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Xiao Q, Chen P, Chen M, Zhou Y, Li J, Lun Y, Li Q, Ye G. Design of an imaging magnetic microsphere based on photopolymerization for magnetic hyperthermia in tumor therapy. Drug Deliv Transl Res 2023; 13:2664-2676. [PMID: 37130996 DOI: 10.1007/s13346-023-01347-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2023] [Indexed: 05/04/2023]
Abstract
Magnetic hyperthermia therapy has been widely used in the nonsurgical treatment of patients with advanced stage cancers that cannot be treated by surgery. It is minimally invasive, precise, and highly efficient and has a good curative effect. In this paper, a magnetic microsphere with Fe3O4 was prepared for thermal therapy and imaging based on a photoinitiated suspension polymerization method from biallelic monomers. The preparation method clearly minimized the degradative chain transfer of allyl polymerization reactions. The microspheres were characterized by microscope observation, spectral analysis, thermal analysis, and magnetic testing. The magnetothermal effect was detected by an infrared thermal imager in vitro and in vivo under a high-frequency alternating magnetic field (AMF). The antitumor effect was verified by testing the viability of H22 cells and observing a tumor-bearing mouse model under high-frequency AMF. Biocompatibility was evaluated by cell viability assay, tissue section observation, and blood biochemical analysis. The imaging capacity was tested by X-ray, MRI, and CT imaging experiments. The results show that the product has good dispersibility, thermal stability, superparamagnetism, and biocompatibility. Under the action of an AMF, the magnetic hyperthermia effect in tumor-bearing mice was better, and an antitumor effect could be achieved.
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Affiliation(s)
- Qinglin Xiao
- Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, the NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences and the Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou, 511436, China
| | - Piaoyi Chen
- Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, the NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences and the Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou, 511436, China
| | - Mianrong Chen
- Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, the NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences and the Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou, 511436, China
- The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, People's Republic of China
| | - Yanfang Zhou
- Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, the NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences and the Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou, 511436, China
| | - Jiesong Li
- Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, the NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences and the Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou, 511436, China
| | - Yingying Lun
- Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, the NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences and the Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou, 511436, China
| | - Qiuxia Li
- Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, the NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences and the Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou, 511436, China
| | - Guodong Ye
- Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, the NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences and the Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou, 511436, China.
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Cassinotto C, Nogue E, Durand Q, Panaro F, Assenat E, Dohan A, Malafaye N, Guiu B, Molinari N. Life expectancy of patients with hepatocellular carcinoma according to the upfront treatment: A nationwide analysis. Diagn Interv Imaging 2023; 104:192-199. [PMID: 36682959 DOI: 10.1016/j.diii.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 01/22/2023]
Abstract
PURPOSE The purpose of this study was to update the life expectancy of patients with hepatocellular carcinoma (HCC) in an exhaustive nationwide population according to the upfront treatment performed. MATERIALS AND METHODS From the French Program for the Medicalization of Information System database, all patients older than 18 years diagnosed with a de novo HCC from January 2011 to December 2018 were retrospectively selected. Five-year survival rates (95% confidence intervals [CI]) were computed according to the first surgical or interventional radiology procedures performed. RESULTS A total of 63,996 patients (80% men) with a median age of 68 years (Q1, Q3: 61, 77) were selected, including 24,007 patients who underwent at least one procedure (5-year survival of 45.5%; (95% CI: 44.8-46.2), and 39,989 with none (5-year survival, 9.6%; (95% CI: 9.3-10.0). Only 20.5% (13,101/63,996) of patients could undergo an upfront curative procedure. Liver transplantation achieved the best outcome, whether performed upfront (n = 791; 5-year survival, 79.0% [95% CI: 76.1-82.1]) or during subsequent steps (n = 2217; 5-year survival 80.9% [95% CI: 79.2-82.7]). Tumor ablation (n = 5306), open resection (n = 5171), and minimally-invasive resection (n = 1833) achieved 5-year survival rates of 53.8% (95% CI: 52.3-55.4), 54.1% (95% CI: 52.6-55.6), and 66.2% (95% CI: 63.7-68.7), respectively, with more patients with cirrhosis and subsequent procedures in the tumor ablation group. Patients with upfront transarterial (chemo)embolization (n = 10,247) and selective internal radiation therapy (n = 659) had 5-year survival rates of 31.3% (95% CI: 30.3-32.4) and 18.5% (95% CI: 15.2-22.5). CONCLUSION While HCC remains mostly diagnosed at an advanced stage associated with a poor prognosis, all the curative options provide 5-year survival rates above 50%.
