Año 2022 / Volumen 114 / Número 10
Original
Risk factors for recurrence beyond Milan criteria after radiofrequency ablation in transplantable small hepatocellular carcinoma

580-585

DOI: 10.17235/reed.2022.8592/2022

Weike Chu, Ping Li, Xue Wu, Peng Zhang, Hui Zhou, Bin Niu,

Resumen
This study aimed to determine the risk factors of recurrence beyond Milan criteria in patients with transplantable early hepatocellular carcinoma (HCC) after the first Radiofrequency ablation (RFA). 95 patients with newly diagnosed transplantable small HCC with single ≤3 cm lesions were analyzed retrospectively. During the 39-month median follow-up period, 12 (21.8%) patients with HCC < 2 cm and 22 (56.4%) patients with HCC ≥ 2 cm relapsed beyond Milan criteria (p = 0.001). The 1- and 3-year recurrence rates beyond Milan criteria were 6.3% and 14.7% in the HCC <2 cm group, compared with 24.1% and 55.6% in HCC ≥2 cm group (p < 0.0001). HCC ≥2 cm, red blood cell distribution width-to-lymphocyte ratio (RLR) ≥ 18.3, alpha-fetoprotein (AFP) >15 ng/ml and early recurrence after RFA were independent predictors of recurrence exceeding Milan criteria. Close follow-up and early liver transplantation should be initiated to obtain the best survival benefit for patients with transplantable early single small HCC with a tumor diameter ≥2 cm and higher RLR and AFP levels before the first RFA and early recurrence after RFA (recurrence within 2 years).
Share Button
Nuevo comentario
Comentarios
No hay comentarios para este artículo.
Bibliografía
Yang, J.D., Hainaut, P., Gores, G.J., et al. A global view of hepatocellular carcinoma: trends, risk, prevention and management. Nat Rev Gastroenterol Hepatol. 16(10), 589-604. http://doi.org/10.1038/s41575-019-0186-y (2019)
Forner, A., Reig, M. &Bruix, J. Hepatocellular carcinoma. The Lancet. 391(10127), 1301-1314. http://doi.org/10.1016/s0140-6736(18)30010-2 (2018)
Cucchetti, A., Piscaglia, F., Cescon, M., et al. Cost-effectiveness of hepatic resection versus percutaneous radiofrequency ablation for early hepatocellular carcinoma. J Hepatol. 59(2), 300-7. http://doi.org/10.1016/j.jhep.2013.04.009 (2013)
European Association for the Study of the Liver. Electronic address, e.e.e. &European Association for the Study of the, L. EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma. J Hepatol. 69(1), 182-236. http://doi.org/10.1016/j.jhep.2018.03.019 (2018)
Heimbach, J.K., Kulik, L.M., Finn, R.S., et al. AASLD guidelines for the treatment of hepatocellular carcinoma. Hepatology. 67(1), 358-380. http://doi.org/10.1002/hep.29086 (2018)
Mazzaferro, V., Regalia, E., Doci, R., et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. The New England journal of medicine. 334(11), 693-699. (1996)
Clavien, P.-A., Lesurtel, M., Bossuyt, P.M.M., et al. Recommendations for liver transplantation for hepatocellular carcinoma: an international consensus conference report. The Lancet. Oncology. 13(1), e11-e22. http://doi.org/10.1016/S1470-2045(11)70175-9 (2012)
Marrero, J.A., Kulik, L.M., Sirlin, C.B., et al. Diagnosis, Staging, and Management of Hepatocellular Carcinoma: 2018 Practice Guidance by the American Association for the Study of Liver Diseases. Hepatology. 68(2), 723-750. http://doi.org/10.1002/hep.29913 (2018)
Mazzaferro, V. Squaring the circle of selection and allocation in liver transplantation for HCC: An adaptive approach. Hepatology (Baltimore, Md.). 63(5), 1707-1717. http://doi.org/10.1002/hep.28420 (2016)
Lim, K.C., Wang, V.W., Siddiqui, F.J., et al. Cost-effectiveness analysis of liver resection versus transplantation for early hepatocellular carcinoma within the Milan criteria. Hepatology. 61(1), 227-37. http://doi.org/10.1002/hep.27135 (2015)
Sapisochin, G. &Bruix, J. Liver transplantation for hepatocellular carcinoma: outcomes and novel surgical approaches. Nat Rev Gastroenterol Hepatol. 14(4), 203-217. http://doi.org/10.1038/nrgastro.2016.193 (2017)
Tsuchiya, K., Asahina, Y., Tamaki, N., et al. Risk factors for exceeding the Milan criteria after successful radiofrequency ablation in patients with early-stage hepatocellular carcinoma. Liver Transpl. 20(3), 291-7. http://doi.org/10.1002/lt.23798 (2014)
Doyle, A., Gorgen, A., Muaddi, H., et al. Outcomes of radiofrequency ablation as first-line therapy for hepatocellular carcinoma less than 3cm in potentially transplantable patients. J Hepatol. 70(5), 866-873. http://doi.org/10.1016/j.jhep.2018.12.027 (2019)
Bruix, J., Sherman, M. &American Association for the Study of Liver, D. Management of hepatocellular carcinoma: an update. Hepatology. 53(3), 1020-2. http://doi.org/10.1002/hep.24199 (2011)
O'Leary, J.G., Lepe, R. &Davis, G.L. Indications for liver transplantation. Gastroenterology. 134(6), 1764-1776. http://doi.org/10.1053/j.gastro.2008.02.028 (2008)
