Application of radiofrequency ablation for the treatment of intermediate-stage hepatocellular carcinoma

Kazuhiro Nouso, Kazuya Kariyama, Shinichiro Nakamura, Ayano Oonishi, Akiko Wakuta, Atsushi Oyama, Soichiro Ako, Chihiro Dohi, Nozomu Wada, Yuki Morimoto, Yasuto Takeuchi, Kenji Kuwaki, Hideki Ohnishi, Fusao Ikeda, Hidenori Shiraha, Akinobu Takaki, Hiroyuki Okada

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background and Aim: Transcatheter arterial chemoembolization (TACE) is a standard therapy for the treatment of intermediate-stage hepatocellular carcinoma (HCC). In this study, we tried to elucidate the possibility of using radiofrequency ablation (RFA) as an alternative treatment of intermediate-stage HCC. Methods: Among 246 patients who were initially diagnosed with intermediate-stage HCC, 76 who were treated with TACE (TACE group) and 91 who were treated with RFA (RFA group) were enrolled in this study. The risk for survival was analyzed with the Cox Proportional Hazard Model, and the survival rates were compared using propensity score matching. Results: About half (50.6%) of the intermediate-stage HCC patients in the RFA group were diagnosed with Barcelona Clinic Liver Cancer substage-B1 (BCLC-B1) compared with only 19.7% of the patients in the TACE group. Survival of the RFA group was longer than that of TACE group in patients with BCLC-B1 and BCLC-B2. In contrast, no difference between groups was observed in patients with BCLC-B3/4. Multivariate analysis revealed that large tumor size (>30 mm, hazard ratio = 1.685, P = 0.043), high des-γ-carboxyprothrombin (>100 mAU/mL, hazard ratio = 1.920, P = 0.012), and TACE group (hazard ratio = 1.896, P = 0.016) were significant risk factors for survival. Overall 3-year survival of the patients in the RFA group (69.5%) was significantly longer than that of patients in the TACE group (51.5%) after propensity score matching (P = 0.032). No significant adverse events were observed in either group. Conclusions: RFA was useful for the treatment of less advanced intermediate-stage HCC and could be an alternative to TACE in selected cases.

Original languageEnglish
Pages (from-to)695-700
Number of pages6
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume32
Issue number3
DOIs
Publication statusPublished - Mar 1 2017

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Hepatocellular Carcinoma
Propensity Score
Survival
Liver Neoplasms
Therapeutics
Proportional Hazards Models
Multivariate Analysis
Survival Rate
Neoplasms

Keywords

  • ablation
  • hepatocellular carcinoma
  • therapeutic embolization

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Application of radiofrequency ablation for the treatment of intermediate-stage hepatocellular carcinoma. / Nouso, Kazuhiro; Kariyama, Kazuya; Nakamura, Shinichiro; Oonishi, Ayano; Wakuta, Akiko; Oyama, Atsushi; Ako, Soichiro; Dohi, Chihiro; Wada, Nozomu; Morimoto, Yuki; Takeuchi, Yasuto; Kuwaki, Kenji; Ohnishi, Hideki; Ikeda, Fusao; Shiraha, Hidenori; Takaki, Akinobu; Okada, Hiroyuki.

In: Journal of Gastroenterology and Hepatology (Australia), Vol. 32, No. 3, 01.03.2017, p. 695-700.

