Repeated Radiofrequency Ablation Combined With Ablated Lesion Elimination and Transarterial Chemoembolization Improves the Outcome of Solitary Huge Hepatocellular Carcinomas 10 cm or Larger

نویسندگان

  • Shan Ke
  • Jun Gao
  • Jian Kong
  • Xue-Mei Ding
  • Hai-Gang Niu
  • Zong-Hai Xin
  • Chun-Min Ning
  • Shi-Gang Guo
  • Xiao-Long Li
  • Long Zhang
  • Yong-Hong Dong
  • Wen-Bing Sun
چکیده

This study investigated the effectiveness of a new strategy, repeated radiofrequency (RF) ablation combined with ablated lesion elimination following transarterial chemoembolization (TACE)/transarterial embolization (TAE), for solitary huge hepatocellular carcinoma (SHHCC) 10 cm or larger. From July 2008 to October 2015, 39 consecutive patients with SHHCC were screened. Of these, 12 were treated with TACE/TAE and repeated RF ablation (TACE/TAE + RF ablation group) and the remaining 27 patients were treated with the aforementioned new strategy (new strategy group). Local tumor progression (LTP)-free survival, intrahepatic distant recurrence (IDR)-free survival, and overall survival (OS) rates were obtained using the Kaplan-Meier method. Univariate and multivariate analyses were performed on several clinicopathological variables to identify factors affecting long-term outcome and intrahepatic recurrence. Correlation analysis was also performed. The 1-, 2-, and 3-year LTP-free survival rates and OS rates were significantly higher in the new strategy group than in the TACE/TAE + RF ablation group (82.9% vs 58.3%, 73.9% vs 29.2%, 18.5% vs 9.7%, P = 0.002; 92.0% vs 75.0%, 84.0% vs 33.3%, 32.7% vs 16.7%, P = 0.025). However, there was no significant difference between the 2 groups in the 1-, 2-, and 3-year IDR-free survival rates (P = 0.108). Using univariate analysis, alpha-fetoprotein (AFP > 200 ng/mL), ablative margin (AM > 1.0 cm), and well-differentiated cells were found to be significant factors for predicting LTP, IDR, and OS. Surgical elimination was found to be a significant factor only for predicting OS. In multivariate analyses, AFP (>200 ng/mL), AM (>1.0 cm), and well-differentiated cells were found to be significant independent factors linked to LTP, IDR, and OS. Correlation analysis indicated that AM > 1.0 cm was strongly associated with surgical elimination (P < 0.001, correlation coefficient = 0.877). For patients with SHHCC who were initially excluded from surgery, the new strategy including repeated RF ablation combined with ablated lesion elimination following TACE/TAE should now be considered as an alternative treatment.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Solitary huge hepatocellular carcinomas 10 cm or larger may be completely ablated by repeated radiofrequency ablation combined with chemoembolization: Initial experience with 9 patients.

The treatment of solitary huge hepatocellular carcinoma (SHHCC) larger than 10 cm remains a challenge. The aim of the present study was to assess the therapeutic effects of repeated radiofrequency ablation (RFA) combined with chemoembolization on SHHCC. This was a retrospective study based on data obtained from a prospectively collected database that included 9 SHHCC patients who underwent repe...

متن کامل

Locoregional Therapy for Hepatocellular Carcinoma

Transplantation, resection, and ablation are recommended for the treatment of very early (single <2 cm diameter) and early (single or <3 nodules <3 cm diameter) stage hepatocellular carcinomas (HCCs) as determined using the Barcelona Clinic Liver Cancer (BCLC) staging system [1]. In addition, transarterial chemoembolization (TACE) is recommended for intermediate-stage multinodular HCCs, systemi...

متن کامل

Locoregional Therapy for Hepatocellular Carcinoma

Transplantation, resection, and ablation are recommended for the treatment of very early (single <2 cm diameter) and early (single or <3 nodules <3 cm diameter) stage hepatocellular carcinomas (HCCs) as determined using the Barcelona Clinic Liver Cancer (BCLC) staging system [1]. In addition, transarterial chemoembolization (TACE) is recommended for intermediate-stage multinodular HCCs, systemi...

متن کامل

Locoregional Therapy for Hepatocellular Carcinoma.

Transplantation, resection, and ablation are recommended for the treatment of very early (single <2 cm diameter) and early (single or <3 nodules <3 cm diameter) stage hepatocellular carcinomas (HCCs) as determined using the Barcelona Clinic Liver Cancer (BCLC) staging system [1]. In addition, transarterial chemoembolization (TACE) is recommended for intermediate-stage multinodular HCCs, systemi...

متن کامل

Preoperative adjuvant transarterial chemoembolization cannot improve the long term outcome of radical therapies for hepatocellular carcinoma

Combinations of transarterial chemoembolization (TACE) and radical therapies (pretransplantation, resection and radiofrequency ablation) for hepatocellular carcinoma (HCC) have been reported as controversial issues in recent years. A consecutive sample of 1560 patients with Barcelona Clinic Liver Cancer (BCLC) stage A/B HCC who underwent solitary Radiofrequency ablation (RFA), resection or live...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 95  شماره 

صفحات  -

تاریخ انتشار 2016