Safety and Local Efficacy of Laser Ablation for the Extrahepatic Metastasis of Hepatocellular Carcinoma: An Available Treatment Strategy

Haiyi Long,Manxia Lin,Guangliang Huang,Xiaoyan Xie,Jianting Long,Baoxian Liu,Bowen Zhuang,Xiaoju Li

doi:10.3390/coatings10100951

Abstract

Thermal ablation plays an important role in the treatment of extrahepatic metastasis of hepatocellular carcinoma (HCC). Yet laser ablation (LA), as a safe thermal ablative modality, is less investigated in this field. In this study, the safety and local effectiveness of LA in the treatment for the extrahepatic metastasis of HCC were evaluated. From May 2012 to May 2019, 17 patients (13 males and 4 females; mean age, 54.1 ± 14.6 years; age range, 34–80 years), who underwent LA for treatment of extrahepatic metastasis of HCC at the First Affiliated Hospital of Sun Yat-sen University, were retrospectively enrolled in this study. Local effectiveness, complications, local tumor progression (LTP), and overall survival (OS) were evaluated. Finally, a total of 28 LA treated extrahepatic metastatic lesions of HCC were reviewed. Neither LA-related mortality nor major complication occurred. Complete ablation (CA) was achieved in 20 out of 28 lesions (71.4%). During the follow-up (mean, 19.5 ± 12.8 months; range, 5–42.7 months), LTP developed in 4 out of 20 lesions with CA (20%). Four patients died of tumor progression or multiple organ dysfunction syndrome. The accumulative one- and three-year OS rates were 79.0% and 65.8%, respectively. In conclusion, LA is a safe and effective therapeutic option in the treatment of extrahepatic metastasis of HCC. Further studies are necessary to evaluate the benefit of LA.

Highlights

Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide, claiming approximately 700,000 deaths per year [1,2]
The diagnosis and evaluation of extrahepatic metastatic lesions were based on imaging data including contrast-enhanced computed tomography (CECT), contrast-enhanced magnetic resonance imaging (CEMRI), contrast-enhanced ultrasound (CEUS) or positron emission tomography/computed tomography (PET/CT)
This study summarizes the percutaneous US-guided laser ablation (LA) in the treatment of extrahepatic metastasis of hepatocellular carcinoma (HCC) and the local efficacy and safety of such therapeutic methods are evaluated

Summary

Introduction

Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide, claiming approximately 700,000 deaths per year [1,2]. The Barcelona Clinic Liver Cancer (BCLC) staging system is a recommended staging model for HCC, endorsed by major academic societies of liver disease [3]. According to the BCLC staging, liver resection remains one of the first-line treatments for patients with early-stage HCC. For patients with advanced-stage HCC, systemic therapy is recommended and Sorafenib has acted as the first-line systemic agent in the past decade [6]. Other systemic agents such as Lenvatinib have shown noninferior performance in overall survival compared with Sorafenib in advanced HCC [7]

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