Stereotactic radiofrequency ablation as first-line treatment of recurrent HCC following hepatic resection
Menée à partir de données portant sur 34 patients présentant une ou plusieurs tumeurs hépatiques après récidive d'un carcinome hépatocellulaire traité par résection (âge médian : 67 ans ; 26 hommes), cette étude évalue l'efficacité, du point de vue de la récidive locale et de la survie globale, et la sécurité d'un traitement de première ligne comportant une ablation stéréotaxique par radiofréquence avec mise en place de plusieurs sondes
Background : To evaluate the therapeutic efficacy, safety and overall clinical outcome of multiprobe stereotactic RF ablation (SRFA) as first-line treatment of HCC recurrence after hepatic resection (HR). Study Design : In this retrospective single-center study, 34 consecutive patients with previous HR were treated by SRFA between 2006 and 2018 for 140 HCCs in 60 ablation sessions. Results : The median treated tumor size was 3.0 cm (range 0.5 to 10 cm). SRFA was primarily successful for 133/140 (95%) tumors. Four tumors were successfully retreated, resulting in a secondary technical efficacy rate of 97.9%. Local tumor recurrence developed in 4 of 140 tumors (2.9%). The major complication rate was 4.8% (3 of 60 ablations). No periprocedural deaths occurred. The overall survival (OS) rates at 1-, 3-, and 5- years from the date of the first SRFA were 94.0%, 70.2%, and 53.3%, respectively, with a median OS of 69.1 months (95% CI 18.8-119.3). The disease-free survival (DFS) was 52.6%, 19.7% and 15.8%, at 1-, 3- and 5- years, respectively, with a median DFS of 12.8 months (95% CI 9.0-28.9). Conclusion : Stereotactic RFA is a safe, feasible and useful option in the management of recurrent HCC following HR with low morbidity paired with good clinical outcome.