Published online Mar 21, 2024. doi: 10.3748/wjg.v30.i11.1533
Peer-review started: January 5, 2024
First decision: January 23, 2024
Revised: February 18, 2024
Accepted: March 8, 2024
Article in press: March 8, 2024
Published online: March 21, 2024
Liver cancer, frequently arising from cirrhosis, presents with accompanying portal hypertension in a substantial portion of cases. Current treatments are limited due to the challenging nature of surgical interventions and poor physical tolerance of affected patients. Radiofrequency ablation (RFA) is a known therapeutic approach, but its application in liver cancer complicated by portal hypertension has been insufficiently explored.
Given the complexity and limited treatment options for patients with liver cancer and portal hypertension, investigating novel therapeutic strategies is crucial. Understanding the potential benefits of combining RFA with sorafenib in this context could offer improved efficacy and survival outcomes.
This study aimed to assess the effectiveness of RFA in combination with sorafenib for patients with liver cancer complicated by portal hypertension, discern prognostic factors, and evaluate their impact on patient outcomes. The study also sought to analyze the potential synergistic effects of both treatments and their impact on liver function and survival rates.
A total of 100 patients were analyzed and categorized into a research group (RFA with sorafenib) and a control group (RFA alone). Short-term efficacy, liver function, portal hypertension, cancer markers, adverse reactions, and survival rates were assessed. Multivariate logistic regression analysis was employed to identify independent risk factors for poor patient prognosis.
The combined RFA and sorafenib treatment demonstrated a significantly higher total effective rate compared to RFA alone, effectively reducing portal vein pressure, improving liver function, and lowering liver cancer markers. Patients in the combined treatment group exhibited higher survival rates at 1-, 2-, and 3-year follow-ups, highlighting the potential long-term benefits of this approach.
The combination of RFA and sorafenib yields promising results in treating liver cancer with portal hypertension, offering improved short- and long-term efficacy. Prognostic factors such as Child-Pugh grade, tumor size, history of hepatitis, and the use of sorafenib were identified as significant predictors of patient outcomes, providing valuable insights for clinical management.
These findings underscore the potential clinical therapeutic value of combining RFA with sorafenib for liver cancer complicated by portal hypertension. However, further research with larger sample sizes is warranted to validate these outcomes and establish guidelines for optimizing treatment protocols and patient care.