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Copyright ©2014 Baishideng Publishing Group Inc.
World J Gastroenterol. May 28, 2014; 20(20): 5987-5998
Published online May 28, 2014. doi: 10.3748/wjg.v20.i20.5987
Table 1 Characteristics of studies using radiofrequency ablation as a pretransplantation bridge therapy
Ref.nTumor size (cm)RFA→LT interval (mo)DropoutRadiologic response necrosisPathologic response necrosisSatellites found in explantsFollow-up after LT (mo)Survival
Pulvirenti et al[34]143.508.00.0%90.7%86.4%57.0%16.0100.0%100.0%
Fontana et al[35]333.607.921.7%66.0%--26.985.0%85.0%
Mazzaferro et al[36]502.759.50.0%70.0%55.0%28.0%22.095.0%83.0%
Pompili et al[37]402.808.60.0%75.0%46.7%14.0%34.491.9%85.4%
Lu et al[38]522.508.75.8%89.6%70.3%24.0%14.985.0%76.0%
Brillet et al[39]212.4011.924.0%76.0%75.0%44.0%25.0--
DuBay et al[40]772.509.521.0%83.0%--30.0-1-1
Table 2 Recommended treatment strategies with curative intent for patients with early-stage hepatocellular carcinoma
Tumors (n)Tumor size (cm)Child-Pugh classTumor characteristicsRecommended strategy
1 ≤ 2AM0, subcapsular, adjacent to intrahepatic vessel trunk or extrahepatic organsLR
BM0, central locationRFA
> 2 to ≤ 4AM0LR or RFA
M0, subcapsular, adjacent to intrahepatic vessel trunk or extrahepatic organsLR
BM0, central locationRFA
> 4AM0LR
2-3 ≤ 3AM0, bilobar diseaseLR and/or RFA
M0, unilobar diseaseLR
Table 3 Characteristics of studies involving treatment of recurrent hepatocellular carcinoma by radiofrequency ablation
Ref.nTumors (n)Tumor size (cm)Radiologic response necrosisPLR→RFA interval (mo)Follow-up after RFA (mo)Overall survival
Disease-free survival
Main findings
Nicoli et al[100]5---43 (31.0-61.0)25.5 (-)-60.0%--20.0%-RFTA is the first-choice treatment in the management of intrahepatic recurrence
Choi et al[101]45532.1 (0.8-4.0)87.0% (46.0/53.0)23 (10.0-40.0)18.0 (2.0-47.0)82.0%54.0%-57.0%34.0%-Percutaneous RFA is effective and safe for intrahepatic recurrent HCC after hepatectomy. Serum alpha-fetoprotein level before RFA and resected tumor size were significant prognostic predictors of long-term survival
Lu et al[102]721242.4 (0.9-7.0)96.0% (119.0/124.0)27.9 (2.0-75.9)21.0 (1.0-215.2)70.0%55.0%28.0%22.0%95.0%83.0%Percutaneous thermal ablative therapies were particularly suitable for recurrent HCC and improved long-term survival
Schindera et al[103]35611.7 (0.5-5.3)85.5% (54.0/61.0)18 (1.0-65.0)-76.0%45.0%----Percutaneous RFA is effective and safe for recurrent HCC after hepatectomy, with a good overall patient survival rate
Yang et al[104]41763.8 (2.0-6.6)93.4% (71.0/76.0)-24.5 (1.0-96.0)73.0%41.0%-46.0%24.0%-Percutaneous RFA is effective and safe for recurrent hepatic tumors after previous partial hepatectomy
Choi et al[105]1021192.0 (0.8-5.0)93.3% (111.0/119.0)35.6 (7.0-83.0)22.3 (1.3-125.7)93.9%65.7%51.6%52.2%21.3%7.2%RFA is effective and safe for recurrent HCC after hepatectomy and is more effective in late than in early recurrence
Liang et al[106]6688-93.9% (62.0/66.0)21.1 (2.4-69.4)-76.6%48.6%39.9%---Percutaneous RFA is as effective as repeat hepatectomy for recurrent small HCC. Percutaneous RFA has an advantage over repeat hepatectomy in terms of being less invasive
Chan et al[107]45-2.2 (0.8-6.0)87.0% (46.0/53.0)35.6 (7.0-83.0)-83.7%43.1%29.1%32.2%12.4%9.3%Repeat resection and RFA attained similar survival benefits in the management of recurrent HCC after hepatectomy. The high repeatability of RFA and its ability to be delivered percutaneously render it a preferred treatment option for selected patients
Eisele et al[108]27-2.8 (-)--21.0 (-)96.0%62.0%32.0%51.0%30.0%11.0%Overall survival and disease-free survival were not significantly different between patients treated by RFA and repeat resection. There was, however, a tendency toward longer tumor-free survival in the resected patients