Percutaneous Radiofrequency Thermal Ablation Combined with Transcatheter 
Arterial Embolization in the Treatment of Large Hepatocellular Carcinoma

Buscarini, L; Buscarini, Elisabetta; Stasi, M.; Quaretti, Pietro; Zangrandi, Adriano

doi:10.1055/s-1999-14233

Cited by 129 publications

(69 citation statements)

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“…15,30,31 In contrast, in this study, we performed the combination therapy on the same day, and the resultant local tumor progression rates were significantly lower than those achieved with RFA monotherapy. Yu et al evaluated the biodistribution properties of the transarterial Lipiodol-based therapeutic regimens in HCC patients.…”

Section: Discussionmentioning

confidence: 77%

Midterm outcomes in patients with intermediate‐sized hepatocellular carcinoma

Morimoto

Numata

Kondou

et al. 2010

Cancer

290

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BACKGROUND:To improve the efficacy of radiofrequency ablation (RFA) for the treatment of intermediate-sized hepatocellular carcinomas (HCCs), the authors compared RFA combined with transcatheter arterial chemoembolization (TACE) to RFA alone. METHODS: The authors randomly assigned 37 patients with solitary HCCs (diameter, 3.1-5.0 cm in the greatest dimension) to 2 groups: the TACE-RFA group, in which the patients received TACE followed by RFA on the same day, and the RFA group, in which the patients received only RFA. RESULTS: Technical success was achieved after 1.4 AE 0.5 RFA sessions in the RFA group and after 1.1 AE 0.2 RFA sessions in the TACE-RFA group (P < .01). The mean diameters of the longer and shorter axes of the RFA-induced ablated areas were 50 AE 8.0 mm and 41 AE 7.1 mm, respectively, in the RFA group and 58 AE 13.2 mm and 50 AE 11.3 mm, respectively, in the TACE-RFA group; the mean diameters of the shorter axes were significantly different (P ¼ .012). The rates of local tumor progression at the end of the third year in the RFA and TACE-RFA groups were 39% and 6%, respectively (P ¼ .012). The 3-year survival rates of the patients in the RFA and TACE-RFA groups were 80% and 93%, respectively (P ¼ .369). CONCLUSIONS: In patients with intermediate-sized HCCs, RFA combined with TACE is more effective than RFA alone for extending the ablated area in fewer treatment sessions and for decreasing the local tumor progression rate. Cancer 2010;116:5452-60.

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Section: Discussionmentioning

confidence: 77%

Midterm outcomes in patients with intermediate‐sized hepatocellular carcinoma

Morimoto

Numata

Kondou

et al. 2010

Cancer

290

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“…A recent study comparing two cohorts of patients with HCC treated by PEI or by RF showed a similar response rate for both treatments, but the number of sessions was significantly fewer for RF than for PEI [9]. Moreover, the use of a triplet of cooled-tip needles [10] as well of a new model of wet-expandable electrode [11] or combined tumor ischemia and RF expandable system ablation [12] has made it possible to treat large tumors, even if the risk is increased [12,13].…”

Section: Introductionmentioning

confidence: 99%

Radiofrequency thermal ablation with expandable needle of focal liver malignancies: complication report

Buscarini

2004

European Radiology

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The aim of this study was to describe type and rate of complications in a series of patients with liver tumors treated by the radiofrequency (RF) expandable system. A total of 166 patients, 114 with hepatocellular carcinoma (HCC; 92 small HCC, 22 large) and 52 with liver metastasis, were treated by the percutaneous RF expandable system. In large HCCs, RF ablation was performed after tumor ischemia (TAE or balloon stop flow of the hepatic artery). Major complications were those that delayed hospital discharge, with or without additional medical procedures or treatments. Minor complications did not require an additional hospital stay. No deaths occurred. Among 151 patients followed, there were 7 (4.6%) early major complications-severe pain with session interruption in 3 cases, capsular necrosis in 1 case, 1 abdominal wall necrosis, 1 dorsal burning, 1 peritoneal hemorrhage-and 3 (1.9%) delayed major complications: sterile fluid collection at the site of the treated tumor in 2 cases and cutaneous seeding in 1 case. There were 49 (32.5%) minor complications. The complication rate is similar to that observed after percutaneous alcohol injection (PEI). With the cooled system, the complication rate is seemingly lower but that may well be due to a different definition of major complications. The seeding rate after expandable system ablation is lower than after PEI. It is the same as or lower than that in other series of patients treated by the cooled system.

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“…This treatment strategy has two distinct characteristics: the combination of TACE and repeated RFA and the combination of high-and low-power RFA electrodes. Several studies (20)(21)(22)(23) have demonstrated that pre-treatment of TACE/TAE prior to RFA may provide better local tumor control than RFA alone for the treatment of patients with medium-sized HCC (3.1-5 cm), presumably by either downsizing the tumor or decreasing the tumor vascularity. Compared to the conventional electrodes, the StarBurst Xli-enhanced RFA electrode used in the present study has a higher power output and longer times covering a wider scope; it can create an ablation zone of up to 7 cm in one application and is thus capable of greater ablation of SHHCC.…”

Section: Discussionmentioning

confidence: 99%

Solitary huge hepatocellular carcinomas 10 cm or larger may be completely ablated by repeated radiofrequency ablation combined with chemoembolization: Initial experience with 9 patients

et al. 2011

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Abstract. The treatment of solitary huge hepatocellular carcinoma (SHHCC) larger than 10 cm remains a challenge. The aim of the present study was to assess the therapeutic effects of repeated radiofrequency ablation (RFA) combined with chemoembolization on SHHCC. This was a retrospective study based on data obtained from a prospectively collected database that included 9 SHHCC patients who underwent repeated RFA combined with chemoembolization between July 2008 and June 2011. A new management strategy for SHHCC was described. The mean tumor size of the patients was 11.5±1.0 cm. No technical failure occurred, no patient succumbed to the disease during this treatment and the median survival of all 9 patients was 34 months. Treatment of the 9 tumors required a mean of 8.2±1.5 sessions. The mean of RF applications per session was 5.3±0.9 and the mean time of one session was 165±30 min, including a mean time of RF application of 113±19 min. The SHHCCs were found to be completely ablated. The mean number of RFA for primary complete ablation was 7.0±0.9 sessions, and the mean time for primary complete ablation was 5.3±1.1 months. The overall survival rate was 100%. There were 4 actual 2-year survivors. Our data reveal that tactically and strategically performed RFA should be recommended to SHHCC patients who are not suitable or do not agree to surgery, with satisfactory efficacy and safety.

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Percutaneous Radiofrequency Thermal Ablation Combined with Transcatheter Arterial Embolization in the Treatment of Large Hepatocellular Carcinoma

Cited by 129 publications

References 0 publications

Midterm outcomes in patients with intermediate‐sized hepatocellular carcinoma

Midterm outcomes in patients with intermediate‐sized hepatocellular carcinoma

Radiofrequency thermal ablation with expandable needle of focal liver malignancies: complication report

Solitary huge hepatocellular carcinomas 10 cm or larger may be completely ablated by repeated radiofrequency ablation combined with chemoembolization: Initial experience with 9 patients

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