Risk factors of secondary infection/recurrence after ablation for liver cancers

Yin, Gang; Zhang, Nengwei; Amin, Buhe; Yan, Wei; Li, Tianxiong; Peng, Jirun

doi:10.4103/jcrt.jcrt_291_21

Cited by 4 publications

(1 citation statement)

References 39 publications

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“…Studies indicate that ablating solid tumours can lead to various complications, including bleeding, infection, local persistent pain, and impairment of organ function. 29 , 30 Furthermore, localised mild hyperthermia such as microwave hyperthermia, hyperthermic intraperitoneal chemotherapy, and bladder perfusion chemotherapy have been reported to cause skin, mucosal, and soft tissue burns due to uneven distribution of body temperature. 31 , 32 , 33 Continuous and repeated heating could elevate the risk of catarrh, particularly when combined with chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Water‐filtered infrared A radiation hyperthermia combined with immunotherapy for advanced gastrointestinal tumours

Liu,

Wu,

Chen

et al. 2024

Cancer Medicine

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IntroductionThis study aimed to validate the effectiveness, safety and feasibility of water‐filtered infrared A radiation (WIRA) whole‐body hyperthermia combined with immune checkpoint inhibitor (ICI) therapy (HIT) and evaluate the real‐world clinical application prospects.MethodsThis open‐label single‐arm phase 2 clinical trial (NCT06022692) aimed to enrol advanced gastrointestinal tumour (GIT) patients with the MSS/pMMR phenotype. The patients were treated with whole‐body hyperthermia on Days 1 and 8 of each HIT cycle along with administration of tislelizumab on Day 2.ResultsBetween 1 June 2020 and 31 May 2022, 18 patients were enrolled in the study, including those with gastric cancer (n = 6), colon cancer (n = 7), rectal cancer (n = 3) and appendiceal cancer (n = 2). As of 19 May 2023, 17 of the 18 patients had died, including 14 deaths caused by tumour progression and three deaths caused by diseases other than cancer, while one patient was still undergoing follow‐up. In terms of efficacy, the median DCR was 55.6%, while the median PFS and OS were 53.5 days and 134 days, respectively. Four patients (22.2%) experienced immune‐related adverse events, and none of the patients reported grade 3 or higher irAEs. Hyperthermia was followed by an increase in the number of tumour immune‐activated cells.ConclusionsHIT can provide survival benefits in patients with GITs by activating antitumour immune function and shows good safety and feasibility.

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Section: Discussionmentioning

confidence: 99%

Water‐filtered infrared A radiation hyperthermia combined with immunotherapy for advanced gastrointestinal tumours

Liu,

Wu,

Chen

et al. 2024

Cancer Medicine

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Risk factors of complications after thermal ablation for hepatocellular carcinoma: the role of assessment of liver background

Xie,

Liu,

Shi

et al. 2024

European Journal of Gastroenterology &Amp; Hepatology

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Objective To use an elastography technology and other clinical and radiological data for assessment of liver background and analyze risk factors of complications after thermal ablation in patients with hepatocellular carcinoma. Methods Demographics, laboratory analyses, and radiological characteristics were collected from all patients. Main elastography-related indicators included F index (fibrosis index), A index (inflammation index), ATT (attenuation coefficient), E (kPa), AREA (area of blue parts), and CORR (correlation). All complications after thermal ablation were collected. Univariate analysis was performed to detect significant variables, which subsequently entered a stepwise logistic regression analysis (conditional forward selection) to identify independent variables. Results A total of 218 patients from October 2020 to June 2023 with 291 thermal ablation sessions were enrolled. 115 patients (52.8%) developed complications. Fifteen patients (6.9%) developed major complications. Minor complications included postoperative pain (20.6%), fever (19.3%), effusion (22.5%), and hyperammonemia (1.8%). AREA (P = 0.034), tumor size (P = 0.005), and abnormal aspartate aminotransferase (AST) (P = 0.018) were independent predictors for complications. F index (P = 0.021), tumor size (P < 0.001), and abnormal AST (P = 0.047) were independent predictors for effusion. The results of univariate analysis of infection showed that tumor size, CORR, ATT, diabetes, Child–Turcotte–Pugh grade, abnormal AST, total protein, and albumin were significant (all P < 0.05). Conclusion Several radiological and combinational elastography indicators related to liver fibrosis, steatosis, or inflammation were significantly correlated with the occurrence of complications. Clinical assessment of the liver background should not be neglected in the management of postablation complications.

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The Value of CEUS LI-RADS combined with AFP in early diagnosis of hepatocellular carcinoma in low- and high-risk patients

Wu,

Chen,

Wei

et al. 2024

Journal of Cancer Research and Therapeutics

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Background: We found that the occurrence of hepatocellular carcinoma (HCC) has increased significantly in non-cirrhotic individuals, with HCC being frequently overlooked or misdiagnosed. Contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) is known to have a high diagnostic quality in high-risk HCC patients. Therefore, we aimed to compare the detection accuracy of CEUS LI-RADS for HCC between low- and high-risk individuals, to confirm its value in low-risk patients at increased risk of HCC, but not yet included in the high-risk groups of LI-RADS. In addition, since CEUS LR-4 and LR-M categories contain a relatively high proportion of HCC, and serum alpha-fetoprotein (AFP) is the most commonly used biomarker for HCC, and the clinically valid, we attempted to further improve the early diagnostic capability of CEUS LI-RADS for HCC in the low-risk and high-risk patients by combining CEUS LR-4 and LR-M categories with AFP. Methods: We defined high-risk groups (HR)-included in the high-risk patients of LI-RADS, low-risk groups (LR)-not included in the high-risk patients of LI-RADS and enrolled 189 HCC patients with LR and HR settings in a retrospective study. All lesions were confirmed histopathologically. The CEUS LI-RADS accuracy for detecting HCC in these two patients was compared. In addition, the diagnostic algorithm in our study was proposed (for CEUS LR-4 and LR-M patients with AFP>20 ng/ml). we analyzed the ability of CEUS LI-RADS as a valid method of establishing the early diagnosis of HCC in LR and HR patients by combining LR-4 and LR-M categories with AFP. Results: Through comparative analysis, the specificity of the CEUS LR-5 category for HCC in the HR group was 78.4%, whereas in the LR group, it was 94.2%. Meanwhile, the sensitivity (63.2% vs. 63.0%) and positive predictive value (PPV) (75.0% vs. 88.7%) did not differ between the LR and HR groups (P = 0.990, P = 0.299). It is noteworthy that there were the high proportion of HCC in CEUS LR-4 and LR-M categories in our cases and when we combined CEUS LR-4 and LR-M categories with AFP significantly improved the sensitivity by 21.0% (84.2%) in the LR group, and by 16.0% (79.0%) in the HR group, with statistically difference in sensitivity after combination in the HR group (P = 0.014). Conclusions: The CEUS LR-5 category has real meaningful utility in the diagnosis of HCC in both LR and HR patients. The early detection power of the CEUS LI-RADS category for HCC patients was further increased when the CEUS LR-4 and LR-M categories were combined with elevated AFP.

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Risk factors of secondary infection/recurrence after ablation for liver cancers

Cited by 4 publications

References 39 publications

Water‐filtered infrared A radiation hyperthermia combined with immunotherapy for advanced gastrointestinal tumours

Water‐filtered infrared A radiation hyperthermia combined with immunotherapy for advanced gastrointestinal tumours

Risk factors of complications after thermal ablation for hepatocellular carcinoma: the role of assessment of liver background

The Value of CEUS LI-RADS combined with AFP in early diagnosis of hepatocellular carcinoma in low- and high-risk patients

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