Subsequent therapy and its effect analysis on local tumor progression of primary liver cancer after thermal ablation

Abstract

Objective To investigate the subsequent therapy and its effect for local tumor progression (LTP) of primary liver cancer after thermal ablation. Methods Clinical data of 22 patients with LTP of primary liver cancer after thermal ablation in the Third Affiliated Hospital of Sun Yat-sen University between January 2008 and December 2012 were retrospectively analyzed. Among the patients, 17 were males and 5 were females with the age ranging from 38 to 77 years old and the median of 56 years old. The informed consents of all patients were obtained and the local ethical committee approval was received. A total of 30 lesions of LTP in the 22 patients were included in this study. The lesions were divided into the single treatment group (n=21) and the combined treatment group (n=9) according to the different subsequent therapies. Patients in the single treatment group were treated with single method of radiofrequency ablation (RFA) or microwave ablation, while patients in the combined treatment group were treated with transcatheter arterial chemoembolization (TACE) or percutaneous ethanol injection combined with RFA. Appropriate auxiliary means of thermal ablation, such as artificial pleural/peritoneal effusion, one-lung ventilation and ultrasonography were utilized in both groups. The complete ablation rate of tumor and complication incidence rate in two groups were compared. The rate was compared using Chi-square test or Fisher's exact probability test. Results Seventy-three percent (22/30) of the lesions were treated with auxiliary means. The complete ablation rate was 90% (19/21) in the single ablation group and 7/9 in the combined treatment group, and no significant difference was observed between two groups ( P=0.563). No serious complication was observed in two groups. Conclusion With the application of various auxiliary therapies, single thermal ablation may achieve the therapeutic effect as good as the combined treatment for the LTP lesions of primary liver cancer after thermal ablation. Key words: Liver neoplasms; Ablation techniques; Neoplasm recurrence, local; Therapeutic effect