Stereotactic radiofrequency ablation as first-line treatment of recurrent HCC following hepatic resection.


Journal

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
ISSN: 1532-2157
Titre abrégé: Eur J Surg Oncol
Pays: England
ID NLM: 8504356

Informations de publication

Date de publication:
08 2020
Historique:
received: 06 11 2019
revised: 04 03 2020
accepted: 16 03 2020
pubmed: 31 3 2020
medline: 1 1 2021
entrez: 31 3 2020
Statut: ppublish

Résumé

To evaluate the therapeutic efficacy, safety and overall clinical outcome of multiprobe stereotactic RF ablation (SRFA) as first-line treatment of HCC recurrence after hepatic resection (HR). In this retrospective single-center study, 34 consecutive patients with previous HR were treated by SRFA between 2006 and 2018 for 140 HCCs in 60 ablation sessions. The median treated tumor size was 3.0 cm (range 0.5-10 cm). SRFA was primarily successful for 133/140 (95%) tumors. Four tumors were successfully retreated, resulting in a secondary technical efficacy rate of 97.9%. Local tumor recurrence developed in 4 of 140 tumors (2.9%). The major complication rate was 4.8% (3 of 60 ablations). No periprocedural deaths occurred. The overall survival (OS) rates at 1-, 3-, and 5- years from the date of the first SRFA were 94.0%, 70.2%, and 53.3%, respectively, with a median OS of 69.1 months (95% CI 18.8-119.3). The disease-free survival (DFS) was 52.6%, 19.7% and 15.8%, at 1-, 3- and 5- years, respectively, with a median DFS of 12.8 months (95% CI 9.0-28.9). Stereotactic RFA is a safe, feasible and useful option in the management of recurrent HCC following HR with low morbidity paired with good clinical outcome.

Sections du résumé

BACKGROUND
To evaluate the therapeutic efficacy, safety and overall clinical outcome of multiprobe stereotactic RF ablation (SRFA) as first-line treatment of HCC recurrence after hepatic resection (HR).
STUDY DESIGN
In this retrospective single-center study, 34 consecutive patients with previous HR were treated by SRFA between 2006 and 2018 for 140 HCCs in 60 ablation sessions.
RESULTS
The median treated tumor size was 3.0 cm (range 0.5-10 cm). SRFA was primarily successful for 133/140 (95%) tumors. Four tumors were successfully retreated, resulting in a secondary technical efficacy rate of 97.9%. Local tumor recurrence developed in 4 of 140 tumors (2.9%). The major complication rate was 4.8% (3 of 60 ablations). No periprocedural deaths occurred. The overall survival (OS) rates at 1-, 3-, and 5- years from the date of the first SRFA were 94.0%, 70.2%, and 53.3%, respectively, with a median OS of 69.1 months (95% CI 18.8-119.3). The disease-free survival (DFS) was 52.6%, 19.7% and 15.8%, at 1-, 3- and 5- years, respectively, with a median DFS of 12.8 months (95% CI 9.0-28.9).
CONCLUSION
Stereotactic RFA is a safe, feasible and useful option in the management of recurrent HCC following HR with low morbidity paired with good clinical outcome.

Identifiants

pubmed: 32222261
pii: S0748-7983(20)30354-1
doi: 10.1016/j.ejso.2020.03.207
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1503-1509

Informations de copyright

Copyright © 2020 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest PS, DP, GL, EL, EB and SS have no conflicts to declare. RB was a consultant for CAScination.

Auteurs

Peter Schullian (P)

Department of Radiology, Microinvasive Therapy instead of Section of Microinvasive Therapy, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.

Gregor Laimer (G)

Department of Radiology, Microinvasive Therapy instead of Section of Microinvasive Therapy, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.

Daniel Putzer (D)

Department of Radiology, Microinvasive Therapy instead of Section of Microinvasive Therapy, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.

Elliot Levy (E)

Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD, USA.

Eva Braunwarth (E)

Department of Visceral, Transplantation and Thoracic Surgery, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.

Stefan Stättner (S)

Department of Visceral, Transplantation and Thoracic Surgery, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.

Reto Bale (R)

Department of Radiology, Microinvasive Therapy instead of Section of Microinvasive Therapy, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria. Electronic address: reto.bale@i-med.ac.at.

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