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Transcatheter arterial chemoembolization combined with radiofrequency ablation delays tumor progression and prolongs overall survival in patients with intermediate (BCLC B) hepatocellular carcinoma.

Yin X, Zhang L, Wang YH, Zhang BH, Gan YH, Ge NL, Chen Y, Li LX, Ren ZG - BMC Cancer (2014)

Bottom Line: The treatment effectiveness, local tumor control and survival outcome between the two groups were compared.The 1-, 3- and 5-year survival rates in combination group were significantly higher than those in TACE alone group (P = 0.01).Radiofrequency ablation following initial transcatheter arterial chemoembolization delays tumor progression and prolongs overall survival of patients with intermediate stage HCC tumors.

View Article: PubMed Central - PubMed

Affiliation: Liver Cancer Institute & Zhongshan Hospital, Fudan University, 136 Yi Xue Yuan Road, Shanghai 200032, China. ren.zhenggang@zs-hospital.sh.cn.

ABSTRACT

Background: This study was designed to evaluate the effectiveness of radiofrequency ablation in patients with intermediate (BCLC B) stage hepatocellular carcinoma who underwent transcatheter arterial chemoembolization.

Methods: Included in this study were 211 patients with intermediate stage HCC who underwent initial transcatheter arterial chemoembolization and were potentially amendable for radiofrequency ablation (single tumor with diameter 5-8 cm, median 6.0 cm; 2-5 multiple nodules with diameter less than 5 cm) between January 2005 and December 2011. According to the inclusion and exclusion criteria, 55 patients were treated with following radiofrequency ablation, and the remaining 156 patients were treated with transcatheter arterial chemoembolization alone. The treatment effectiveness, local tumor control and survival outcome between the two groups were compared.

Results: The complete tumor necrosis rate after treatment was 76.9% in combination group vs. 46.5% in transcatheter arterial chemoembolization alone group (P = 0.02). The major complication rate was 1.8% in combination group vs. 2.6% in transcatheter arterial chemoembolization alone group. Follow-up observation showed that the total tumor control rate was 74.5% in combination group versus 54.5% in transcatheter arterial chemoembolization alone group (P < 0.001). The 1-, 3- and 5-year survival rates in combination group were significantly higher than those in TACE alone group (P = 0.01).

Conclusions: Radiofrequency ablation following initial transcatheter arterial chemoembolization delays tumor progression and prolongs overall survival of patients with intermediate stage HCC tumors.

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Related in: MedlinePlus

Contrast-enhanced CT images obtained in a patient with 6-cm single HCC before TACE treatment. (A-C) show a patient with hepatitis B-induced liver cirrhosis and a 6-cm solitary HCC tumor in the hepatic segment VI. The contrast-enhanced CT scan before TACE revealed arterial enhancement of the HCC lesion.
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Fig1: Contrast-enhanced CT images obtained in a patient with 6-cm single HCC before TACE treatment. (A-C) show a patient with hepatitis B-induced liver cirrhosis and a 6-cm solitary HCC tumor in the hepatic segment VI. The contrast-enhanced CT scan before TACE revealed arterial enhancement of the HCC lesion.

Mentions: In TACE+RFA group, patients received median 2.0 (range 1–5) sessions of TACE treatment, followed by1-3 sessions of RFA. While in TACE alone group, patients received median 3.0 (range: 1–9) sessions of TACE treatment. Due to the presence of residual enhanced lesions after treatment, 18 tumors in 9 patients received additional sessions of RFA or TACE in TACE+RFA group. The follow-up CT or MRI scan showed that 60 tumor nodules in RFA+TACE group (Figures 1 and 2) and 108 tumor nodules in TACE alone group were completely necrosed, resulting in a technical effectiveness rate of 76.9% (60/78) and 46.5% (108/232), respectively (P < 0.001).Figure 1


Transcatheter arterial chemoembolization combined with radiofrequency ablation delays tumor progression and prolongs overall survival in patients with intermediate (BCLC B) hepatocellular carcinoma.

Yin X, Zhang L, Wang YH, Zhang BH, Gan YH, Ge NL, Chen Y, Li LX, Ren ZG - BMC Cancer (2014)

Contrast-enhanced CT images obtained in a patient with 6-cm single HCC before TACE treatment. (A-C) show a patient with hepatitis B-induced liver cirrhosis and a 6-cm solitary HCC tumor in the hepatic segment VI. The contrast-enhanced CT scan before TACE revealed arterial enhancement of the HCC lesion.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4256894&req=5

Fig1: Contrast-enhanced CT images obtained in a patient with 6-cm single HCC before TACE treatment. (A-C) show a patient with hepatitis B-induced liver cirrhosis and a 6-cm solitary HCC tumor in the hepatic segment VI. The contrast-enhanced CT scan before TACE revealed arterial enhancement of the HCC lesion.
Mentions: In TACE+RFA group, patients received median 2.0 (range 1–5) sessions of TACE treatment, followed by1-3 sessions of RFA. While in TACE alone group, patients received median 3.0 (range: 1–9) sessions of TACE treatment. Due to the presence of residual enhanced lesions after treatment, 18 tumors in 9 patients received additional sessions of RFA or TACE in TACE+RFA group. The follow-up CT or MRI scan showed that 60 tumor nodules in RFA+TACE group (Figures 1 and 2) and 108 tumor nodules in TACE alone group were completely necrosed, resulting in a technical effectiveness rate of 76.9% (60/78) and 46.5% (108/232), respectively (P < 0.001).Figure 1

Bottom Line: The treatment effectiveness, local tumor control and survival outcome between the two groups were compared.The 1-, 3- and 5-year survival rates in combination group were significantly higher than those in TACE alone group (P = 0.01).Radiofrequency ablation following initial transcatheter arterial chemoembolization delays tumor progression and prolongs overall survival of patients with intermediate stage HCC tumors.

View Article: PubMed Central - PubMed

Affiliation: Liver Cancer Institute & Zhongshan Hospital, Fudan University, 136 Yi Xue Yuan Road, Shanghai 200032, China. ren.zhenggang@zs-hospital.sh.cn.

ABSTRACT

Background: This study was designed to evaluate the effectiveness of radiofrequency ablation in patients with intermediate (BCLC B) stage hepatocellular carcinoma who underwent transcatheter arterial chemoembolization.

Methods: Included in this study were 211 patients with intermediate stage HCC who underwent initial transcatheter arterial chemoembolization and were potentially amendable for radiofrequency ablation (single tumor with diameter 5-8 cm, median 6.0 cm; 2-5 multiple nodules with diameter less than 5 cm) between January 2005 and December 2011. According to the inclusion and exclusion criteria, 55 patients were treated with following radiofrequency ablation, and the remaining 156 patients were treated with transcatheter arterial chemoembolization alone. The treatment effectiveness, local tumor control and survival outcome between the two groups were compared.

Results: The complete tumor necrosis rate after treatment was 76.9% in combination group vs. 46.5% in transcatheter arterial chemoembolization alone group (P = 0.02). The major complication rate was 1.8% in combination group vs. 2.6% in transcatheter arterial chemoembolization alone group. Follow-up observation showed that the total tumor control rate was 74.5% in combination group versus 54.5% in transcatheter arterial chemoembolization alone group (P < 0.001). The 1-, 3- and 5-year survival rates in combination group were significantly higher than those in TACE alone group (P = 0.01).

Conclusions: Radiofrequency ablation following initial transcatheter arterial chemoembolization delays tumor progression and prolongs overall survival of patients with intermediate stage HCC tumors.

Show MeSH
Related in: MedlinePlus