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Long-term outcomes of combined radiofrequency ablation and multipronged ethanol ablation for the treatment of unfavorable hepatocellular carcinoma
PURPOSE: To evaluate the local efficacy, safety, and long-term outcomes of combined radiofrequency ablation (RFA) and multipronged ethanol ablation (EA) in the treatment of unfavorable hepatocellular carcinoma (HCC) and to determine the prognostic factors for survival. METHODS: Between August 2009 a...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Galenos Publishing
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10679715/ https://www.ncbi.nlm.nih.gov/pubmed/36987999 http://dx.doi.org/10.4274/dir.2022.22832 |
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author | Liu, Ming Li, Xiao-Ju Zhang, Xiao-Er Kuang, Ming Xie, Xiao-Yan Huang, Guang-Liang |
author_facet | Liu, Ming Li, Xiao-Ju Zhang, Xiao-Er Kuang, Ming Xie, Xiao-Yan Huang, Guang-Liang |
author_sort | Liu, Ming |
collection | PubMed |
description | PURPOSE: To evaluate the local efficacy, safety, and long-term outcomes of combined radiofrequency ablation (RFA) and multipronged ethanol ablation (EA) in the treatment of unfavorable hepatocellular carcinoma (HCC) and to determine the prognostic factors for survival. METHODS: Between August 2009 and December 2017, 98 patients with 110 unfavorable HCC nodules who underwent combined RFA and multipronged EA were retrospectively enrolled in the study. Unfavorable HCC was defined as a medium (3.1–5.0 cm) or large (5.1–7.0 cm) HCC nodule, a tumor located at a high-risk site, or a perivascular tumor. The treatment response, overall survival (OS), and recurrence-free survival (RFS) were analyzed. The Kaplan–Meier method and Cox proportional hazards regression model were used to evaluate the prognostic factors. RESULTS: Complete ablation was obtained in 80.9% (89/110) of the tumors after initial treatment. Major complications were observed in 3 (3.1%) patients. The cumulative incidence of local tumor progression (LTP) was 23.5% at five years, and no variable was found to be an independent predictive factor for LTP. The five-year OS and RFS rates were 41.9% and 34.0%, respectively. Multivariate analysis showed that the serum alpha-fetoprotein level, tumor size, presence of residual tumor after ablation, and extrahepatic metastases were significant prognostic factors for OS (P = 0.023, P = 0.030, P = 0.001, and P = 0.010, respectively). Tumor type and the number of tumors were predictive factors for RFS (P = 0.029 and P = 0.001, respectively). A perivascular tumor was not an independent predictive factor for OS or RFS. CONCLUSION: Combined RFA and multipronged EA is a safe and effective treatment for unfavorable HCC, especially for perivascular tumors. |
format | Online Article Text |
id | pubmed-10679715 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Galenos Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-106797152023-12-05 Long-term outcomes of combined radiofrequency ablation and multipronged ethanol ablation for the treatment of unfavorable hepatocellular carcinoma Liu, Ming Li, Xiao-Ju Zhang, Xiao-Er Kuang, Ming Xie, Xiao-Yan Huang, Guang-Liang Diagn Interv Radiol Interventional Radiology - Original Article PURPOSE: To evaluate the local efficacy, safety, and long-term outcomes of combined radiofrequency ablation (RFA) and multipronged ethanol ablation (EA) in the treatment of unfavorable hepatocellular carcinoma (HCC) and to determine the prognostic factors for survival. METHODS: Between August 2009 and December 2017, 98 patients with 110 unfavorable HCC nodules who underwent combined RFA and multipronged EA were retrospectively enrolled in the study. Unfavorable HCC was defined as a medium (3.1–5.0 cm) or large (5.1–7.0 cm) HCC nodule, a tumor located at a high-risk site, or a perivascular tumor. The treatment response, overall survival (OS), and recurrence-free survival (RFS) were analyzed. The Kaplan–Meier method and Cox proportional hazards regression model were used to evaluate the prognostic factors. RESULTS: Complete ablation was obtained in 80.9% (89/110) of the tumors after initial treatment. Major complications were observed in 3 (3.1%) patients. The cumulative incidence of local tumor progression (LTP) was 23.5% at five years, and no variable was found to be an independent predictive factor for LTP. The five-year OS and RFS rates were 41.9% and 34.0%, respectively. Multivariate analysis showed that the serum alpha-fetoprotein level, tumor size, presence of residual tumor after ablation, and extrahepatic metastases were significant prognostic factors for OS (P = 0.023, P = 0.030, P = 0.001, and P = 0.010, respectively). Tumor type and the number of tumors were predictive factors for RFS (P = 0.029 and P = 0.001, respectively). A perivascular tumor was not an independent predictive factor for OS or RFS. CONCLUSION: Combined RFA and multipronged EA is a safe and effective treatment for unfavorable HCC, especially for perivascular tumors. Galenos Publishing 2023-03-29 /pmc/articles/PMC10679715/ /pubmed/36987999 http://dx.doi.org/10.4274/dir.2022.22832 Text en © Copyright 2023 by Turkish Society of Radiology | Diagnostic and Interventional Radiology, published by Galenos Publishing House. https://creativecommons.org/licenses/by-nc/4.0/Content of this journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. (https://creativecommons.org/licenses/by-nc/4.0/) |
spellingShingle | Interventional Radiology - Original Article Liu, Ming Li, Xiao-Ju Zhang, Xiao-Er Kuang, Ming Xie, Xiao-Yan Huang, Guang-Liang Long-term outcomes of combined radiofrequency ablation and multipronged ethanol ablation for the treatment of unfavorable hepatocellular carcinoma |
title | Long-term outcomes of combined radiofrequency ablation and multipronged ethanol ablation for the treatment of unfavorable hepatocellular carcinoma |
title_full | Long-term outcomes of combined radiofrequency ablation and multipronged ethanol ablation for the treatment of unfavorable hepatocellular carcinoma |
title_fullStr | Long-term outcomes of combined radiofrequency ablation and multipronged ethanol ablation for the treatment of unfavorable hepatocellular carcinoma |
title_full_unstemmed | Long-term outcomes of combined radiofrequency ablation and multipronged ethanol ablation for the treatment of unfavorable hepatocellular carcinoma |
title_short | Long-term outcomes of combined radiofrequency ablation and multipronged ethanol ablation for the treatment of unfavorable hepatocellular carcinoma |
title_sort | long-term outcomes of combined radiofrequency ablation and multipronged ethanol ablation for the treatment of unfavorable hepatocellular carcinoma |
topic | Interventional Radiology - Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10679715/ https://www.ncbi.nlm.nih.gov/pubmed/36987999 http://dx.doi.org/10.4274/dir.2022.22832 |
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