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European Radiology

Erschienen in:

10.02.2017 | Hepatobiliary-Pancreas

Microwave ablation for the treatment of hepatocellular carcinoma that met up-to-seven criteria: feasibility, local efficacy and long-term outcomes

verfasst von: Yun Xu, Qiang Shen, Pei Liu, Zhongqi Xu, Panpan Wu, Zhenghua Lu, Yi Chen, Bin Huang, Guojun Qian

Erschienen in: European Radiology | Ausgabe 9/2017

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Abstract

Objectives

This study aimed to evaluate the feasibility, local efficacy and long-term outcomes of microwave (MW) ablation for the treatment of hepatocellular carcinoma (HCC) that met up-to-seven criteria.

Methods

Between January 2007 and January 2012, 142 HCC patients with 294 nodules, which conformed to up-to-seven criteria, were enrolled into this retrospective study. All patients were followed up for more than 3 years after receiving MW ablation. Technical success, complications, local tumour progression (LTP) and distant recurrence (DR) were monitored. Recurrence-free survival (RFS), overall survival (OS) and prognostic factors were analysed.

Results

Primary technical efficacy was achieved in 95.2% (280/294) of the carcinomatous nodules, and major complications occurred in four (2.8%) patients. Among the 294 tumours, LTP was observed in 44 (15.0%) tumours. Among the 142 patients, DR was observed in 97 (68.3%) patients. The estimated OS rates after MW ablation at 1, 3 and 5 years were 97.2%, 75.4% and 50.6%, respectively; and the corresponding RFS rates were 76.1%, 33.1% and 19.5%, respectively.

Conclusions

MW ablation is a safe and effective treatment with a high rate of primary technical efficacy for patients with HCC that met up-to-seven criteria.

Key Points

• The first study expanding MW ablation to HCC category beyond Milan criteria.

• The first report that used up-to-seven criteria as indications for MW ablation.

• HCC of up-to-seven criteria viewed as a subgroup of BCLC stage B.

• MW ablation is safe and effective for treating HCC within up-to-seven criteria.

• MW ablation is preferable in treating unresectable HCC within up-to-seven criteria.

Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011) Global cancer statistics. CA Cancer J Clin 61:69–90CrossRefPubMed

Mazzaferro V, Regalia E, Doci R et al (1996) Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. New Engl J Med 334:693–700CrossRefPubMed

Bruix J, Sherman M (2011) Management of hepatocellular carcinoma, an update. Hepatology 53:1020–1022CrossRefPubMedPubMedCentral

Takuma Y, Takabatake H, Morimoto Y et al (2013) Comparison of combined transcatheter arterial chemoembolization and radiofrequency ablation with surgical resection by using propensity score matching in patients with hepatocellular carcinoma within Milan criteria. Radiology 269:927–937CrossRefPubMed

Shi J, Sun Q, Wang Y et al (2014) Comparison of microwave ablation and surgical resection for treatment of hepatocellular carcinomas conforming to Milan criteria. J Gastroen Hepatol 29:1500–1507CrossRef

Huang J, Yan L, Cheng Z et al (2010) A randomized trial comparing radiofrequency ablation and surgical resection for HCC conforming to the Milan criteria. Ann Surg 252:903–912CrossRefPubMed

Lee HS (2007) Liver transplantation for hepatocellular carcinoma beyond the Milan criteria: the controversies continue. Dig Dis 25:296–298CrossRefPubMed

Yao FY (2008) Liver transplantation for hepatocellular carcinoma: beyond the Milan criteria. Am J Transplant 8:1982–1989CrossRefPubMed

Mazzaferro V, Llovet JM, Miceli R et al (2009) Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria: a retrospective, exploratory analysis. Lancet Oncol 10:35–43CrossRefPubMed

10.

Wright AS, Sampson LA, Warner TF, Mahvi DM, Lee FT Jr (2005) Radiofrequency versus microwave ablation in a hepatic porcine model. Radiology 236:132–139CrossRefPubMed

11.

Qian GJ, Wang N, Shen Q et al (2012) Efficacy of microwave versus radiofrequency ablation for treatment of small hepatocellular carcinoma: experimental and clinical studies. Eur Radiol 22:1983–1990CrossRefPubMed

12.

Martin RCG, Scoggins CR, McMasters KM (2010) Safety and efficacy of microwave ablation of hepatic tumors: a prospective review of a 5-year experience. Ann Surg Oncol 17:171–178CrossRefPubMed

13.

Yin XY, Xie XY, Lu MD et al (2009) Percutaneous thermal ablation of medium and large hepatocellular carcinoma long-term outcome and prognostic factors. Cancer 115:1914–1923CrossRefPubMed

14.

Bruix J, Sherman M, Llovet JM et al (2001) Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver. J Hepatol 35:421–430CrossRefPubMed

15.

Teratani T, Yoshida H, Shiina S et al (2006) Radiofrequency ablation for hepatocellular carcinoma in so-called high-risk locations. Hepatology 2006:1101–1108CrossRef

16.

Ahmed M, Solbiati L, Brace CL et al (2014) Image-guided tumor ablation: standardization of terminology and reporting criteria–a 10-year update. Radiology 273:241–260CrossRefPubMedPubMedCentral

17.

LencioniR CXP, Dagher L, Venook AP (2010) Treatment of intermediate/advanced hepatocellular carcinoma in the clinic: how can outcomes be improved? Oncologist 15(Suppl 4):S42–S52CrossRef

18.

Biolato M, Marrone G, Racco S et al (2010) Transarterial chemoembolization (TACE) for unresectable HCC: a new life begins? Eur Rev Med Pharmaco Sci 14:356–362

19.