Pompili, M., Saviano, A., de Matthaeis, N., et al. Long-term effectiveness of resection and radiofrequency ablation for single hepatocellular carcinoma ≤3 cm. Results of a multicenter Italian survey. Journal of hepatology. 59(1), 89-97. http://doi.org/10.1016/j.jhep.2013.03.009 (2013)
Cho, J.Y., Choi, M.S., Lee, G.S., et al. Clinical significance and predictive factors of early massive recurrence after radiofrequency ablation in patients with a single small hepatocellular carcinoma. Clin Mol Hepatol. 22(4), 477-486. http://doi.org/10.3350/cmh.2016.0048 (2016)
Kim, Y.-s., Lim, H.K., Rhim, H., et al. Ten-year outcomes of percutaneous radiofrequency ablation as first-line therapy of early hepatocellular carcinoma: analysis of prognostic factors. Journal of hepatology. 58(1), 89-97. http://doi.org/10.1016/j.jhep.2012.09.020 (2013)
Lee, H.Y., Rhim, H., Lee, M.W., et al. Early diffuse recurrence of hepatocellular carcinoma after percutaneous radiofrequency ablation: analysis of risk factors. European radiology. 23(1), 190-197. http://doi.org/10.1007/s00330-012-2561-8 (2013)
Lu, X.-Y., Xi, T., Lau, W.-Y., et al. Pathobiological features of small hepatocellular carcinoma: correlation between tumor size and biological behavior. Journal of cancer research and clinical oncology. 137(4), 567-575. http://doi.org/10.1007/s00432-010-0909-5 (2011)
Mitsuhashi, N., Kobayashi, S., Doki, T., et al. Clinical significance of alpha-fetoprotein: involvement in proliferation, angiogenesis, and apoptosis of hepatocellular carcinoma. Journal of gastroenterology and hepatology. 23(7 Pt 2), e189-e197. http://doi.org/10.1111/j.1440-1746.2008.05340.x (2008)
Zheng, Y., Zhu, M. &Li, M. Effects of alpha-fetoprotein on the occurrence and progression of hepatocellular carcinoma. J Cancer Res Clin Oncol. 146(10), 2439-2446. http://doi.org/10.1007/s00432-020-03331-6 (2020)
Tateishi, R., Shiina, S., Yoshida, H., et al. Prediction of recurrence of hepatocellular carcinoma after curative ablation using three tumor markers. Hepatology (Baltimore, Md.). 44(6), 1518-1527. (2006)
Ueno, M., Hayami, S., Shigekawa, Y., et al. Prognostic impact of surgery and radiofrequency ablation on single nodular HCC ⩽5 cm: Cohort study based on serum HCC markers. Journal of hepatology. 63(6), 1352-1359. http://doi.org/10.1016/j.jhep.2015.07.013 (2015)
Grivennikov, S.I., Greten, F.R. &Karin, M. Immunity, inflammation, and cancer. Cell. 140(6), 883-899. http://doi.org/10.1016/j.cell.2010.01.025 (2010)
Cruz, J.C., Watchmaker, J.M., Albin, M.M., et al. Neutrophil/Lymphocyte Ratio Predicts Increased Risk of Immediate Progressive Disease following Chemoembolization of Hepatocellular Carcinoma. Journal of vascular and interventional radiology : JVIR. 30(12), 1887-1892. http://doi.org/10.1016/j.jvir.2019.08.001 (2019)
Mano, Y., Shirabe, K., Yamashita, Y.-I., et al. Preoperative neutrophil-to-lymphocyte ratio is a predictor of survival after hepatectomy for hepatocellular carcinoma: a retrospective analysis. Annals of surgery. 258(2), 301-305. http://doi.org/10.1097/SLA.0b013e318297ad6b (2013)
Huang, J., Zhao, Y., Liao, L., et al. Evaluation of Red Cell Distribution Width to Lymphocyte Ratio as Potential Biomarker for Detection of Colorectal Cancer. Biomed Res Int. 2019, 9852782. http://doi.org/10.1155/2019/9852782 (2019)
Wang, S., Deng, Y., Yu, X., et al. Prognostic significance of preoperative systemic inflammatory biomarkers in patients with hepatocellular carcinoma after microwave ablation and establishment of a nomogram. Scientific reports. 11(1), 13814. http://doi.org/10.1038/s41598-021-93289-3 (2021)
Wang, C., Zhao, K., Hu, S., et al. A predictive model for treatment response in patients with locally advanced esophageal squamous cell carcinoma after concurrent chemoradiotherapy: based on SUVmean and NLR. BMC cancer. 20(1), 544. http://doi.org/10.1186/s12885-020-07040-8 (2020)
Rashid, F., Waraich, N., Bhatti, I., et al. A pre-operative elevated neutrophil: lymphocyte ratio does not predict survival from oesophageal cancer resection. World journal of surgical oncology. 8, 1. http://doi.org/10.1186/1477-7819-8-1 (2010)
Chen, Y., Yang, Y., Zhang, X.-Y., et al. Nomogram Based on Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio to Predict Recurrence in Patients with Hepatocellular Carcinoma after Radiofrequency Ablation. Cardiovascular and interventional radiology. http://doi.org/10.1007/s00270-021-02872-8 (2021)
Goyal, H. &Hu, Z.D. Prognostic value of red blood cell distribution width in hepatocellular carcinoma. Ann Transl Med. 5(13), 271. http://doi.org/10.21037/atm.2017.06.30 (2017)
Wu, J., Zhang, X., Liu, H., et al. RDW, NLR and RLR in predicting liver failure and prognosis in patients with hepatitis E virus infection. Clin Biochem. 63, 24-31. http://doi.org/10.1016/j.clinbiochem.2018.11.012 (2019)
Zhang, X., Wang, D., Chen, Z., et al. Red cell distribution width-to-lymphocyte ratio: A novel predictor for HBV-related liver cirrhosis. Medicine. 99(23), e20638. http://doi.org/10.1097/MD.0000000000020600 (2020)
Artículos relacionados

