Treatment Options in Hepatocellular Carcinoma Today

Livraghi, Tito; Mäkisalo, Heikki; Line, Pål–Dag

doi:10.1177/145749691110000105

Cited by 97 publications

(106 citation statements)

References 53 publications

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“…Radiofrequency ablation (RFA) was first described by Rossi et al (2) as a local thermal ablation therapy for HCC. It has been endorsed as a curative treatment modality by several clinical management guidelines for early-stage, unresectable HCC (3)(4)(5)(6)(7)(8)(9). However, to further improve the treatment outcomes of RFA for HCC, it is important to accurately identify the position of tumors on performing ultrasonography.…”

Section: Introductionmentioning

confidence: 99%

Effect of treatment support on preventing local recurrence of hepatocellular carcinoma directly adjacent to the diaphragm

Ishikawa

Imai

et al. 2017

Molecular and Clinical Oncology

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Abstract. Treatment support is anticipated to improve the results of radiofrequency ablation (RFA) treatment in cases in which visualization of tumors using the conventional B-mode is unclear. In the present study, the effectiveness of treatment support for RFA reducing the local recurrence rate of hepatocellular carcinoma (HCC) that are located directly adjacent to the diaphragm, and which are difficult to visualize with B-mode ultrasound imaging, was investigated. A total of 103 HCC tumors measuring <5 cm, which were located abutting the diaphragm, and which were difficult to visualize using the B-mode, were treated using RFA. Thirty-three of those HCC tumors were treated using RFA without treatment support, whereas the remaining 70 HCC tumors were treated using RFA with treatment support, including artificial pleural effusion, contrast-enhanced ultrasonography (CEUS) with the contrasting agent, Sonazoid™, and fusion imaging, either alone or in combination to improve the visualization of the tumors. The rate of local recurrence, and factors affecting local recurrence, were analyzed. Local recurrences were confirmed in 17 of the 103 nodules (16.50%). The overall rate of local recurrence was 13.1% at 6 months, and 20.2% at 12 months. The rate of local recurrence using RFA with artificial pleural effusion was significantly lower compared with those cases of HCC tumors treated without artificial pleural effusion (P=0.008). Similarly, the rate of local recurrence for CEUS RFA with Sonazoid™ was significantly lower compared with those cases of HCC tumors treated without Sonazoid™ (P=0.00081). In a multivariate analysis, CEUS RFA with Sonazoid™ and artificial pleural effusion contributed to the decrease in the rate of local recurrence (hazard ratios, 0.075 and 0.143, respectively). Based on these results, it is possible to conclude that CEUS with Sonazoid™ as a treatment support was the most effective method for reducing the rate of local recurrences abutting the diaphragm that are difficult to visualize using B-mode ultrasonography. IntroductionHepatocellular carcinoma (HCC) is the fifth most common cancer in men, and the seventh most common cancer in women worldwide, and it is the most common cause of cancer-associated mortality (1). Radiofrequency ablation (RFA) was first described by Rossi et al (2) as a local thermal ablation therapy for HCC. It has been endorsed as a curative treatment modality by several clinical management guidelines for early-stage, unresectable HCC (3-9). However, to further improve the treatment outcomes of RFA for HCC, it is important to accurately identify the position of tumors on performing ultrasonography. Even in cases for which the visualization of tumors is difficult with the conventional B-mode ultrasound imaging, performing RFA using treatment support such as artificial pleural effusion, fusion imaging, and contrast-enhanced ultrasound with Sonazoid™ (Perflubutane; Daiichi Sankyo Co., Ltd., Tokyo, Japan), is expected to improve treatment outcomes in clinical settings (10).The aim...

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Section: Introductionmentioning

confidence: 99%

Effect of treatment support on preventing local recurrence of hepatocellular carcinoma directly adjacent to the diaphragm

Ishikawa

Imai

et al. 2017

Molecular and Clinical Oncology

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“…Furthermore, nearly half of patients who underwent hepatectomy would have a recurrent or metastatic disease within two years. Therefore, effective therapeutic approaches are urgently desired for patients with HCC (El-Serag, 2011;Livraghi et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Characterization and Resistance Mechanisms of A 5-fluorouracil-resistant Hepatocellular Carcinoma Cell Line

Fang²,

Li³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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“…Hepatocellular carcinoma (HCC) is the fifth most common cancer and the third highest cause of cancer-related mortality in the world (1,2). Although hepatic resection or liver transplantation are the standard methods of treatment for liver cancer, thermal ablation treatment, including radiofrequency ablation (RFA), is also widely utilized.…”

Section: Introductionmentioning

confidence: 99%

Hepatic abscess with hepatobronchial fistula following percutaneous radiofrequency ablation for hepatocellular carcinoma: A case report

Dai

Cui

et al. 2015

Oncology Letters

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Abstract. Radiofrequency ablation (RFA) has a low rate of complication and is one of the most effective and minimally invasive techniques for the treatment of liver tumors. However, a number of complications may occur in rare cases, including bronchobiliary fistula, hollow viscera perforation, diaphragmatic perforation and hernia. The present study reports a case of hepatic abscess with hepatobronchial fistula following RFA of hepatocellular carcinoma; this led to severe lung infection, respiratory failure and mortality. The present case report aims to improve understanding of the cause and mechanism of the complications arising through RFA of the liver, and highlight important factors in the prevention and management process. This case indicates that the complications of RFA may be prevented or effectively managed through preoperative evaluation, intraoperative and postoperative monitoring.

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Treatment Options in Hepatocellular Carcinoma Today

Cited by 97 publications

References 53 publications

Effect of treatment support on preventing local recurrence of hepatocellular carcinoma directly adjacent to the diaphragm

Effect of treatment support on preventing local recurrence of hepatocellular carcinoma directly adjacent to the diaphragm

Characterization and Resistance Mechanisms of A 5-fluorouracil-resistant Hepatocellular Carcinoma Cell Line

Hepatic abscess with hepatobronchial fistula following percutaneous radiofrequency ablation for hepatocellular carcinoma: A case report

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