Combined locoregional treatment of patients with hepatocellular carcinoma: State of the art
Open Access
- 1 January 2016
- journal article
- review article
- Published by Baishideng Publishing Group Inc. in World Journal of Gastroenterology
- Vol. 22 (6), 1935-42
- https://doi.org/10.3748/wjg.v22.i6.1935
Abstract
In recent years, a combination of intervention therapies has been widely applied in the treatment of hepatocellular carcinoma (HCC). One such combined strategy is based on the combination of the percutaneous approach, such as radiofrequency ablation (RFA), and the intra-arterial locoregional approach, such as trans-arterial chemoembolization (TACE). Several types of evidence have supported the feasibility and benefit of combined therapy, despite some studies reporting conflicting results and outcomes. The aim of this review was to explain the technical aspects of different combined treatments and to comprehensively analyze and compare the clinical efficacy and safety of this combined treatment option and monotherapy, either as TACE or RFA alone, in order to provide clinicians with an unbiased opinion and valuable information. Based on a literature review and our experience, combined treatment seems to be a safe and effective option in the treatment of patients with early/intermediate HCC when surgical resection is not feasible; furthermore, this approach provides better results than RFA and TACE alone for the treatment of large HCC, defined as those exceeding 3 cm in size. It can also expand the indication for RFA to previously contraindicated “complex cases”, with increased risk of thermal ablation related complications due to tumor location, or to “complex patients” with high bleeding risk.Keywords
This publication has 39 references indexed in Scilit:
- Role of Radiofrequency Ablation in Patients with Hepatocellular Carcinoma Who Undergo Prior Transarterial Chemoembolization: Long-Term Outcomes and Predictive FactorsGut and Liver, 2014
- Radiofrequency ablation combined with transarterial chemoembolization for intermediate hepatocellular carcinomaHepatology Research, 2013
- Radiofrequency Ablation With or Without Transcatheter Arterial Chemoembolization in the Treatment of Hepatocellular Carcinoma: A Prospective Randomized TrialJournal of Clinical Oncology, 2013
- Radiofrequency Ablation Combined with Transcatheter Arterial Chemoembolization for the Treatment of Single Hepatocellular Carcinoma of 2 to 5 cm in Diameter: Comparison with Surgical ResectionKorean Journal of Radiology, 2013
- CT-guided radiofrequency ablation after with transarterial chemoembolization in treating unresectable hepatocellular carcinoma with long overall survival improvementEuropean Journal of Radiology, 2012
- Medium-Sized (3.1–5.0 cm) Hepatocellular Carcinoma: Transarterial Chemoembolization Plus Radiofrequency Ablation Versus Radiofrequency Ablation AloneAnnals of Surgical Oncology, 2011
- Hepatocellular Carcinoma: Current ManagementCurrent Problems in Surgery, 2010
- Prospective Randomized Study of Doxorubicin-Eluting-Bead Embolization in the Treatment of Hepatocellular Carcinoma: Results of the PRECISION V StudyCardioVascular and Interventional Radiology, 2009
- Early-Stage Hepatocellular Carcinoma: Radiofrequency Ablation Combined with Chemoembolization versus HepatectomyRadiology, 2008
- 2004 Dr. Gary J. Becker Young Investigator Award: Relative Thermosensitivity of Cytotoxic Drugs Used in Transcatheter Arterial ChemoembolizationJournal of Vascular and Interventional Radiology, 2004