Radiofrequency ablation versus surgical resection for multiple HCCs meeting the Milan criteria: propensity score analyses of 10-year therapeutic outcomes

Min, Ji Hye; Kang, Tae Wook; Cha, D.I.; Song, Kyoung Doo; Lee, M.W.; Rhim, Hyunchul; Sinn, Dong Hyun; Kim, J.M.; Sohn, Insuk

doi:10.1016/j.crad.2018.02.007

Cited by 14 publications

(20 citation statements)

References 37 publications

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“…There have been some reports comparing the efficacy of RFA with SR in small, solitary HCC, however the results proved to be contradictory (2,4,6,7,13). In the analysis of patients with HCC measuring ≥3 cm, SR was shown to be superior to RFA with respect to OS and CSS in our study regardless of PSM, whereas several studies reported that the effect of RFA on HCC ≥3 cm was comparable to that of SR. For example, the results of a study from France including 281 patients with HCC measuring ≤5 cm have shown no survival difference between the RFA and SR group (5).…”

Section: Discussioncontrasting

confidence: 64%

“…Liver transplantation is regarded as the best choice of therapy if possible, as it also treats the remaining liver that is most often cirrhotic. The Milan criteria (4)(5)(6), the standard for liver transplant eligibility, are defined as a solitary nodule ≤ 5 cm, or up to 3 nodules ≤ 3 cm, with no evidence of vascular invasion, and enough liver functional reserve. But owing to the shortage of available liver donors, this technique is limited in clinical practice and only a few patients have the chance to accept this kind of treatment.…”

Section: Introductionmentioning

confidence: 99%

“…Currently, there are many studies that have investigated the efficacy of these two therapies (2,4,7,8). But it is still controversial whether RFA or SR results in more favorable treatment outcomes for patients with small lesions.…”

Section: Introductionmentioning

confidence: 99%

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Comparative Effectiveness of Radiofrequency Ablation vs. Surgical Resection for Patients With Solitary Hepatocellular Carcinoma Smaller Than 5 cm

et al. 2020

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Background: This study aims to compare survival outcome after receiving radiofrequency ablation (RFA) and surgical resection (SR) for solitary hepatocellular carcinoma (HCC) with size large as 5 cm. Methods: The SEER database was queried for patients with HCC tumors who were treated with RFA or SR between 2004 and 2015. Univariate and multivariate Cox analysis was used to assess the influence of potential variables on the patients' outcome. Additionally, propensity score matching (PSM) and multiple imputations (MI) were used as sensitivity analyses. Results: Of 1,985 cases, 934 patients received RFA treatment, while the rest underwent surgical resection. The patients in the RFA group had poorer overall survival (OS) and cancer-specific survival (CSS) than those in the SR group regardless of the tumor size before matching and MI. By using PSM analysis at a 1:1 ratio, 1,302 cases were paired and we have found that SR had a positive impact on OS and CSS of patients with tumors measuring from 3.1 to 5 cm. However, when the tumor size was <3 cm, patients undergoing SR had similar survival benefit with those after RFA. The above results were confirmed after performing PSM analysis at a 1:2 and 1:3 ratio. Conclusion: By applying several effective sensitivity analyses, we demonstrated that OS and CSS were similar between the patients with tumors smaller than 3 cm receiving RFA and SR. But SR may be a superior treatment option with better long-term outcome than RFA in patients with tumor measuring 3.1-5 cm.

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Section: Discussioncontrasting

confidence: 64%

Section: Introductionmentioning

confidence: 99%

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Comparative Effectiveness of Radiofrequency Ablation vs. Surgical Resection for Patients With Solitary Hepatocellular Carcinoma Smaller Than 5 cm

et al. 2020

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“…Palliative RT was performed from a single fraction of SBRT to 10 fractions of 3D-CRT, depending on the status of patients including the extent of disease, liver function, life expectancy, and performance status. 23,24…”

Section: Radiotherapymentioning

confidence: 99%

Clinical significance of radiotherapy before and/or during nivolumab treatment in hepatocellular carcinoma

