Radiofrequency vs Microwave Ablation After Neoadjuvant Transarterial Bland and Drug-Eluting Microsphere Chembolization for the Treatment of Hepatocellular Carcinoma

Lindsay M. Thornton, Roniel Cabrera, Melissa Kapp, Michael Lazarowicz, Jeffrey D. Vogel, Beau B. Toskich

Research output: Contribution to journalArticle

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Abstract

Aim To retrospectively compare the initial response, local recurrence, and complication rates of radiofrequency ablation (RFA) vs microwave ablation (MWA) when combined with neoadjuvant bland transarterial embolization (TAE) or drug-eluting microsphere chemoembolization (TACE) for the treatment of hepatocellular carcinoma (HCC). Methods A total of 35 subjects with Barcelona Clinic Liver Cancer (BCLC) very early and early-stage HCC (range: 1.2-4.1 cm) underwent TAE (23) or TACE (12) with RFA (15) or microwave ablation (MWA) (20) from January 2009 to June 2015 as either definitive therapy or a bridge to transplant. TAE and TACE were performed with 40-400 μm particles and 30-100 μm plus either doxorubicin- or epirubicin-eluting microspheres, respectively. Initial response and local progression were evaluated using modified response evaluation criteria in solid tumors. Complications were graded using common terminology criteria for adverse events version 5.0. Results Complete response rates were 80% (12/15) for RFA + TAE/TACE and 95% (19/20) for MWA + TAE/TACE (P = 0.29). Local recurrence rate was 30% (4/12) for RFA + TAE/TACE and 0% (0/19) for MWA + TAE/TACE. Durability of response, defined as local disease control for duration of the study, demonstrated a significant difference in favor of MWA (P = 0.0091). There was no statistical difference in complication rates (3 vs 2). Conclusions MWA and RFA when combined with neoadjuvant TAE or TACE have similar safety and efficacy in the treatment of early-stage HCC. MWA provided more durable disease control in this study; however, prospective data remain necessary to evaluate superiority of either modality.

Original languageEnglish (US)
Pages (from-to)402-409
Number of pages8
JournalCurrent Problems in Diagnostic Radiology
Volume46
Issue number6
DOIs
StatePublished - Nov 2017

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Microwaves
Microspheres
Hepatocellular Carcinoma
Pharmaceutical Preparations
Recurrence
Epirubicin
Liver Neoplasms
Terminology
Doxorubicin
Transplants
Safety

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Radiofrequency vs Microwave Ablation After Neoadjuvant Transarterial Bland and Drug-Eluting Microsphere Chembolization for the Treatment of Hepatocellular Carcinoma. / Thornton, Lindsay M.; Cabrera, Roniel; Kapp, Melissa; Lazarowicz, Michael; Vogel, Jeffrey D.; Toskich, Beau B.

In: Current Problems in Diagnostic Radiology, Vol. 46, No. 6, 11.2017, p. 402-409.

Research output: Contribution to journalArticle

Thornton, Lindsay M. ; Cabrera, Roniel ; Kapp, Melissa ; Lazarowicz, Michael ; Vogel, Jeffrey D. ; Toskich, Beau B. / Radiofrequency vs Microwave Ablation After Neoadjuvant Transarterial Bland and Drug-Eluting Microsphere Chembolization for the Treatment of Hepatocellular Carcinoma. In: Current Problems in Diagnostic Radiology. 2017 ; Vol. 46, No. 6. pp. 402-409.
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abstract = "Aim To retrospectively compare the initial response, local recurrence, and complication rates of radiofrequency ablation (RFA) vs microwave ablation (MWA) when combined with neoadjuvant bland transarterial embolization (TAE) or drug-eluting microsphere chemoembolization (TACE) for the treatment of hepatocellular carcinoma (HCC). Methods A total of 35 subjects with Barcelona Clinic Liver Cancer (BCLC) very early and early-stage HCC (range: 1.2-4.1 cm) underwent TAE (23) or TACE (12) with RFA (15) or microwave ablation (MWA) (20) from January 2009 to June 2015 as either definitive therapy or a bridge to transplant. TAE and TACE were performed with 40-400 μm particles and 30-100 μm plus either doxorubicin- or epirubicin-eluting microspheres, respectively. Initial response and local progression were evaluated using modified response evaluation criteria in solid tumors. Complications were graded using common terminology criteria for adverse events version 5.0. Results Complete response rates were 80{\%} (12/15) for RFA + TAE/TACE and 95{\%} (19/20) for MWA + TAE/TACE (P = 0.29). Local recurrence rate was 30{\%} (4/12) for RFA + TAE/TACE and 0{\%} (0/19) for MWA + TAE/TACE. Durability of response, defined as local disease control for duration of the study, demonstrated a significant difference in favor of MWA (P = 0.0091). There was no statistical difference in complication rates (3 vs 2). Conclusions MWA and RFA when combined with neoadjuvant TAE or TACE have similar safety and efficacy in the treatment of early-stage HCC. MWA provided more durable disease control in this study; however, prospective data remain necessary to evaluate superiority of either modality.",
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AU - Kapp, Melissa

AU - Lazarowicz, Michael

AU - Vogel, Jeffrey D.

AU - Toskich, Beau B.

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AB - Aim To retrospectively compare the initial response, local recurrence, and complication rates of radiofrequency ablation (RFA) vs microwave ablation (MWA) when combined with neoadjuvant bland transarterial embolization (TAE) or drug-eluting microsphere chemoembolization (TACE) for the treatment of hepatocellular carcinoma (HCC). Methods A total of 35 subjects with Barcelona Clinic Liver Cancer (BCLC) very early and early-stage HCC (range: 1.2-4.1 cm) underwent TAE (23) or TACE (12) with RFA (15) or microwave ablation (MWA) (20) from January 2009 to June 2015 as either definitive therapy or a bridge to transplant. TAE and TACE were performed with 40-400 μm particles and 30-100 μm plus either doxorubicin- or epirubicin-eluting microspheres, respectively. Initial response and local progression were evaluated using modified response evaluation criteria in solid tumors. Complications were graded using common terminology criteria for adverse events version 5.0. Results Complete response rates were 80% (12/15) for RFA + TAE/TACE and 95% (19/20) for MWA + TAE/TACE (P = 0.29). Local recurrence rate was 30% (4/12) for RFA + TAE/TACE and 0% (0/19) for MWA + TAE/TACE. Durability of response, defined as local disease control for duration of the study, demonstrated a significant difference in favor of MWA (P = 0.0091). There was no statistical difference in complication rates (3 vs 2). Conclusions MWA and RFA when combined with neoadjuvant TAE or TACE have similar safety and efficacy in the treatment of early-stage HCC. MWA provided more durable disease control in this study; however, prospective data remain necessary to evaluate superiority of either modality.

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