sizes ( 6) [17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Survival benefits of computed tomography-guided thermal ablation for adrenal metastases from hepatocellular carcinoma

Lyu

Kong

et al. 2019

International Journal of Hyperthermia

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Purpose: To evaluate the safety, efficacy, and survival outcomes of computed tomography (CT)-guided thermal ablation for adrenal metastases from hepatocellular carcinoma (HCC). Methods: This long-term retrospective study included 27 male patients (median age, 50 years; range, 34-77 years) with 29 adrenal metastatic tumors associated with HCC who underwent ablation between January 2004 and December 2015. The technical success rate, effectiveness rate, complications, and survival were recorded. Complications were assessed according to the Common Terminology Criteria for Adverse Events. Survival curves were estimated using the Kaplan-Meier method. A Cox regression model was used for the evaluation of factors predicting survival. Results: A total of 33 ablation sessions were performed for the 29 tumors. No ablation-related death was observed, and the incidence of complications was 87.9%. Grade 1-2 complications occurred in 23 of the 33 sessions (69.7%), and grade 3 hypertension was the only major complication, occurring in eight sessions (24.2%). The technical success and effectiveness rates were 93.1% (27 of 29 tumors) and 92.6% (25 of 27 patients), respectively. The median progression-free survival and overall survival (OS) durations for the 27 patients were 6.9 months and 16.8 months, respectively. The median OS duration was longer for patients with adrenal oligometastases (21.8 months) than for those with (12.8 months) multiple metastases (p ¼ .037). Adrenal oligometastases were the only significant predictor of OS (p ¼ .043). Conclusions: CT-guided ablation is a feasible and safe procedure for adrenal metastases from HCC, and it may be more beneficial for patients with adrenal oligometastases.

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“…For patients assessed with atypical progression after 3 months of ablation, repeated subtotal ablation was allowed. Details of computed tomography-guided RFA or MWA were described in the Supplementary Methods ( 26 , 27 ).…”

Section: Methodsmentioning

confidence: 99%

Ablation Reboots the Response in Advanced Hepatocellular Carcinoma With Stable or Atypical Response During PD-1 Therapy: A Proof-of-Concept Study

Lyu

Kong

et al. 2020

Front. Oncol.

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Background: The anti-programmed cell death protein-1 (PD-1) inhibitor is one of the second-line therapies for advanced hepatocellular carcinoma (HCC) after sorafenib failure. The goal of this study is to evaluate the feasibility and safety of ablation on the tumor in patients with advanced HCC who had stable disease or atypical response during single anti-PD-1 therapy after sorafenib failure. Atypical response defined as mixed responses in different lesions of the same individual (e.g., active or stable lesions mixed with progressive lesions). Patients and Methods: This proof-of-concept clinical trial enrolled 50 patients treated with an anti-PD-1 inhibitor of nivolumab or pembrolizumab monotherapy between July 2015 and Nov 2017. Thirty-three cases with stable disease or atypical response to anti-PD-1 inhibitor received subtotal thermal ablation. The safety and the response of ablation during anti-PD-1 therapy were evaluated. The survival was estimated by the Kaplan-Meier curve. Results: Of all 50 patients treated with anti-PD-1 therapy, the rate of response, stable disease, atypical and typical progression were 10% ( n = 5), 42% ( n = 21) 32% ( n = 16), and 12% ( n = 6), respectively. Additional ablation improved efficacy with tolerable toxicity, and the response rate was increased from 10 to 24% (12/50). The median time to progression, progression-free survival, and overall survival was 6.1 months (95%CI, 2.6–11.2), 5 months (95%CI, 2.9–7.1), and 16.9 months (95%CI, 7.7–26.1), respectively. Conclusions: This proof-of-concept trial suggested that additional ablation may increase the objective response rate with tolerated toxicity and achieved a relatively better median survival, in advanced HCC patients who had stable or atypical progressive diseases during anti-PD-1 therapy, which may provide a potentially promising strategy to treat advanced HCC. Trial registration number: ClinicalTrials.gov identifier: NCT03939975.

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Percutaneous CT-guided radiofrequency ablation for patients with extrahepatic oligometastases of hepatocellular carcinoma: long-term results

Abstract: CT-guided RFA for oligometastatic HCC may provide favourable efficacy and technical success with a minimally invasive approach.

Cited by 25 publications

References 40 publications

Percutaneous radiofrequency ablation of adrenal metastases from hepatocellular carcinoma: a single-center experience

Percutaneous radiofrequency ablation of adrenal metastases from hepatocellular carcinoma: a single-center experience

Survival benefits of computed tomography-guided thermal ablation for adrenal metastases from hepatocellular carcinoma

Ablation Reboots the Response in Advanced Hepatocellular Carcinoma With Stable or Atypical Response During PD-1 Therapy: A Proof-of-Concept Study

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