Lencioni R, Cioni D, Crocetti L et al (2005) Early stage hepatocellular carcinoma in patients with cirrhosis: long-term results of percutaneous image-guided radiofrequency ablation. Radiology 234:961–967CrossRefPubMed

20.

Liang P, Wang Y, Yu XL, Dong BW (2009) Malignant liver tumors: treatment with percutaneous microwave ablation - complications among cohort of 1136 patients. Radiology 251:933–940CrossRefPubMed

21.

Kim YS, Rhim H, Cho OK, Koh BH, Kim Y (2006) Intrahepatic recurrence after percutaneous radiofrequency ablation of hepatocellular carcinoma: analysis of the pattern and risk factors. Eur J Radiol 59:432–441CrossRefPubMed

22.

Yu J, Liang P, Yu X et al (2015) Local tumor progression after ultrasound-guided microwave ablation of liver malignancies: risk factors analysis of 2529 tumors. Eur Radiol 25:1119–1126CrossRefPubMed

23.

Mulier S, Ni Y, Jamart J, Ruers T, Marchal G, Michel L (2005) Local recurrence after hepatic radiofrequency coagulation: multivariate meta-analysis and review of contributing factors. Ann Surg 242:158–171CrossRefPubMedPubMedCentral

24.

Lu XY, Xi T, Lau WY et al (2011) Pathobiological features of small hepatocellular carcinoma: correlation between tumor size and biological behavior. J Cancer Res Clin 137:567–575CrossRef

25.

Weinmann A, Koch S, Sprinzl M et al (2015) Survival analysis of proposed BCLC‐B subgroups in hepatocellular carcinoma patients. Liver Int 35:591–600CrossRefPubMed

26.

Kim JM, Kwon CHD, Joh JW et al (2010) Patients with unresectable hepatocellular carcinoma beyond Milan criteria: should we perform transarterial chemoembolization or liver transplantation? Transpl P 42:821–824CrossRef

27.

Hsu CY, Hsia CY, Huang YH et al (2012) Comparison of surgical resection and transarterial chemoembolization for hepatocellular carcinoma beyond the Milan criteria: a propensity score analysis. Ann Surg Oncol 19:842–849CrossRefPubMed

28.

Liu W, Zhou JG, Sun Y et al (2015) Hepatic resection improved the long-term survival of patients with BCLC stage B hepatocellular carcinoma in Asia: a systematic review and meta-analysis. J Gastrointest Surg 19:1271–1280CrossRefPubMed

29.

Lei Y, Hui L, Li AJ et al (2014) Partial hepatectomy versus transcatheter arterial chemoembolization for resectable multiple hepatocellular carcinoma beyond Milan criteria: a RCT. J Hepatol 61:82–88CrossRef

30.

Bolondi L, Burroughs A, Dufour JF et al (2012) Heterogeneity of patients with intermediate (BCLC B) hepatocellular carcinoma: proposal for a subclassification to facilitate treatment decisions. Semin Liver Dis 32:348–359PubMed

31.

Ha Y, Shim JH, Kim SO, Kim KO, Lim YS, Lee HC et al (2014) Clinical appraisal of the recently proposed Barcelona Clinic Liver Cancer stage B subclassification by survival analysis. J Gastroen Hepatol 29:787–793CrossRef

32.

Ciria R, López-Cillero P, Gallardo AB et al (2015) Optimizing the management of patients with BCLC stage-B hepatocellular carcinoma: modern surgical resection as a feasible alternative to transarterial chemoemolization. Eur J Surg Oncol 41:1153–1161CrossRefPubMed

33.

Zhou L, Rui JA, Wang SB et al (2011) Prognostic factors of solitary large hepatocellular carcinoma, the importance of differentiation grade. Eur J Surg Oncol 37:521–525CrossRefPubMed

34.

Zhong JH, Rodriguez AC, Ke Y (2015) Hepatic resection as a safe and effective treatment for hepatocellular carcinoma involving a single large tumor, multiple tumors, or macrovascular invasion. Medicine 94, e396CrossRefPubMedPubMedCentral

35.

Goh BKP, Chow PKH, Teo JY et al (2014) Number of nodules, Child-Pugh status, margin positivity, and microvascular invasion, but not tumor size, are prognostic factors of survival after liver resection for multifocal hepatocellular carcinoma. J Gastrointest Surg 18:1477–1485CrossRefPubMed

36.

Chen X, Zhang B, Yin X, Ren Z, Qiu S, Zhou J (2013) Lipiodolized transarterial chemoembolization in hepatocellular carcinoma patients after curative resection. J Cancer Res Clin Oncol 139:773–781CrossRefPubMed

37.

Arrieta O, Cacho B, Morales-Espinosa D, Ruelas-Villavicencio A, Flores-Estrada D, Hernandez-Pedro N (2007) The progressive elevation of alpha fetoprotein for the diagnosis of hepatocellular carcinoma in patients with liver cirrhosis. BMC Cancer 8, e28CrossRef

38.

Portolani N, Coniglio A, Ghidoni S et al (2006) Early and late recurrence after liver resection for hepatocellular carcinoma: prognostic and therapeutic implications. Ann Surg 243:229–235CrossRefPubMedPubMedCentral

Titel: Microwave ablation for the treatment of hepatocellular carcinoma that met up-to-seven criteria: feasibility, local efficacy and long-term outcomes
verfasst von: Yun Xu
Qiang Shen
Pei Liu
Zhongqi Xu
Panpan Wu
Zhenghua Lu
Yi Chen
Bin Huang
Guojun Qian
Publikationsdatum: 10.02.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 9/2017
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-017-4740-0

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