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Radiofrequency thermal ablation (RFA) after transarterial chemoembolization (TACE) as a combined therapy for unresectable non-early hepatocellular carcinoma (HCC)

  • Hepatobiliary-Pancreas
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Abstract

The treatment of unresectable “non-early” (according to the BCLC classification) hepatocellular carcinoma (HCC) in cirrhotic patients with transcatheter arterial chemoembolization (TACE) followed by radiofrequency ablation (RFA) is retrospectively evaluated and possible prognostic factors of this combined therapy are investigated. Forty-six consecutive cirrhotic patients (Child-Pugh class A or B) with solitary or oligonodular HCC underwent RFA after TACE. The treated lesions were 51 overall (size 30–80 mm, mean 48.9). RFA was performed by a multitined expandable electrodes device after one TACE administration. Local efficacy was evaluated with multiphasic computed tomography (CT) performed an average of 2 months after treatment and then during follow-up. Patient survival rate was also evaluated (follow-up time 1–51 months, mean 15 months). Technical success (defined as complete devascularization during the arterial phase) was achieved in 34/51 lesions (66.7%) at the first CT check and in 29/51 (56.9%) during the succeeding follow-up. Among the considered prognostic factors, only lesion diameter (< or >=50 mm) was statistically significant in the Fisher's exact test in terms of local control (85.2 vs. 45.8% at first CT, p=.0065; 70.4 vs. 41.7% during follow-up, p=.051). There were two major complications (6.5%): one hepatic failure and one death. A Kaplan-Meier analysis showed survival rates of 89.7% at 12 months and 67.1% at 24 months. Combined therapy for non-early HCC shows a relatively high complete local response (especially in lesions less than 5 cm in diameter) and promising mid-term clinical success. Its overall usefulness has yet to be established by a larger series and risk-benefit analysis.

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Acknowledgement

The work of Eva Pagano was supported by the Compagnia di San Paolo, Special Project Oncology.

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Authors and Affiliations

  1. Institute of Diagnostic and Interventional Radiology, University of Turin, Via Genova 3, 10126, Torino, Italy

    Andrea Veltri, Paolo Moretto, Andrea Doriguzzi, Giovanna Carrara & Giovanni Gandini

  2. Unit of Cancer Epidemiology, University of Turin, Via Santena 7, 10126, Torino, Italy

    Eva Pagano

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  1. Andrea Veltri
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  2. Paolo Moretto
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  3. Andrea Doriguzzi
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  4. Eva Pagano
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Correspondence to Andrea Veltri.

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Veltri, A., Moretto, P., Doriguzzi, A. et al. Radiofrequency thermal ablation (RFA) after transarterial chemoembolization (TACE) as a combined therapy for unresectable non-early hepatocellular carcinoma (HCC). Eur Radiol 16, 661–669 (2006). https://doi.org/10.1007/s00330-005-0029-9

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  • DOI: https://doi.org/10.1007/s00330-005-0029-9

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