Radiofrequency ablation and percutaneous ethanol injection versus radiofrequency ablation alone for hepatocellular carcinoma: a systematic review and meta-analysis

Lu, De-En; Cheng, Sheng-Wei; Lin, Yang‐Sheng; Tu, Mei-Wen; Lee, Chia-Hsiang; Chen, Chiehfeng; Chen, Kee Hsin

doi:10.1016/j.aohep.2022.100729

Cited by 11 publications

(10 citation statements)

References 25 publications

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“…This study comprised 13 papers with a significant number of patients with hepatoma who were diagnosed and treated using various interventional radiology techniques. In terms of the study designs, Sex studies were systematic reviews [12][13][14][15][16][17], two were randomized controlled [18,19], one was a casecontrol study [20], one was a prospective study [7], two were retrospective studies [21,22] and one pilot study [23]. The purpose of this study was to assess overall survival (OS) and local recurrence (LR) after radiofrequency ablation (RFA), microwave ablation (MWA), and cryoablation (CA) for very early and early hepatocellular carcinoma (HCC).…”

Section: Characteristics Of the Studies Includedmentioning

confidence: 99%

Role of Interventional Radiology in Management of Hepatocellular Carcinoma: Systematic Review

Alhammami¹,

Alanazi²,

Alanazi³

et al. 2023

Arch Pharm Pract

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The purpose of this study is to analyse and evaluate the function of interventional radiology in such instances by evaluating several elements of each procedure, such as its influence on survival rates, recurrence, tumour response, and complications. The following databases were searched: PubMed, Web of Science, Science Direct, EBSCO, and the Cochrane Library. Using Rayyan QCRI, study papers were screened by title and abstract before being subjected to a full-text evaluation. This review included 13 studies with participants of varying ages and genders; more than half were males. All included studies discussing the role of interventional radiology in hepatoma cases in diagnosis and treatment. We included Sex studies that were systematic reviews; two were randomized controlled, one was a case-control study, one was a prospective study, two were retrospective studies, and one was a pilot study. In the ablation therapy of hepatocellular carcinoma nodules, we determined that microwave ablation had greater complete ablation and lower local tumour growth than radiofrequency ablation. In large tumors (up to 6 cm), mwa is preferred, and cryoablation is preferred in recurrent disease. Because of a lesser heat-sink effect, mwa and cryoablation are preferred to RFA in perivascular disease. Chemoablation can be used in smaller lesions (<3 cm). In intermediate-stage, multifocal lesions (>3), tace, debs, and tare are to be used.

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Section: Characteristics Of the Studies Includedmentioning

confidence: 99%

Role of Interventional Radiology in Management of Hepatocellular Carcinoma: Systematic Review

Alhammami¹,

Alanazi²,

Alanazi³

et al. 2023

Arch Pharm Pract

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“…A 2022 study of 107 patients with large HCC lesions found that transarterial ethanol ablation (TEA) had significantly better tumor response and OS, with the average OS being 21.6 months compared with 9.9 months for historical cohort of TACE and TARE. 24 25 26…”

Section: Percutaneous Ethanol Injectionmentioning

confidence: 99%

“…Furthermore, in patients with cirrhosis-related HCC, bleeding in the bile ducts has been found. 26 Pleural effusion, venous thrombosis, hepatic abscess, seeding, and cholangitis have all been described with PEI. 12…”

Section: Percutaneous Ethanol Injectionmentioning

confidence: 99%

Non-Thermal Liver Ablation: Existing and New Technology

Nakla,

Chow,

Pham

et al. 2023

Semin intervent Radiol

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Cancer has and continues to be a complex health crisis plaguing millions around the world. Alcohol ablation was one of the initial methods used for the treatment of liver lesions. It was surpassed by thermal ablation which has played a big role in the therapeutic arsenal for primary and metastatic liver tumors. However, thermal ablation has several shortcomings and limitations that prompted the development of alternative technologies including electroporation and histotripsy. Percutaneous alcohol injection in the liver lesion leads to dehydration and coagulative necrosis. This technology is limited to the lesion with relative sparing of the surrounding tissue, making it safe to use adjacent to sensitive structures. Electroporation utilizes short high-voltage pulses to permeabilize the cell membrane and can result in cell death dependent on the threshold reached. It can effectively target the tumor margins and has lower damage rates to surrounding structures due to the short pulse duration. Histotripsy is a novel technology, and although the first human trial was just completed, its results are encouraging, given the sharp demarcation of the targeted tissue, lack of thermal damage, and potential for immunomodulation of the tumor microenvironment. Herein, we discuss these techniques, their uses, and overall clinical benefit.

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“…Many centers considered EI as an adjuvant therapy for combination strategies (158). Studies have indicated that EI can enhance the efficacy of RFA in the treatment of HCC (159,160), the underlying mechanism of which is that EI can induce microthrombi formation to occlude blood vessels and then reduce heat dissipation to increase the efficacy of RFA. EI combined with TACE was found to be safe for the treatment of advanced HCC and PVTT, and it resulted in a significant survival advantage over TACE alone (161).…”

Section: Percutaneous Ablationmentioning

confidence: 99%