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Affiliation(s)
- Christophe Cassinotto
- Department of Diagnostic and Interventional Radiology, Saint-Eloi Hospital, University Hospital of Montpellier, 34090 Montpellier, France; Institut Desbrest d'Epidémiologie et de Santé Publique, IDESP UMR UA11 INSERM, University Hospital of Montpellier, 34090 Montpellier, France.
| | - Erika Nogue
- Clinical Research and Epidemiology Unit, University Hospital of Montpellier, Montpellier University, 34090 Montpellier, France
| | - Quentin Durand
- Department of Diagnostic and Interventional Radiology, Saint-Eloi Hospital, University Hospital of Montpellier, 34090 Montpellier, France
| | - Fabrizio Panaro
- Department of Surgery/ Division of HBP Surgery and Transplantation, Saint-Eloi Hospital, University Hospital of Montpellier, 34090 Montpellier, France
| | - Eric Assenat
- Department of Oncology, Saint-Eloi Hospital, University Hospital of Montpellier, 34090 Montpellier, France
| | - Anthony Dohan
- Department of Radiology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France; Université Paris Cité, Faculté de Médecine, 75006 Paris, France
| | - Nicolas Malafaye
- Clinical Research and Epidemiology Unit, University Hospital of Montpellier, Montpellier University, 34090 Montpellier, France
| | - Boris Guiu
- Department of Diagnostic and Interventional Radiology, Saint-Eloi Hospital, University Hospital of Montpellier, 34090 Montpellier, France; Institut Desbrest d'Epidémiologie et de Santé Publique, IDESP UMR UA11 INSERM, University Hospital of Montpellier, 34090 Montpellier, France
| | - Nicolas Molinari
- Institut Desbrest d'Epidémiologie et de Santé Publique, IDESP UMR UA11 INSERM, University Hospital of Montpellier, 34090 Montpellier, France; Clinical Research and Epidemiology Unit, University Hospital of Montpellier, Montpellier University, 34090 Montpellier, France
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Yang D, Su Y, Zhao F, Hu Y, Zhao K, Xiong X, Zhu M, Pei J, Ding Y. Low-grade hepatocellular carcinoma characteristics, a practical nomogram and risk stratification system: a SEER population-based study. Expert Rev Gastroenterol Hepatol 2022; 16:1115-1123. [PMID: 36412566 DOI: 10.1080/17474124.2022.2150610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The purpose of this study is to establish a nomogram and risk stratification system to predict OS in patients with low-grade HCC. RESEARCH DESIGN AND METHODS Data were extracted from the SEER database. C-index, time-dependent AUCs, and calibration plots were used to evaluate the effective performance of the nomogram. NRI, IDI, and DCA curves were adopted to compare the clinical utility of nomogram with AJCC. RESULTS 3415 patients with low-grade HCC were available. The C-indices for the training and validation cohorts were 0.773 and 0.772. The time-dependent AUCs in the training cohort were 0.821, 0.817, and 0.846 at 1, 3 and 5 years. Calibration plots for 1-, 3- and 5-year OS showed good consistency between actual observations and that predicted by the nomogram. The values of NRI at 1, 3, and 5 years were 0.37, 0.66, and 0.64. The IDI values at 1, 3, and 5 years were 0.11, 0.16, and 0.23 (P< 0.001). DCA curves demonstrated that the nomogram showed better ability of predicting 1-, 3-, and 5-year OS probabilities than AJCC. CONCLUSIONS A nomogram and risk stratification system for predicting OS in patients with low-grade HCC were established and validated.
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Affiliation(s)
- Dashuai Yang
- Department of Hepatobiliary Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Yang Su
- Department of Gastrointestinal Surgery, Tongji Hospital, Tongji Medical College in Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Fangrui Zhao
- Department of Oncology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Yong Hu
- Departments of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Kailiang Zhao
- Department of Hepatobiliary Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Xiangyun Xiong
- Department of Hepatobiliary Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Mingqiang Zhu
- Department of Hepatobiliary Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Junpeng Pei
- Department of Hepatobiliary Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Youming Ding
- Department of Hepatobiliary Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
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Salem R, Tselikas L, De Baere T. Interventional treatment of hepatocellular carcinoma. J Hepatol 2022; 77:1205-1206. [PMID: 35705428 DOI: 10.1016/j.jhep.2022.03.037] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/19/2022] [Accepted: 03/22/2022] [Indexed: 12/22/2022]
Affiliation(s)
- Riad Salem
- Department of Radiology, Northwestern Feinberg School of Medicine, Chicago, IL, USA
| | - Lambros Tselikas
- Interventional Radiology, Gustave Roussy, Université Paris-Saclay, Villejuif, France.
