The Combination Strategy of Transarterial Chemoembolization and Radiofrequency Ablation or Microwave Ablation against Hepatocellular Carcinoma

Xu, Zhentian; Xie, Haiyang; Zhou, Lin; Chen, Xinhua; Zheng, Shusen

doi:10.1155/2019/8619096

Cited by 49 publications

(51 citation statements)

References 51 publications

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“…Ablation with curative intent is an effective alternative to resection, particularly for tumors smaller than 3 cm [114]. For tumors 3-5 cm in diameter, the combination of TACE and ablation demonstrate good outcomes albeit not curative [132][133][134][135]. Caution must be exercised when lesions are close to major vessels, biliary structures, diaphragm, and other intra-abdominal organs.…”

Section: Patient Selectionmentioning

confidence: 99%

Locoregional Therapy Approaches for Hepatocellular Carcinoma: Recent Advances and Management Strategies

Makary

Khandpur

Cloyd

et al. 2020

Cancers

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Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and third leading cause of cancer-related mortality worldwide. While surgical resection and transplantation are the standard first-line treatments for early-stage HCC, most patients do not fulfill criteria for surgery. Fortunately, catheter-directed and percutaneous locoregional approaches have evolved as major treatment modalities for unresectable HCC. Improved outcomes have been achieved with novel techniques which can be employed for diverse applications ranging from curative-intent for small localized tumors, to downstaging or bridging to resection and transplantation for early and intermediate disease, and locoregional control and palliation for advanced disease. This review explores recent advances in liver-directed techniques for HCC including bland transarterial embolization, chemoembolization, radioembolization, and ablative therapies, with a focus on patient selection, procedural technique, periprocedural management, and outcomes.

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Section: Patient Selectionmentioning

confidence: 99%

Locoregional Therapy Approaches for Hepatocellular Carcinoma: Recent Advances and Management Strategies

Makary

Khandpur

Cloyd

et al. 2020

Cancers

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“…In fact, Ablation (chemical or thermal) with TACE is established wherever the lipiodol deposition is incomplete and the lesion is targetable, and percutaneous acetic acid or ethanol injection is one of the important additional treatment options with TACE to improve outcome as it is cost effective [9][10][11][12]. Furthermore, the researchers revealed that MWA has recently gained importance and acceptance due to better tumor control as compared to radiofrequency ablation (RFA) [8,13,14]. The purpose of our retrospective study was to analyze the safety and efficacy of TACE combined with simultaneous DynaCT guided MWA by comparing the patient group that received single treatment with TACE for SHCC.…”

Section: Introductionmentioning

confidence: 99%

Transcatheter arterial chemoembolization combined with simultaneous DynaCT-guided microwave ablation in the treatment of small hepatocellular carcinoma

Jiao

Han

et al. 2020

Cancer Imaging

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Purpose: To evaluate the method and effectiveness of transcatheter arterial chemoembolization (TACE) combined with simultaneous DynaCT-guided Microwave ablation (MWA) for the treatment of small hepatocellular carcinoma (SHCC). Materials and methods: From June 2015 to May 2017, a total of 28 consecutive patients with SHCC received single treatment of TACE and 23 subjects received a combination treatment of TACE with simultaneous DynaCTguided MWA. Following 1 month of treatment, the tumor response was assessed using the mRECIST criteria and the outcomes were analyzed including intervention-associated complications, changes in liver function, imaging response, and progression-free survival (PFS). Results: The technical success rate was 100%. The rates of CR (65%) in the combined TACE and MWA group were higher than those of the TACE group (46%). The rate of common adverse events, such as liver abscess, spontaneous bacterial peritonitis and liver dysfunction, in the combined TACE and MWA group (56%) was comparable to the corresponding rate of the TACE group (P > 0.411). The median and mean PFS of the TACE group were significantly lower than those of the combined TACE and MWA group (19.00 months vs. 29.00 months, 21.076 months vs. 24.693 months, p = 0.019, log-rank test). Conclusion: Stereotactic DynaCT-guided MWA is a safe and effective method for the treatment of SHCC, which usually provides an effective tumor puncture path, notably for lesions that cannot be detected following TACE. Overall, the data suggested that this treatment method could improve the clinical outcome of patients with SHCC.

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“…There is also emerging data to support microwave ablation either alone or in combination with TACE in patients with intermediate stage HCC. 61 , 62 …”

Section: Standard Management Of Intermediate Stage Hcc: Tacementioning

confidence: 99%

Management of patients with intermediate stage hepatocellular carcinoma

Prince

Liu

et al. 2020

Ther Adv Med Oncol

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Hepatocellular carcinoma (HCC) causes a significant health burden globally and its impact is expected to increase in the coming years. Intermediate stage HCC, as defined by the Barcelona Clinic Liver Cancer (BCLC) system stage B, represents up to 30% of patients at diagnosis and encompasses a broad spectrum of tumor burden. Several attempts have been made to further subclassify this heterogenous group. The current standard of care recommended by BCLC for intermediate stage HCC patients is transarterial chemoembolization (TACE), with modest outcomes reported. While refinements have been made to TACE technique and patient selection, it remains non-curative. In the real-world setting, only 60% of patients with intermediate stage HCC receive TACE, with the remainder deviating to a range of other therapies that have shown promise in select patient subgroups. These include curative treatments (resection, ablation, and liver transplantation), radiotherapy (stereotactic and radioembolization), systemic therapies, and their combination. In this review, we summarize the classifications and current management for patients with intermediate stage HCC as well as highlight recent key developments in this space.

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The Combination Strategy of Transarterial Chemoembolization and Radiofrequency Ablation or Microwave Ablation against Hepatocellular Carcinoma

Cited by 49 publications

References 51 publications

Locoregional Therapy Approaches for Hepatocellular Carcinoma: Recent Advances and Management Strategies

Locoregional Therapy Approaches for Hepatocellular Carcinoma: Recent Advances and Management Strategies

Transcatheter arterial chemoembolization combined with simultaneous DynaCT-guided microwave ablation in the treatment of small hepatocellular carcinoma

Management of patients with intermediate stage hepatocellular carcinoma

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