Uni-, Bi- or Trifocal Hepatocellular Carcinoma in Western Patients: Recurrence and Survival after Percutaneous Thermal Ablation
Multifocality is usually reported as a pejorative factor after percutaneous thermal ablation (PTA) of HCC but little is known in Western series. Recurrence and survival were extracted from a prospective database of all patients who underwent PTA for <i>≤</i>3 cm HCC. From January 2015 to...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-05-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/11/2700 |
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| author | Ancelin Preel Margaux Hermida Carole Allimant Eric Assenat Chloé Guillot Cecilia Gozzo Serge Aho-Glele Georges-Philippe Pageaux Christophe Cassinotto Boris Guiu |
| author_facet | Ancelin Preel Margaux Hermida Carole Allimant Eric Assenat Chloé Guillot Cecilia Gozzo Serge Aho-Glele Georges-Philippe Pageaux Christophe Cassinotto Boris Guiu |
| author_sort | Ancelin Preel |
| collection | DOAJ |
| description | Multifocality is usually reported as a pejorative factor after percutaneous thermal ablation (PTA) of HCC but little is known in Western series. Recurrence and survival were extracted from a prospective database of all patients who underwent PTA for <i>≤</i>3 cm HCC. From January 2015 to April 2020, we analyzed 281 patients with unifocal (<i>n</i> = 216), bifocal (<i>n</i> = 46) and trifocal (<i>n</i> = 16) HCC. PTA of bi- and trifocal HCC resulted in a high risk of very early (<6 months) distant recurrence (38.8% and 50%, respectively). Median RFS was 23.3 months (95% CI:18.6–30.4), 7.7 months (95% CI:5.1–11.43, <i>p</i> = 0.002) and 5.2 months (95% CI:3–12.3, <i>p</i> = 0.015), respectively, for uni-, bi- and trifocal HCC groups. In a multivariate analysis, both bifocal (HR = 2.46, <i>p</i> < 0.001) and trifocal (HR = 2.70, <i>p</i> = 0.021) vs. unifocal HCC independently predicted shorter RFS. Median OS in trifocal HCC group was 30.3 months (95 CI:19.3-not reached). Trifocal vs. unifocal HCC independently predicted shorter OS (HR = 3.30, <i>p</i> = 0.008), whereas bifocal vs. unifocal HCC did not (<i>p</i> = 0.27). Naïve patient (HR = 0.42, <i>p</i> = 0.007), AFP > 100 ng/mL (HR = 3.03, <i>p</i> = 0.008), MELD > 9 (HR = 2.84, <i>p</i> = 0.001) and steatotic HCC (HR = 0.12, <i>p</i> = 0.038) were also independent predictors of OS. In conclusion, multifocal HCCs in a Western population have a dramatically increased risk of distant recurrence. OS after PTA of trifocal HCC is significantly below what was expected after a curative treatment. |
| first_indexed | 2024-03-10T10:53:10Z |
| format | Article |
| id | doaj.art-e9f4b9628ead47f7aeca9d2c1d2fa105 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T10:53:10Z |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-e9f4b9628ead47f7aeca9d2c1d2fa1052023-11-21T22:05:50ZengMDPI AGCancers2072-66942021-05-011311270010.3390/cancers13112700Uni-, Bi- or Trifocal Hepatocellular Carcinoma in Western Patients: Recurrence and Survival after Percutaneous Thermal AblationAncelin Preel0Margaux Hermida1Carole Allimant2Eric Assenat3Chloé Guillot4Cecilia Gozzo5Serge Aho-Glele6Georges-Philippe Pageaux7Christophe Cassinotto8Boris Guiu9Department of Radiology, St-Eloi University Hospital, 34980 Montpellier, FranceDepartment of Radiology, St-Eloi University Hospital, 34980 Montpellier, FranceDepartment of Radiology, St-Eloi University Hospital, 34980 Montpellier, FranceDepartment of Oncology, St-Eloi University Hospital, 34295 Montpellier, FranceDepartment of Radiology, St-Eloi University