Luwen Mu1,2,3, Lin Sun1,4,5, Tao Pan3, Ning Lyu1,2, Shaolong Li1,2, Xishan Li6, Jianpeng Wang7, Qiankun Xie1,2, Haijing Deng1,2, Lie Zheng1,4, Jianhong Peng1,8, Lujun Shen1,2, Weijun Fan1,2, Peihong Wu1,2, Ming Zhao1,2. 1. a State Key Laboratory of Oncology in South China , Collaborative Innovation Center for Cancer Medicine , Guangzhou , PR China. 2. b Minimally Invasive Interventional Division , Sun Yat-sen University Cancer Center , Guangzhou , PR China. 3. c Department of Vascular Interventional Radiology , Third Affiliated Hospital of Sun Yat-sen University , Guangzhou , PR China. 4. d Department of Medical Imaging , Sun Yat-sen University Cancer Center , Guangzhou , PR China. 5. e Department of Medical Imaging , Guangdong Second Provincial General Hospital, Guangdong Provincial Emergency Hospital , Guangzhou , PR China. 6. f Department of Interventional Radiology , Guangzhou First People's Hospital Guangzhou Medical University , Guangzhou , PR China. 7. g Target and Interventional Therapy Department of Oncology , First People's Hospital of Foshan, Affiliated Foshan Hospital of Sun Yat-sen University , Foshan , PR China. 8. h Department of Colorectal Surgery , Sun Yat-sen University Cancer Center, Guangzhou , PR China.
Abstract
BACKGROUND: The aim of this study was to evaluate the therapeutic outcome of percutaneous computed tomography (CT)-guided radiofrequency ablation (RFA) for extrahepatic oligometastases of hepatocellular carcinoma (HCC). METHODS: Institutional review board approval was obtained for this retrospective study, and all patients provided written informed consent. Between April 2004 and December 2015, 116 oligometastases (diameter, 5-50 mm; 20.3 ± 10.4) in 79 consecutive HCC patients (73 men and 6 women; average age, 50.3 years ±13.0) were treated with RFA. We focussed on patients with 1-3 extrahepatic metastases (EHM) confined to 1-2 organs (including the lung, adrenal gland, bone, lymph node and pleura/peritoneum) who were treated naïve with curative intent. Survival, technical success and safety were evaluated. The log-rank test and Cox proportional hazards regression models were used to analyse the survival data. RESULTS: No immediate technical failure occurred, and at 1 month, the technique effectiveness rate was determined to be 95.8%. After a median follow-up time of 28.0 months (range, 6-108 months), the 1-, 2- and 3-year overall survival (OS) rates were 91, 70 and 48%, respectively, with a median survival time of 33.5 months. Time to unoligometastatic progression (TTUP) of less than 6 months (p < 0.001) and a Child-Pugh score of more than 5 (p = 0.001) were significant indicators of shorter OS. The 1-, 2- and 3-year disease free survival (DFS) rates were 34, 21 and 8%, respectively, with a median DFS time of 6.8 months. DFS was better for those with lung metastases (p = 0.006). Major complication occurred in nine (9.5%, 9/95) RFA sessions without treatment-related mortality. CONCLUSIONS: CT-guided RFA for oligometastatic HCC may provide favourable efficacy and technical success with a minimally invasive approach.
BACKGROUND: The aim of this study was to evaluate the therapeutic outcome of percutaneous computed tomography (CT)-guided radiofrequency ablation (RFA) for extrahepatic oligometastases of hepatocellular carcinoma (HCC). METHODS: Institutional review board approval was obtained for this retrospective study, and all patients provided written informed consent. Between April 2004 and December 2015, 116 oligometastases (diameter, 5-50 mm; 20.3 ± 10.4) in 79 consecutive HCCpatients (73 men and 6 women; average age, 50.3 years ±13.0) were treated with RFA. We focussed on patients with 1-3 extrahepatic metastases (EHM) confined to 1-2 organs (including the lung, adrenal gland, bone, lymph node and pleura/peritoneum) who were treated naïve with curative intent. Survival, technical success and safety were evaluated. The log-rank test and Cox proportional hazards regression models were used to analyse the survival data. RESULTS: No immediate technical failure occurred, and at 1 month, the technique effectiveness rate was determined to be 95.8%. After a median follow-up time of 28.0 months (range, 6-108 months), the 1-, 2- and 3-year overall survival (OS) rates were 91, 70 and 48%, respectively, with a median survival time of 33.5 months. Time to unoligometastatic progression (TTUP) of less than 6 months (p < 0.001) and a Child-Pugh score of more than 5 (p = 0.001) were significant indicators of shorter OS. The 1-, 2- and 3-year disease free survival (DFS) rates were 34, 21 and 8%, respectively, with a median DFS time of 6.8 months. DFS was better for those with lung metastases (p = 0.006). Major complication occurred in nine (9.5%, 9/95) RFA sessions without treatment-related mortality. CONCLUSIONS: CT-guided RFA for oligometastatic HCC may provide favourable efficacy and technical success with a minimally invasive approach.
Entities:
Keywords:
Hepatocellular carcinoma; extrahepatic metastases; oligometastases; overall survival; radiofrequency ablation; time to unoligometastatic progression
Authors: Stefano Giusto Picchi; Giulia Lassandro; Andrea Bianco; Andrea Coppola; Anna Maria Ierardi; Umberto G Rossi; Francesco Lassandro Journal: Med Oncol Date: 2020-03-27 Impact factor: 3.064