Radiofrequency (thermal) ablation versus no intervention or other interventions for hepatocellular carcinoma

Weis, Sebastian; Franke, Annegret; Mössner, Joachim; Jakobsen, Janus Christian; Schoppmeyer, Konrad

doi:10.1002/14651858.cd003046.pub3

Cited by 89 publications

(83 citation statements)

References 87 publications

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“…Randomized controlled trials comparing RFA with PEI demonstrate that RFA is superior to ethanol injection in terms of treatment response, number of sessions, recurrences, and overall survival (2-year local recurrence rate: 2 -18 % versus 11 -45 %) [104, 105, 108 -112] as further supported by meta-analyses [88,111,113]. A meta-analysis of six RCTs comparing RFA with PEI and enrolling patients with a tumor size of ≤ 5 cm found RFA significantly superior to PEI with overall survival (HR 1.64, 95 % CI 1.31 to 2.07), and lack of local progression (HR 2.44, 95 % CI 1.71 -3.49) [88]. The efficacy of the methods is similar for tumors ≤ 2 cm [43,104,105,114].…”

Section: Rfa Versus Peimentioning

confidence: 94%

“…This analysis assessed the role of specific tumor size thresholds in early HCC, showing that size had a great impact on the effectiveness of RFA but not of surgery. A systematic review of 8000 patients [14] with a current Cochrane analysis [88] reported uncertainty regarding the question of the impact of RFA versus surgery. However, a more recent meta-analysis, published after the Cochrane analysis [89], showed that there were differences in age and liver function between patients with early HCC submitted to either RFA or resection.…”

Section: Rfa Versus Surgical Resection In Small Hccsmentioning

confidence: 99%

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Untitled

2016

Ultraschall in Med

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Section: Rfa Versus Peimentioning

confidence: 94%

Section: Rfa Versus Surgical Resection In Small Hccsmentioning

confidence: 99%

Untitled

2016

Ultraschall in Med

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“…It is recommended by the EASL-EORTC guidelines for early-stages of HCC in patients who are not eligible for surgery or transplantation. According to an actual systematic Cochrane Database review [35] , there is moderate evidence, that RFA is superior to percutaneous ethanol injection [36] , but inferior to hepatic resection of HCC [37,38] with regard to recurrence-free and overall survival. In contrast, RFA is superior to hepatic resection with regard to procedure-related complications due to the less invasive character of the procedure [39] .…”

Section: Rfamentioning

confidence: 99%

Hepatocellular carcinoma: Surgeon's view on latest findings and future perspectives

Slotta

Kollmar

Ellenrieder

et al. 2015

WJH

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Hepatocellular carcinoma (HCC) is the most common liver-derived malignancy with a high fatality rate. Risk factors for the development of HCC have been identified and are clearly described. However, due to the lack of tumor-specific symptoms, HCC are diagnosed at progressed tumor stages in most patients, and thus curative therapeutic options are limited. The focus of this review is on surgical therapeutic options which can be offered to patients with HCC with special regard to recent findings, not exclusively focused on surgical therapy, but also to other treatment modalities. Further, potential promising future perspectives for the treatment of HCC are discussed. EPIDEMIOLOGYHepatocellular carcinoma (HCC) is a very common malignant disease with more than 700000 new patients diagnosed per year. Interestingly, the incidence of HCC varies relevantly throughout the world. Whereas HCC is a very common malignant disease in sub-Saharan Africa, and central and south-east Asia with incidence rates of 20-47/100000 habitants, the incidence of REVIEW Submit a

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“…Other forms of ablation such as ethanol injection (PEI) and cryoablation have been abandoned as first-line treatment in favor of RFA, which is associated with a significantly lower local recurrence [29][30][31]. PEI and cryoablation are reserved for lesions in anatomic areas with higher risk of local thermal complications (e.g., abutting the diaphragm, gallbladder, or other viscera).…”

Section: Locoregional Ablationmentioning

confidence: 99%

Therapeutic Strategies for Hepatocellular Carcinoma: New Advances and Challenges

Vilarinho

Taddei

2015

Curr Treat Options Gastro

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Hepatocellular carcinoma (HCC) is the fastest growing malignancy in the USA, and its prognosis remains poor with a 5-year survival around 12 %. Clinical data demonstrate that 85 % of cases occur in individuals with underlying cirrhosis and only 15 % develop in non-cirrhotic livers. Therefore, American and European guidelines recommend routine HCC screening for high-risk individuals (patients with cirrhosis) with abdominal ultrasound every 6 months. Once a lesion is identified or suspected on ultrasound, dynamic imaging is then indicated. The diagnosis of HCC is established in a patient with cirrhosis when a lesion measures at least 1 cm in diameter and demonstrates arterial enhancement and portal venous washout on contrast-enhanced computerized tomography or magnetic resonance imaging. Indeterminate lesions should be followed with surveillance imaging or further investigated with biopsy according to the level of suspicion for malignancy. Given the clinical, pathological, and molecular heterogeneity of HCC, there are multiple therapeutic modalities available. These may be curative, such as surgical resection, liver transplantation, and local ablation, or palliative, such as catheter-directed therapies (transarterial chemo, radio, or bland embolization), and systemic therapy (sorafenib). Patients with a single lesion, good performance status, and preserved liver synthetic function should be offered curative surgical resection or ablation therapy. Patients with HCC and decompensated liver disease should be evaluated and listed for liver transplantation. For unresectable disease or tumor burden precluding transplantation or curative ablation, palliative therapeutic modalities should be offered. Sorafenib is indicated for patients with vascular invasion and/or extra-hepatic metastasis if the estimated life expectancy is more than 3 months. Systemic internal radiation therapy using yttrium-90 microspheres in cases of multifocal bi-lobar disease and/or portal vein occlusion is an emerging therapy. Best supportive care is recommended for patients who lack the hepatic reserve to tolerate therapy.

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Radiofrequency (thermal) ablation versus no intervention or other interventions for hepatocellular carcinoma

Cited by 89 publications

References 87 publications

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Hepatocellular carcinoma: Surgeon's view on latest findings and future perspectives

Therapeutic Strategies for Hepatocellular Carcinoma: New Advances and Challenges

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