Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 1/2018

01-01-2018 | Clinical Investigation

Iodized Oil Transarterial Chemoembolization and Radiofrequency Ablation for Small Periportal Hepatocellular Carcinoma: Comparison with Nonperiportal Hepatocellular Carcinoma

Published in: CardioVascular and Interventional Radiology | Issue 1/2018

Login to get access

Abstract

Purpose

This study aims to evaluate the treatment outcomes of iodized oil transarterial chemoembolization (TACE) and subsequent radiofrequency ablation (RFA) for small (≤3 cm) periportal hepatocellular carcinoma (HCC) compared with nonperiportal HCC.

Methods

Twenty-three patients [periportal group (PG); mean age, 59.8 years; 22 men, 1 woman] with periportal HCC (in contact with the portal vein >3 mm in diameter) and 279 patients [nonperiportal group (NPG); mean age, 59.1 years; 234 men, 45 women] with nonperiportal HCC were treated between March 2010 and January 2014. All cases were contraindicated for ultrasound-guided RFA or resection. Mean tumor size was 1.2 cm in each group. The baseline characteristics were not different between the groups, except for alpha-fetoprotein level (41.0 ng/dL in NPG vs. 8.8 ng/dL in PG, p = 0.001). Local tumor progression (LTP), disease-free survival (DFS), overall survival (OS), intrasegmental recurrence, and complications were analyzed using the Kaplan–Meier method and Fisher’s exact test.

Results

TACE and RFA were successfully performed in all patients. Mean follow-up period of PG and NPG was 33.8 and 42.8 months, respectively. LTP (p = 0.701), DFS (p = 0.718), and OS (p = 0.359) were not different between the two groups. Intrasegmental recurrence occurred in two patients (one in each group), and its incidence was not different (p = 0.212). Complications requiring further treatment occurred in 1/23 (4.3%) in PG and 5/279 (1.8%) in NPG. No procedure-related mortality occurred.