| | - Thierry De Baere
- Interventional Radiology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
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Garcia-Monaco RD, Chung JW, Vilgrain V, Bouattour M, Covey AM. Summary of key guidelines for locoregional treatment of HCC in Asia, Europe, South and North America. Br J Radiol 2022; 95:20220179. [PMID: 35848758 PMCID: PMC9815746 DOI: 10.1259/bjr.20220179] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 06/01/2022] [Accepted: 07/13/2022] [Indexed: 01/26/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide accounting for over 800,000 new cases in 2018, with the highest incidence in Asia and Africa where hepatitis B is the most common risk factor. In Europe, Japan, and the United States, hepatitis C chronic alcohol abuse and non-alcoholic fatty liver disease are more common risk factors. Five-year survival is low, less than 20% worldwide. HCC is a particularly challenging disease to treat because therapeutic options and prognosis must also consider hepatitis or cirrhosis independent of the malignancy. Locoregional therapies (LRT) including ablation, arterially directed therapy and external beam radiation are the preferred treatments for patients with good performance status, unresectable disease limited to the liver and preserved liver function. In practice, patients with portal vein tumor thrombus and limited extrahepatic disease may also be considered candidates for LRT. There are several guidelines developed by expert panels provide recommendations on treating this challenging disease including the Barcelona Clinic Liver Cancer, European Association for the Study of the Liver, European Society for Medical Oncology, American Association for the Study of the Liver Diseases, and the National Comprehensive Cancer Network. The purpose of this paper is to review the guidelines as they are applied clinically in regions with high incidence of HCC.
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Affiliation(s)
- Ricardo D Garcia-Monaco
- Vascular and Interventional Radiology Hospital Italiano, University of Buenos Aires, Buenos Aires, Argentina
| | - Jin Wook Chung
- Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea
| | - Valérie Vilgrain
- Department of Radiology, Department of OncHepatology Hopital Beaujon, APHP.Nord, Clichy, France
| | - Mohamed Bouattour
- Department of Radiology, Department of OncHepatology Hopital Beaujon, APHP.Nord, Clichy, France
| | - Anne M Covey
- Memorial Sloan Kettering Cancer Center Professor of Radiology, Weill Cornell Medical Center, New York, United States
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Jost R, Al-Shatti N, Ghosn M, Bonnet B, Champiat S, Deschamps F, Gelli M, Boige V, Danlos FX, Susini S, Hollebecque A, Ammari S, Marabelle A, de Baere T, Tselikas L. Synergizing liver systemic treatments with interventional oncology: friend or foe? Br J Radiol 2022; 95:20220548. [PMID: 36075034 PMCID: PMC9815737 DOI: 10.1259/bjr.20220548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/20/2022] [Accepted: 08/24/2022] [Indexed: 01/13/2023] Open
Abstract
Interventional radiology techniques provide excellent local tumor control for small tumors in various organs, but several limitations can hamper the oncological outcomes such as the tumor size or the number of lesions. Technical improvements, optimal patient selection and combination with systemic therapies, including immune checkpoint inhibitors, have been successfully developed to overcome these barriers.In this setting, chemotherapy and targeted therapies aim to diminish the tumor burden in addition to local treatments, while immunotherapies may have a synergistic effect in terms of mechanism of action on the tumor cell as well as the immune environment, with multiple treatment combinations being available. Finally, interventional Rrdiology treatments often increase tumor antigen exposure to the immune system, and thus stimulate a specific antitumor immune response that can act beyond the treated site. Notwithstanding their many benefits, combination treatment may also result in complications, the most feared may be auto-immune-related adverse events.In early studies, several combined therapies have shown promising levels of safety and efficacy, particularly in hepatocellular carcinoma.This review provides a comprehensive and up-to-date overview of results of combined therapies for primary and secondary liver malignancies. Recent advances and future perspectives will be discussed.
