Circulating Tumor Cell Is a Clinical Indicator of Pretransplant Radiofrequency Ablation for Patients with Hepatocellular Carcinoma.

Zhitao Chen,Maogen Chen,Yihao Ma,Tielong Wang,Jia Yu,Changjun Huang,Xiaoshun He,Weiqiang Ju,Xitao Hong,Yiwen Guo,Chuanbao Chen,Irena Ilic

doi:10.1155/2021/7776389

Zhitao Chen, Maogen Chen + Show 10 more

Open Access

https://doi.org/10.1155/2021/7776389

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Abstract

Introduction It is of great significance to confirm reliable indicators for the guidance of pretransplant radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC). In this study, we aim to investigate whether circulating tumor cell (CTC) status is a clinical indicator for RFA before liver transplantation (LT) in HCC patients. Method CTC analyses were measured in 79 HCC patients. Clinical outcomes including progression-free (PFS) and overall survival (OS) were compared and analyzed between patients with and without pretransplant RFA. Result Forty-two patients were detected as CTC-positive and 18 patients received pretransplant RFA. Recurrence was correlated with CTC count (P=0.024), tumor number (P=0.035), liver cirrhosis (P=0.001), Milan criteria (P=0.003), and University of California San Francisco (UCSF) criteria (P=0.001). Kaplan–Meier analysis revealed that patients with CTC-positive had a lower PFS rate (P=0.0257). For CTC-positive patients, the PFS rate of the pretransplant RFA group was significantly higher than the non-pretransplant RFA group (100% vs. 46.7%, P=0.0236). For CTC-negative patients, both PFS rate and OS rate were similar and without significant differences. In multivariate analysis, pretransplant RFA was the independent factor for PFS (P=0.025). Conclusion Pretransplant CTC status can guide the administration of pretransplant RFA in HCC patients which can improve PFS in CTC-positive HCC patients.

Highlights

It is of great significance to confirm reliable indicators for the guidance of pretransplant radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC)
In patients for whom transplantation is not an option, local and systemic treatment are available as bridging therapy for HCC. ermal ablation, for example, radiofrequency ablation (RFA), is considered as the preferred treatment for local tumor control and used for bridging or downstaging HCC patients before liver transplantation (LT) [8]
We aim to investigate whether circulating tumor cell (CTC) status is a clinical indicator for RFA before LT in patients with HCC

Summary

Introduction

It is of great significance to confirm reliable indicators for the guidance of pretransplant radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC). We aim to investigate whether circulating tumor cell (CTC) status is a clinical indicator for RFA before liver transplantation (LT) in HCC patients. Forty-two patients were detected as CTC-positive and 18 patients received pretransplant RFA. Kaplan–Meier analysis revealed that patients with CTC-positive had a lower PFS rate (P 0.0257). In patients for whom transplantation is not an option (tumor size and numbers is beyond Milan criteria), local and systemic treatment are available as bridging therapy for HCC. Ermal ablation, for example, radiofrequency ablation (RFA), is considered as the preferred treatment for local tumor control and used for bridging or downstaging HCC patients before LT [8]. The current clinical use of RFA depends on the experiences based on the traditional tumor characteristics, like tumor size, tumor numbers, and alpha-fetoprotein (AFP), and whether

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