Conclusions

Iodized oil TACE and subsequent RFA are effective alternative treatments for small periportal HCC (≤3 cm) when percutaneous ultrasound- or CT-guided RFA or resection is not feasible.
Literature
1.
2.
Hyun D, Cho SK, Shin SW, Rhim H, Koh KC, Paik SW. Treatment of small hepatocellular carcinoma (</=2 cm) in the caudate lobe with sequential transcatheter arterial chemoembolization and radiofrequency ablation. Cardiovasc Interv Radiol. 2016;39:1015–22.CrossRef
3.
Yang W, Yan K, Wu GX, et al. Radiofrequency ablation of hepatocellular carcinoma in difficult locations: strategies and long-term outcomes. World J Gastroenterol. 2015;21:1554–66.CrossRefPubMedPubMedCentral
4.
Morimoto M, Numata K, Kondo M, et al. Radiofrequency ablation combined with transarterial chemoembolization for subcapsular hepatocellular carcinoma: a prospective cohort study. Eur J Radiol. 2013;82:497–503.CrossRefPubMed
5.
Yamakado K, Nakatsuka A, Takaki H, et al. Subphrenic versus nonsubphrenic hepatocellular carcinoma: combined therapy with chemoembolization and radiofrequency ablation. AJR Am J Roentgenol. 2010;194:530–5.CrossRefPubMed
6.
Lim S, Lee MW, Rhim H, et al. Mistargeting after fusion imaging-guided percutaneous radiofrequency ablation of hepatocellular carcinomas. J Vasc Interv Radiol. 2014;25:307–14.CrossRefPubMed
7.
Kang TW, Lim HK, Lee MW, et al. Aggressive intrasegmental recurrence of hepatocellular carcinoma after radiofrequency ablation: risk factors and clinical significance. Radiology. 2015;276:274–85.CrossRefPubMed
8.
Lu DS, Raman SS, Limanond P, et al. Influence of large peritumoral vessels on outcome of radiofrequency ablation of liver tumors. J Vasc Interv Radiol. 2003;14:1267–74.CrossRefPubMed
9.
Lu DS, Raman SS, Vodopich DJ, Wang M, Sayre J, Lassman C. Effect of vessel size on creation of hepatic radiofrequency lesions in pigs: assessment of the “heat sink” effect. AJR Am J Roentgenol. 2002;178:47–51.CrossRefPubMed
10.
Kim JH, Won HJ, Shin YM, et al. Medium-sized (3.1–5.0 cm) hepatocellular carcinoma: transarterial chemoembolization plus radiofrequency ablation versus radiofrequency ablation alone. Ann Surg Oncol. 2011;18:1624–9.CrossRefPubMed
11.
Chevallier P, Baudin G, Anty R, et al. Treatment of hepatocellular carcinomas by thermal ablation and hepatic transarterial chemoembolization. Diagn Interv Imaging. 2015;96:637–46.CrossRefPubMed
12.
Morimoto M, Numata K, Nozawa A, et al. Radiofrequency ablation of the liver: extended effect of transcatheter arterial embolization with iodized oil and gelatin sponge on histopathologic changes during follow-up in a pig model. J Vasc Interv Radiol. 2010;21:1716–24.CrossRefPubMed
13.
Bonomo G, Della Vigna P, Monfardini L, et al. Combined therapies for the treatment of technically unresectable liver malignancies: bland embolization and radiofrequency thermal ablation within the same session. Cardiovasc Intervent Radiol. 2012;35:1372–9.CrossRefPubMed
14.
Lee IJ, Kim YI, Kim KW, et al. Radiofrequency ablation combined with transcatheter arterial embolisation in rabbit liver: investigation of the ablation zone according to the time interval between the two therapies. Br J Radiol. 2012;85:e987–94.CrossRefPubMedPubMedCentral
15.
Yamanaka T, Yamakado K, Takaki H, et al. Ablative zone size created by radiofrequency ablation with and without chemoembolization in small hepatocellular carcinomas. Jpn J Radiol. 2012;30:553–9.CrossRefPubMed
16.
Hyun D, Cho SK, Shin SW, et al. Early stage hepatocellular carcinomas not feasible for ultrasound-guided radiofrequency ablation: comparison of transarterial chemoembolization alone and combined therapy with transarterial chemoembolization and radiofrequency ablation. Cardiovasc Interv Radiol. 2016;39:417–25.CrossRef
17.
Omata M, Lesmana LA, Tateishi R, et al. Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma. Hepatol Int. 2010;4:439–74.CrossRefPubMedPubMedCentral
18.
Goldberg SN, Charboneau JW, Dodd GD 3rd, et al. Image-guided tumor ablation: proposal for standardization of terms and reporting criteria. Radiology. 2003;228:335–45.CrossRefPubMed
19.
Sacks D, McClenny TE, Cardella JF, Lewis CA. Society of Interventional Radiology clinical practice guidelines. J Vasc Interv Radiol. 2003;14:S199–202.CrossRefPubMed
20.