Hospital, 34980 Montpellier, FranceDepartment of Radiology, St-Eloi University Hospital, 34980 Montpellier, FranceDepartment of Epidemiology & Biostatistics, Dijon University Hospital, 21000 Dijon, FranceDepartment of Hepatology, St-Eloi University Hospital, 34295 Montpellier, FranceDepartment of Radiology, St-Eloi University Hospital, 34980 Montpellier, FranceDepartment of Radiology, St-Eloi University Hospital, 34980 Montpellier, FranceMultifocality is usually reported as a pejorative factor after percutaneous thermal ablation (PTA) of HCC but little is known in Western series. Recurrence and survival were extracted from a prospective database of all patients who underwent PTA for <i>≤</i>3 cm HCC. From January 2015 to April 2020, we analyzed 281 patients with unifocal (<i>n</i> = 216), bifocal (<i>n</i> = 46) and trifocal (<i>n</i> = 16) HCC. PTA of bi- and trifocal HCC resulted in a high risk of very early (<6 months) distant recurrence (38.8% and 50%, respectively). Median RFS was 23.3 months (95% CI:18.6–30.4), 7.7 months (95% CI:5.1–11.43, <i>p</i> = 0.002) and 5.2 months (95% CI:3–12.3, <i>p</i> = 0.015), respectively, for uni-, bi- and trifocal HCC groups. In a multivariate analysis, both bifocal (HR = 2.46, <i>p</i> < 0.001) and trifocal (HR = 2.70, <i>p</i> = 0.021) vs. unifocal HCC independently predicted shorter RFS. Median OS in trifocal HCC group was 30.3 months (95 CI:19.3-not reached). Trifocal vs. unifocal HCC independently predicted shorter OS (HR = 3.30, <i>p</i> = 0.008), whereas bifocal vs. unifocal HCC did not (<i>p</i> = 0.27). Naïve patient (HR = 0.42, <i>p</i> = 0.007), AFP > 100 ng/mL (HR = 3.03, <i>p</i> = 0.008), MELD > 9 (HR = 2.84, <i>p</i> = 0.001) and steatotic HCC (HR = 0.12, <i>p</i> = 0.038) were also independent predictors of OS. In conclusion, multifocal HCCs in a Western population have a dramatically increased risk of distant recurrence. OS after PTA of trifocal HCC is significantly below what was expected after a curative treatment.https://www.mdpi.com/2072-6694/13/11/2700liver cancermetastasisprognosisradiofrequency ablationmicrowave ablation |
| spellingShingle | Ancelin Preel Margaux Hermida Carole Allimant Eric Assenat Chloé Guillot Cecilia Gozzo Serge Aho-Glele Georges-Philippe Pageaux Christophe Cassinotto Boris Guiu Uni-, Bi- or Trifocal Hepatocellular Carcinoma in Western Patients: Recurrence and Survival after Percutaneous Thermal Ablation Cancers liver cancer metastasis prognosis radiofrequency ablation microwave ablation |
| title | Uni-, Bi- or Trifocal Hepatocellular Carcinoma in Western Patients: Recurrence and Survival after Percutaneous Thermal Ablation |
| title_full | Uni-, Bi- or Trifocal Hepatocellular Carcinoma in Western Patients: Recurrence and Survival after Percutaneous Thermal Ablation |
| title_fullStr | Uni-, Bi- or Trifocal Hepatocellular Carcinoma in Western Patients: Recurrence and Survival after Percutaneous Thermal Ablation |
| title_full_unstemmed | Uni-, Bi- or Trifocal Hepatocellular Carcinoma in Western Patients: Recurrence and Survival after Percutaneous Thermal Ablation |
| title_short | Uni-, Bi- or Trifocal Hepatocellular Carcinoma in Western Patients: Recurrence and Survival after Percutaneous Thermal Ablation |
| title_sort | uni bi or trifocal hepatocellular carcinoma in western patients recurrence and survival after percutaneous thermal ablation |
| topic | liver cancer metastasis prognosis radiofrequency ablation microwave ablation |
| url | https://www.mdpi.com/2072-6694/13/11/2700 |
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