PURPOSE: The vast majority of hepatocellular carcinomas (HCC) occur in patients with underlying liver dysfunction, making surgical resection available to only a subset of patients with adequate hepatic reserve. This study analyzes the authors' results with bland arterial embolization combined with radiofrequency ablation (RFA) or percutaneous ethanol injection (PEIT) compared with surgical resection for the treatment of solitary HCC up to 7 cm in size. MATERIALS AND METHODS: A retrospective review of all patients undergoing either surgical resection or bland embolization combined with local ablation for solitary HCC between January 1996 and August 2002 was performed. Progression-free survival rate and overall survival rate were calculated by the Kaplan-Meier method. RESULTS: There were 40 patients who underwent surgical resection and 33 patients who underwent embolization and ablation. Age, gender, and size of the treated lesion were not significantly different between the groups. The embolization/ablation group had more patients classified as Okuda stage II (P<.001). The surgical group had a longer median recurrence-free survival rate (53.1 vs 25.1 months). With a median follow-up of 23 months, the 1-, 3- and 5-year actuarial overall survival rates were 97%, 77%, and 56% for the embolization/ablation group and 81%, 70%, and 58% for the surgical group, respectively. There was no statistical difference in overall survival rates (P=.20). CONCLUSIONS: Bland arterial embolization in combination with ablation is effective in treating solitary HCC lesions up to 7 cm and achieves similar overall survival rates to surgical resection in selected patients.
PURPOSE: The vast majority of hepatocellular carcinomas (HCC) occur in patients with underlying liver dysfunction, making surgical resection available to only a subset of patients with adequate hepatic reserve. This study analyzes the authors' results with bland arterial embolization combined with radiofrequency ablation (RFA) or percutaneous ethanol injection (PEIT) compared with surgical resection for the treatment of solitary HCC up to 7 cm in size. MATERIALS AND METHODS: A retrospective review of all patients undergoing either surgical resection or bland embolization combined with local ablation for solitary HCC between January 1996 and August 2002 was performed. Progression-free survival rate and overall survival rate were calculated by the Kaplan-Meier method. RESULTS: There were 40 patients who underwent surgical resection and 33 patients who underwent embolization and ablation. Age, gender, and size of the treated lesion were not significantly different between the groups. The embolization/ablation group had more patients classified as Okuda stage II (P<.001). The surgical group had a longer median recurrence-free survival rate (53.1 vs 25.1 months). With a median follow-up of 23 months, the 1-, 3- and 5-year actuarial overall survival rates were 97%, 77%, and 56% for the embolization/ablation group and 81%, 70%, and 58% for the surgical group, respectively. There was no statistical difference in overall survival rates (P=.20). CONCLUSIONS: Bland arterial embolization in combination with ablation is effective in treating solitary HCC lesions up to 7 cm and achieves similar overall survival rates to surgical resection in selected patients.
Authors: Al B Benson; Thomas A Abrams; Edgar Ben-Josef; P Mark Bloomston; Jean F Botha; Bryan M Clary; Anne Covey; Steven A Curley; Michael I D'Angelica; Rene Davila; William D Ensminger; John F Gibbs; Daniel Laheru; Mokenge P Malafa; Jorge Marrero; Steven G Meranze; Sean J Mulvihill; James O Park; James A Posey; Jasgit Sachdev; Riad Salem; Elin R Sigurdson; Constantinos Sofocleous; Jean-Nicolas Vauthey; Alan P Venook; Laura Williams Goff; Yun Yen; Andrew X Zhu Journal: J Natl Compr Canc Netw Date: 2009-04 Impact factor: 11.908
Authors: Julie N Leal; Mithat Gonen; Anne M Covey; Joseph P Erinjeri; George Getrajdman; Constantinos T Sofocleous; Michael D'Angelica; Ronald P DeMatteo; Ghassan K Abou-Alfa; William R Jarnagin; Yuman Fong; Karen T Brown Journal: J Vasc Interv Radiol Date: 2015-05-30 Impact factor: 3.464
Authors: Al B Benson; Michael I D'Angelica; Daniel E Abbott; Thomas A Abrams; Steven R Alberts; Daniel Anaya Saenz; Chandrakanth Are; Daniel B Brown; Daniel T Chang; Anne M Covey; William Hawkins; Renuka Iyer; Rojymon Jacob; Andrea Karachristos; R Kate Kelley; Robin Kim; Manisha Palta; James O Park; Vaibhav Sahai; Tracey Schefter; Carl Schmidt; Jason K Sicklick; Gagandeep Singh; Davendra Sohal; Stacey Stein; G Gary Tian; Jean-Nicolas Vauthey; Alan P Venook; Andrew X Zhu; Karin G Hoffmann; Susan Darlow Journal: J Natl Compr Canc Netw Date: 2017-05 Impact factor: 11.908