Kim JW, Kim JH, Won HJ, et al. Hepatocellular carcinomas 2–3 cm in diameter: transarterial chemoembolization plus radiofrequency ablation vs. radiofrequency ablation alone. Eur J Radiol. 2012;81:e189–93.CrossRefPubMed
21.
Shibata T, Isoda H, Hirokawa Y, Arizono S, Shimada K, Togashi K. Small hepatocellular carcinoma: is radiofrequency ablation combined with transcatheter arterial chemoembolization more effective than radiofrequency ablation alone for treatment? Radiology. 2009;252:905–13.CrossRefPubMed
22.
Fujimori M, Takaki H, Nakatsuka A, et al. Survival with up to 10-year follow-up after combination therapy of chemoembolization and radiofrequency ablation for the treatment of hepatocellular carcinoma: single-center experience. J Vasc Interv Radiol. 2013;24:655–66.CrossRefPubMed
23.
Iwamoto T, Kawai N, Sato M, et al. Effectiveness of hepatic arterial embolization on radiofrequency ablation volume in a swine model: relationship to portal venous flow and liver parenchymal pressure. J Vasc Interv Radiol. 2008;19:1646–51.CrossRefPubMed
24.
Kitamoto M, Imagawa M, Yamada H, et al. Radiofrequency ablation in the treatment of small hepatocellular carcinomas: comparison of the radiofrequency effect with and without chemoembolization. AJR Am J Roentgenol. 2003;181:997–1003.CrossRefPubMed
25.
Tateishi R, Shiina S, Akahane M, et al. Frequency, risk factors and survival associated with an intrasubsegmental recurrence after radiofrequency ablation for hepatocellular carcinoma. PLoS ONE. 2013;8:e59040.CrossRefPubMedPubMedCentral
26.
Sugimori K, Nozawa A, Morimoto M, et al. Extension of radiofrequency ablation of the liver by transcatheter arterial embolization with iodized oil and gelatin sponge: results in a pig model. J Vasc Interv Radiol. 2005;16:849–56.CrossRefPubMed
27.
Miyayama S, Matsui O, Yamashiro M, et al. Ultraselective transcatheter arterial chemoembolization with a 2-f tip microcatheter for small hepatocellular carcinomas: relationship between local tumor recurrence and visualization of the portal vein with iodized oil. J Vasc Interv Radiol. 2007;18:365–76.CrossRefPubMed
28.
Matsui O, Miyayama S, Sanada J, et al. Interventional oncology: new options for interstitial treatments and intravascular approaches: superselective TACE using iodized oil for HCC: rationale, technique and outcome. J Hepatobiliary Pancreat Sci. 2010;17:407–9.CrossRefPubMed
29.
Kang TW, Lim HK, Lee MW, Kim YS, Choi D, Rhim H. Perivascular versus nonperivascular small HCC treated with percutaneous RF ablation: retrospective comparison of long-term therapeutic outcomes. Radiology. 2014;270:888–99.CrossRefPubMed
30.
Peng ZW, Zhang YJ, Liang HH, Lin XJ, Guo RP, Chen MS. Recurrent hepatocellular carcinoma treated with sequential transcatheter arterial chemoembolization and RF ablation versus RF ablation alone: a prospective randomized trial. Radiology. 2012;262:689–700.CrossRefPubMed
31.
Peng ZW, Zhang YJ, Chen MS, et al. Radiofrequency ablation with or without transcatheter arterial chemoembolization in the treatment of hepatocellular carcinoma: a prospective randomized trial. J Clin Oncol. 2013;31:426–32.CrossRefPubMed
Metadata
Title
Iodized Oil Transarterial Chemoembolization and Radiofrequency Ablation for Small Periportal Hepatocellular Carcinoma: Comparison with Nonperiportal Hepatocellular Carcinoma
Publication date
01-01-2018
Published in
CardioVascular and Interventional Radiology / Issue 1/2018
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-017-1783-1

Other articles of this Issue 1/2018

CardioVascular and Interventional Radiology 1/2018 Go to the issue

Clinical Investigation

The Aortic Bifurcation Angle as a Factor in Application of the Outback for Femoropopliteal Lesions in Ipsilateral Versus Contralateral Approaches

Clinical Investigation

Outcomes of Percutaneous Portal Vein Intervention in a Single UK Paediatric Liver Transplantation Programme

Clinical Investigation

The Impact of Bridging LRT on Survival in Patients Listed for Liver Transplantation

Laboratory Investigation

Hepatic Intra-arterial Delivery of a “Trojan-horses” Gene Therapy: A Pilot Study on Rabbit VX2 Hepatic Tumor Model

Clinical Investigation

Safety of the Solitaire 4 × 40 mm Stent Retriever in the Treatment of Ischemic Stroke

Clinical Investigation

Port Implantation in Patients with Severe Thrombocytopenia is Safe with Interventional Radiology