Comparison of no-touch multi-bipolar vs. monopolar radiofrequency ablation for small HCC

TitreComparison of no-touch multi-bipolar vs. monopolar radiofrequency ablation for small HCC
Type de publicationArticle de revue
AuteurHocquelet, Arnaud, Aubé, Christophe , Rode, Agnès, Cartier, Victoire , Sutter, Olivier, Manichon, Anne Frederique, Boursier, Jérôme , N'Kontchou, Gisèle, Merle, Philippe, Blanc, Jean-Frédéric, Trillaud, Hervé, Seror, Olivier
TypeArticle scientifique dans une revue à comité de lecture
DateJanvier 2017
Titre de la revueJournal of Hepatology
Mots-clésAdult, Aged, Carcinoma, Hepatocellular, Case-Control Studies, Catheter Ablation, Female, France, Humans, Liver neoplasms, Male, Middle Aged, Neoplasm Invasiveness, Neoplasm Recurrence, Local, Neoplasm Staging, Outcome Assessment (Health Care), Tumor Burden
Résumé en anglais

BACKGROUND & AIMS: The primary aim of this study was to compare the rate of global radiofrequency ablation (RFA) failure between monopolar RFA (MonoRFA) vs. no-touch multi-bipolar RFA (NTmbpRFA) for small hepatocellular carcinoma (HCC) ⩽5cm in cirrhotic patients.

METHODS: A total of 362 cirrhotic patients were included retrospectively across four French centres (181 per treatment group). Global RFA failure (primary RFA failure or local tumour progression) was analysed using the Kaplan-Meier method after coarsened exact matching. Cox regression models were used to identify factors associated with global RFA failure and overall survival (OS).

RESULTS: Patients were well matched according to tumour size (⩽30/>30mm); tumour number (one/several); tumour location (subcapsular and near large vessel); serum AFP (<10; 10-100; >100ng/ml); Child-Pugh score (A/B) and platelet count (30mm and HCC near large vessel were independent factors associated with global RFA failure. Five-year OS was 37.2% following MonoRFA vs. 46.4% following NTmbpRFA p=0.378.

CONCLUSIONS: This large multicentre case-matched study showed that NTmbpRFA provided better primary RFA success and sustained local tumour response without increasing severe complications rates, for HCC ⩽5cm.

LAY SUMMARY: Using no-touch multi-bipolar radiofrequency ablation for hepatocellular carcinoma ⩽5cm provide a better sustained local tumour control compared to monopolar radiofrequency ablation.

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Titre abrégéJ. Hepatol.
Identifiant (ID) PubMed27422750