Lee

et al. 2019

Cancer Medicine

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Background This study aimed to investigate the clinical significance of previous and/or concurrent application of radiotherapy (RT) in the course of nivolumab treatment for advanced hepatocellular carcinoma (HCC). Methods Patients with advanced HCC who received nivolumab treatment between March 2017 and May 2018. were included. Nivolumab treatment was indicated in patients who did not respond to conventional therapy including locoregional therapy and/or sorafenib. RT was performed when necessary for curative/palliative purpose. Results Among the 76 HCC patients who received nivolumab, 54 (71.1%) had received RT for HCC before and/or during the treatment. The period from initial HCC diagnosis to nivolumab treatment was significantly longer (P = .007) and the rate of undergoing transarterial chemoembolization (TACE; P = .006) and sorafenib treatment (P = .007) was significantly higher in patients who received previous/concurrent RT than in those who did not. Nivolumab‐related toxicities were generally tolerable regardless of the history of RT. During the follow‐up, 39 (51.3%) patients died and 54 (71.1%) patients experienced disease progression according to the RECIST v1.1. Patients who had received previous/concurrent RT had a significantly longer progression‐free survival (PFS; P = .008) and overall survival (OS; P = .007) than those who did not receive RT; however, this trend was not observed in patients with a history of radiofrequency ablation or TACE (all P > .05). Conclusion Previous and/or concurrent application of RT in the course of nivolumab treatment was related with longer PFS and OS in advanced HCC patients. Nonetheless, further clinical studies are warranted to confirm our findings.

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“…Finally, 18 articles were included after reading the full papers. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Figure 1: Flow diagram of searching strategy.…”

Section: Search Strategy and Study Identificationmentioning

confidence: 99%

Comparison of the outcome of radiofrequency ablation or hepatic resection between solitary hepatocellular carcinoma and oligonodular hepatocellular carcinoma meeting Milan criteria: a systematic review and meta-analysis

Adhikari

Wen

Shrestha³

et al. 2019

Int Surg J

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There are more literatures on the comparison of the outcome of small HCC between HR and RFA, but rare is about the comparison of the outcome between small solitary HCC and small oligonodular HCC meeting Milan criteria by HR or by RFA. Thus, the aim of the present study is to evaluate the outcome between small solitary HCC and small oligonodular HCC meeting Milan criteria treated by HR or by RFA. Total eighteen studies including 4,823 patients was included in this study. Among them LR group included 2,564 cases, and RFA group included 2,259 cases. We divided them into small solitary HCC sub-group and small oligonodular HCC sub-group and compared the survival difference between them. In the HR group, 1, 3, and 5 years OS of the small solitary HCC sub-group were 93.9%, 81.3%, and 72.0%, and the small oligonodular HCC sub-group were 83.3%, 70.4%, and 45.4%, respectively. For the DFS in the HR group, 1, 3, and 5 years of the small solitary HCC sub-group were 76.4%, 56.0%, and 44.0%, and 65.9%, 40.7%, and 11.1% of the small oligonodular HCC sub-group, respectively. In the RFA group, 1, 3, and 5 years OS of the small solitary HCC sub-group were 91.2%, 74.1%, and 54.5%, and the small oligonodular HCC sub-group were 82.0%, 55.4%, and 38.2%, respectively. For the DFS in the RFA group, 1, 3, and 5years of the small solitary HCC sub-group were 74.1%, 49.8%, and 22.1%, and 62.6% and 37.3%, 8.2% of the small oligonodular HCC sub-group, respectively.

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Radiofrequency ablation versus surgical resection for multiple HCCs meeting the Milan criteria: propensity score analyses of 10-year therapeutic outcomes

Cited by 14 publications

References 37 publications

Comparative Effectiveness of Radiofrequency Ablation vs. Surgical Resection for Patients With Solitary Hepatocellular Carcinoma Smaller Than 5 cm

Comparative Effectiveness of Radiofrequency Ablation vs. Surgical Resection for Patients With Solitary Hepatocellular Carcinoma Smaller Than 5 cm

Clinical significance of radiotherapy before and/or during nivolumab treatment in hepatocellular carcinoma

Comparison of the outcome of radiofrequency ablation or hepatic resection between solitary hepatocellular carcinoma and oligonodular hepatocellular carcinoma meeting Milan criteria: a systematic review and meta-analysis

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