Computed tomography-guided radiofrequency ablation of the retained iodized oil after simultaneous combination with transarterial embolization in small recurrent or residual hepatocellular carcinoma

Zhimei Huang; Yangkui Gu; Shaoyong Wu; Chunxiao Lai; Xiuchen Wang; Jinhua Huang

doi:10.1016/j.jimed.2020.01.008

Computed tomography-guided radiofrequency ablation of the retained iodized oil after simultaneous combination with transarterial embolization in small recurrent or residual hepatocellular carcinoma

J Interv Med. 2020 Jan 21;3(1):49-54. doi: 10.1016/j.jimed.2020.01.008. eCollection 2020 Feb.

Authors

Zhimei Huang¹, Yangkui Gu¹, Shaoyong Wu², Chunxiao Lai³, Xiuchen Wang¹, Jinhua Huang¹

Affiliations

¹ Department of Minimal Invasive Intervention, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, People's Republic of China.
² Anesthesiology Department, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, People's Republic of China.
³ Department of Gasptroenterology, Clifford Hospital, People's Republic of China.

Abstract

Objective: To assess the clinical efficacy and safety of transarterial embolization (TAE) in simultaneous combination with computed tomography (CT)-guided radiofrequency ablation (RFA) for recurrent or residual hepatocellular carcinoma (HCC), and to determine the risk factors influencing local tumor progression following this procedure.

Methods: One hundred eighteen patients with recurrent or residual HCC (tumor size, 10-30 mm) underwent RFA. During the 19-month follow-up, 59 patients received RFA only (RFA group), and the remaining 59 received RFA immediately after TAE (TAE + RFA group). All patients were followed up to observe the short-term therapeutic effects and complications. The cumulative local tumor progression rates in both groups were calculated using unpaired Student's t tests and the Kaplan-Meier method.

Results: The rate of major complications was 5.08% in the TAE + RFA group and 3.39% in the RFA group. The overall response rate was 96.61% in the TAE + RFA group and 79.66% in the RFA group (P = 0.008). The disease control rate was significantly higher in the TAE + RFA group than in the RFA group (94.92% vs. 79.66%, P = 0.024). The median time to local tumor progression was 4.8 months in the RFA group and 9.6 months in the TAE + RFA group. The cumulative local tumor progression rate at 1 year was 10.60% in the RFA group and 23.60% in the TAE + RFA group (P = 0.016).

Conclusion: TAE in simultaneous combination with CT-guided RFA was effective and safe against recurrent or residual HCC. Local tumor progression can be minimized by the complete ablation of targeted iodized oil deposits after simultaneous TAE.

Keywords: Computed tomography-guided; Hepatocellular carcinoma; Recurrent; Residual; Transarterial embolization.