Research output: Contribution to journalArticle

Nouso, K, Kariyama, K, Nakamura, S, Oonishi, A, Wakuta, A, Oyama, A, Ako, S, Dohi, C, Wada, N, Morimoto, Y, Takeuchi, Y, Kuwaki, K, Ohnishi, H, Ikeda, F, Shiraha, H, Takaki, A & Okada, H 2017, 'Application of radiofrequency ablation for the treatment of intermediate-stage hepatocellular carcinoma', Journal of Gastroenterology and Hepatology (Australia), vol. 32, no. 3, pp. 695-700. https://doi.org/10.1111/jgh.13586
Nouso, Kazuhiro ; Kariyama, Kazuya ; Nakamura, Shinichiro ; Oonishi, Ayano ; Wakuta, Akiko ; Oyama, Atsushi ; Ako, Soichiro ; Dohi, Chihiro ; Wada, Nozomu ; Morimoto, Yuki ; Takeuchi, Yasuto ; Kuwaki, Kenji ; Ohnishi, Hideki ; Ikeda, Fusao ; Shiraha, Hidenori ; Takaki, Akinobu ; Okada, Hiroyuki. / Application of radiofrequency ablation for the treatment of intermediate-stage hepatocellular carcinoma. In: Journal of Gastroenterology and Hepatology (Australia). 2017 ; Vol. 32, No. 3. pp. 695-700.
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abstract = "Background and Aim: Transcatheter arterial chemoembolization (TACE) is a standard therapy for the treatment of intermediate-stage hepatocellular carcinoma (HCC). In this study, we tried to elucidate the possibility of using radiofrequency ablation (RFA) as an alternative treatment of intermediate-stage HCC. Methods: Among 246 patients who were initially diagnosed with intermediate-stage HCC, 76 who were treated with TACE (TACE group) and 91 who were treated with RFA (RFA group) were enrolled in this study. The risk for survival was analyzed with the Cox Proportional Hazard Model, and the survival rates were compared using propensity score matching. Results: About half (50.6{\%}) of the intermediate-stage HCC patients in the RFA group were diagnosed with Barcelona Clinic Liver Cancer substage-B1 (BCLC-B1) compared with only 19.7{\%} of the patients in the TACE group. Survival of the RFA group was longer than that of TACE group in patients with BCLC-B1 and BCLC-B2. In contrast, no difference between groups was observed in patients with BCLC-B3/4. Multivariate analysis revealed that large tumor size (>30 mm, hazard ratio = 1.685, P = 0.043), high des-γ-carboxyprothrombin (>100 mAU/mL, hazard ratio = 1.920, P = 0.012), and TACE group (hazard ratio = 1.896, P = 0.016) were significant risk factors for survival. Overall 3-year survival of the patients in the RFA group (69.5{\%}) was significantly longer than that of patients in the TACE group (51.5{\%}) after propensity score matching (P = 0.032). No significant adverse events were observed in either group. Conclusions: RFA was useful for the treatment of less advanced intermediate-stage HCC and could be an alternative to TACE in selected cases.",
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AU - Kariyama, Kazuya

AU - Nakamura, Shinichiro

AU - Oonishi, Ayano

AU - Wakuta, Akiko

AU - Oyama, Atsushi

AU - Ako, Soichiro

AU - Dohi, Chihiro

AU - Wada, Nozomu

AU - Morimoto, Yuki

AU - Takeuchi, Yasuto

AU - Kuwaki, Kenji

AU - Ohnishi, Hideki

AU - Ikeda, Fusao

AU - Shiraha, Hidenori

AU - Takaki, Akinobu

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N2 - Background and Aim: Transcatheter arterial chemoembolization (TACE) is a standard therapy for the treatment of intermediate-stage hepatocellular carcinoma (HCC). In this study, we tried to elucidate the possibility of using radiofrequency ablation (RFA) as an alternative treatment of intermediate-stage HCC. Methods: Among 246 patients who were initially diagnosed with intermediate-stage HCC, 76 who were treated with TACE (TACE group) and 91 who were treated with RFA (RFA group) were enrolled in this study. The risk for survival was analyzed with the Cox Proportional Hazard Model, and the survival rates were compared using propensity score matching. Results: About half (50.6%) of the intermediate-stage HCC patients in the RFA group were diagnosed with Barcelona Clinic Liver Cancer substage-B1 (BCLC-B1) compared with only 19.7% of the patients in the TACE group. Survival of the RFA group was longer than that of TACE group in patients with BCLC-B1 and BCLC-B2. In contrast, no difference between groups was observed in patients with BCLC-B3/4. Multivariate analysis revealed that large tumor size (>30 mm, hazard ratio = 1.685, P = 0.043), high des-γ-carboxyprothrombin (>100 mAU/mL, hazard ratio = 1.920, P = 0.012), and TACE group (hazard ratio = 1.896, P = 0.016) were significant risk factors for survival. Overall 3-year survival of the patients in the RFA group (69.5%) was significantly longer than that of patients in the TACE group (51.5%) after propensity score matching (P = 0.032). No significant adverse events were observed in either group. Conclusions: RFA was useful for the treatment of less advanced intermediate-stage HCC and could be an alternative to TACE in selected cases.

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