Editorial

Hemofilia y hepatología, un regreso al futuro

DOI: 10.17235/reed.2024.10105/2023

Carta

Recurrencia del schwannoma gástrico

DOI: 10.17235/reed.2023.9480/2023

Imagen en Patología Digestiva

Hepatocarcinoma quístico gigante en ausencia de cirrosis

DOI: 10.17235/reed.2021.8313/2021

Carta

Biopsia en el carcinoma hepatocelular: solo en ocasiones

DOI: 10.17235/reed.2020.6935/2020

Carta

Diagnóstico de hepatocarcinoma. Una reflexión necesaria

DOI: 10.17235/reed.2020.6845/2019

Carta

Rabdomiolisis en paciente en tratamiento con sorafenib

DOI: 10.17235/reed.2020.6440/2019

Caso Clínico

Hepatocarcinoma sobre hígado ectópico peritoneal

DOI: 10.17235/reed.2019.6408/2019

Imagen en Patología Digestiva

Debut de cirrosis hepática poco habitual

Instrucciones para citar
Chu W, Li P, Wu X, Zhang P, Zhou H, Niu B, et all. Risk factors for recurrence beyond Milan criteria after radiofrequency ablation in transplantable small hepatocellular carcinoma. 8592/2022


Descargar en un gestor de citas

Descargue la cita de este artículo haciendo clic en uno de los siguientes gestores de citas:

Métrica
Este artículo ha sido visitado 1349 veces.
Este artículo ha sido descargado 75 veces.

Estadísticas de Dimensions


Estadísticas de Plum Analytics

Ficha Técnica

Recibido: 11/01/2022

Aceptado: 18/01/2022

Prepublicado: 19/01/2022

Publicado: 07/10/2022

Tiempo de revisión del artículo: 6 días

Tiempo de prepublicación: 8 días

Tiempo de edición del artículo: 269 días


Compartir
Este artículo ha sido valorado por 1 lectores .
Valoración del lector:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
La REED es el órgano oficial de la Sociedad Española de Patología Digestiva, la SociedadEspañola de Endoscopia Digestiva y la Asociación Española de Ecografía Digestiva
Política de cookies Política de Privacidad Aviso Legal © Copyright 2023 y Creative Commons. Revista Española de Enfermedades Digestivas