Arnaud Hocquelet1, Christophe Aubé2, Agnès Rode3, Victoire Cartier4, Olivier Sutter5, Anne Frederique Manichon3, Jérome Boursier6, Gisèle N'kontchou7, Philippe Merle8, Jean-Frédéric Blanc9, Hervé Trillaud10, Olivier Seror11. 1. Service de Radiologie de l'Hôpital Haut-lévêque, CHU de Bordeaux, Avenue Magellan, 33600 Pessac, France; EA IMOTION (Imagerie moléculaire et thérapies innovantes en oncologie), Université de Bordeaux, 146 rue Leo Saignat, Case 127, 33076 Bordeaux, France. Electronic address: arnaud.hocquelet@gmail.com. 2. Département de radiologie, CHU d'Angers, LUNAM Université, 49933 Angers, France; Laboratoire HIFIH, UPRES 3859, LUNAM Université, Université d'Angers, 49045 Angers, France. 3. Service d'imagerie Médicale, Hôpital de la Croix Rousse, Lyon, France. 4. Département de radiologie, CHU d'Angers, LUNAM Université, 49933 Angers, France. 5. Service de Radiologie de l'Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique Hôpitaux de Paris, Bondy, France; Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Paris 13, Communauté d'Universités et Etablissements Sorbonne Paris Cité, Paris, France. 6. Laboratoire HIFIH, UPRES 3859, LUNAM Université, Université d'Angers, 49045 Angers, France; Service de Gastroenterologie et Hépatologie, LUNAM Université, CHU d'Angers, 49933 Angers, France. 7. Service d'Hepatologie de l'Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique Hôpitaux de Paris, Bondy, France. 8. Service d'Hépatologie, Hôpital de la Croix Rousse, Lyon, France. 9. Service d'Hépatologie de l'Hôpital Haut-lévêque, CHU de Bordeaux, Avenue Magellan, 33600 Pessac, France. 10. Service de Radiologie de l'Hôpital Haut-lévêque, CHU de Bordeaux, Avenue Magellan, 33600 Pessac, France; EA IMOTION (Imagerie moléculaire et thérapies innovantes en oncologie), Université de Bordeaux, 146 rue Leo Saignat, Case 127, 33076 Bordeaux, France. 11. Service de Radiologie de l'Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique Hôpitaux de Paris, Bondy, France; Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Paris 13, Communauté d'Universités et Etablissements Sorbonne Paris Cité, Paris, France; Unité mixte de Recherche 1162, Génomique Fonctionnelle des Tumeurs Solides, Institut National de la Santé et de la Recherche Médicale, Paris, France.
Abstract
BACKGROUND & AIMS: The primary aim of this study was to compare the rate of global radiofrequency ablation (RFA) failure between monopolar RFA (MonoRFA) vs. no-touch multi-bipolar RFA (NTmbpRFA) for small hepatocellular carcinoma (HCC) ⩽5cm in cirrhotic patients. METHODS: A total of 362 cirrhotic patients were included retrospectively across four French centres (181 per treatment group). Global RFA failure (primary RFA failure or local tumour progression) was analysed using the Kaplan-Meier method after coarsened exact matching. Cox regression models were used to identify factors associated with global RFA failure and overall survival (OS). RESULTS: Patients were well matched according to tumour size (⩽30/>30mm); tumour number (one/several); tumour location (subcapsular and near large vessel); serum AFP (<10; 10-100; >100ng/ml); Child-Pugh score (A/B) and platelet count (</⩾100G/L), p=1 for all. One case of perioperative mortality was observed in the NTmbpRFA group and the rate of major complications was 7.2% in both groups (p=1). The cumulative rates of global RFA failure at 1, 3 and 5years were respectively 13.3%, 31% and 36.7% for MonoRFA vs. 0.02%, 7.9% and 9.2% for NTmbpRFA, p<0.001. Monopolar RFA, tumour size >30mm and HCC near large vessel were independent factors associated with global RFA failure. Five-year OS was 37.2% following MonoRFA vs. 46.4% following NTmbpRFA p=0.378. CONCLUSIONS: This large multicentre case-matched study showed that NTmbpRFA provided better primary RFA success and sustained local tumour response without increasing severe complications rates, for HCC ⩽5cm. LAY SUMMARY: Using no-touch multi-bipolar radiofrequency ablation for hepatocellular carcinoma ⩽5cm provide a better sustained local tumour control compared to monopolar radiofrequency ablation. Copyright Â
BACKGROUND & AIMS: The primary aim of this study was to compare the rate of global radiofrequency ablation (RFA) failure between monopolar RFA (MonoRFA) vs. no-touch multi-bipolar RFA (NTmbpRFA) for small hepatocellular carcinoma (HCC) ⩽5cm in cirrhotic patients. METHODS: A total of 362 cirrhotic patients were included retrospectively across four French centres (181 per treatment group). Global RFA failure (primary RFA failure or local tumour progression) was analysed using the Kaplan-Meier method after coarsened exact matching. Cox regression models were used to identify factors associated with global RFA failure and overall survival (OS). RESULTS:Patients were well matched according to tumour size (⩽30/>30mm); tumour number (one/several); tumour location (subcapsular and near large vessel); serum AFP (<10; 10-100; >100ng/ml); Child-Pugh score (A/B) and platelet count (</⩾100G/L), p=1 for all. One case of perioperative mortality was observed in the NTmbpRFA group and the rate of major complications was 7.2% in both groups (p=1). The cumulative rates of global RFA failure at 1, 3 and 5years were respectively 13.3%, 31% and 36.7% for MonoRFA vs. 0.02%, 7.9% and 9.2% for NTmbpRFA, p<0.001. Monopolar RFA, tumour size >30mm and HCC near large vessel were independent factors associated with global RFA failure. Five-year OS was 37.2% following MonoRFA vs. 46.4% following NTmbpRFA p=0.378. CONCLUSIONS: This large multicentre case-matched study showed that NTmbpRFA provided better primary RFA success and sustained local tumour response without increasing severe complications rates, for HCC ⩽5cm. LAY SUMMARY: Using no-touch multi-bipolar radiofrequency ablation for hepatocellular carcinoma ⩽5cm provide a better sustained local tumour control compared to monopolar radiofrequency ablation. Copyright Â
Authors: Sae-Jin Park; Eun Ju Cho; Jeong-Hoon Lee; Su Jong Yu; Yoon Jun Kim; Jung-Hwan Yoon; Hyo-Jin Kang; Jeong Hee Yoon; Dong Ho Lee; Se Hyung Kim; Jae Young Lee; Jeong Min Lee Journal: Liver Cancer Date: 2020-12-08 Impact factor: 11.740
Authors: Won Chang; Jeong Min Lee; Jeong Hee Yoon; Dong Ho Lee; Sang Min Lee; Kyoung Bun Lee; Bo Ram Kim; Tae-Hyung Kim; Seunghyun Lee; Joon Koo Han Journal: PLoS One Date: 2017-04-26 Impact factor: 3.240
Authors: F G M Poch; C A Neizert; B Geyer; O Gemeinhardt; S M Niehues; J L Vahldiek; K K Bressem; K S Lehmann Journal: Sci Rep Date: 2021-07-06 Impact factor: 4.379