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Affiliation(s)
- Raphaël Jost
- Département d’Anésthésie, Chirurgie et Imagerie Interventionnelle, Gustave Roussy, Villejuif, France
| | | | - Mario Ghosn
- Département d’Anésthésie, Chirurgie et Imagerie Interventionnelle, Gustave Roussy, Villejuif, France
| | - Baptiste Bonnet
- Département d’Anésthésie, Chirurgie et Imagerie Interventionnelle, Gustave Roussy, Villejuif, France
| | | | - Frederic Deschamps
- Département d’Anésthésie, Chirurgie et Imagerie Interventionnelle, Gustave Roussy, Villejuif, France
| | - Maximiliano Gelli
- Département d’Anésthésie, Chirurgie et Imagerie Interventionnelle, Gustave Roussy, Villejuif, France
| | - Valérie Boige
- Department of medical oncology, Gustave Roussy, Villejuif, France
| | | | | | - Antoine Hollebecque
- Département d’Innovation Thérapeutique et d’Essais Précoces (DITEP), Gustave Roussy, Villejuif, France
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Gozzo C, Hermida M, Herrero A, Panaro F, Cassinotto C, Mohamad AM, Assenat E, Guillot C, Allimant C, Schembri V, Basile A, Dharancy S, Ursic-Bedoya J, Guiu B. Non-transplantable recurrence after percutaneous thermal ablation of ≤3-cm HCC: Predictors and implications for treatment allocation. Hepatol Commun 2022; 6:2975-2987. [PMID: 35932178 PMCID: PMC9512464 DOI: 10.1002/hep4.2063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/27/2022] [Accepted: 07/02/2022] [Indexed: 12/02/2022] Open
Abstract
Percutaneous thermal ablation (PTA), resection, and liver transplantation are the standard curative options for hepatocellular carcinoma (HCC). Liver transplantation yields the best long‐term outcomes but is limited by graft shortage. Thus, patients with ≤3‐cm HCC are primarily treated by PTA even though recurrence is frequent and may occur outside transplant criteria. Data on non‐transplantable recurrence (NTR) following PTA are lacking, however. We therefore investigated the incidence and predictors of NTR among 213 potentially transplantable patients (cirrhosis, 93%; Child‐Pugh A, 98.6%; alcohol‐related disease, 62%) with ≤3‐cm HCC(s) treated by PTA, to stratify them according to their NTR risk and to improve treatment allocation. During follow‐up (median: 41.2 months), NTR occurred in 18.3% (alpha‐fetoprotein [AFP] model) and 23% (Milan) patients. NTR prediction with competing‐risk analysis and internal validation revealed AFP > 100 ng/ml (subdistribution hazard ratio: 7.28; p < 0.001) and prior HCC (subdistribution hazard ratio: 3.77; p = 0.002) as independent predictors (Harrell's C: 0.76). Based on this model using the AFP score (equally predictive within Milan criteria), patients were stratified into three NTR risk categories: HCC‐naïve with AFP < 100 ng/ml (low risk, n = 108 of 213), non‐HCC naïve with AFP < 100 ng/ml (intermediate risk, n = 92 of 213), AFP ≥ 100 ng/ml (high risk, n = 13 of 213), among whom 9.3% (3.7% [Milan]), 22.8% (25% [Milan]), and 61.5% (38/5% [Milan]) presented NTR (p < 0.001). Median recurrence‐free survival was 4.6, 14.5, and 43.4 months, respectively, in high‐risk, intermediate‐risk, and low‐risk categories (p < 0.001). Median overall survival, which was 19.1 months in high‐risk patients, was not reached otherwise (p < 0.001). Conclusion: Overall, PTA of ≤3‐cm HCC incurs a low NTR risk. Simple and noninvasive predictors (HCC naivety, AFP) accurately stratified patients' risk of NTR, and should help to improve treatment allocation. Patients with AFP ≥ 100 ng/ml have a high risk of NTR, poor recurrence‐free survival, and overall survival. Further studies evaluating preemptive transplantation or adjuvant/neoadjuvant strategies are highly needed in this small patient subset.
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Affiliation(s)
- Cecilia Gozzo
- Department of Radiology, St-Eloi University Hospital, Montpellier, France.,Radiodiagnostic and Radiotherapy Unit, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Margaux Hermida
- Department of Radiology, St-Eloi University Hospital, Montpellier, France
| | - Astrid Herrero
- Department of Liver Surgery, St-Eloi University Hospital, Montpellier, France
| | - Fabrizio Panaro
- Division of HBP Surgery & Transplantation, Department of Surgery, Montpellier University Hospital, Montpellier, France
| | | | | | - Eric Assenat
- Department of Oncology, St-Eloi University Hospital, Montpellier, France.,Department of Hepatology, St-Eloi University Hospital, Montpellier, France
| | - Chloé Guillot
- Department of Radiology, St-Eloi University Hospital, Montpellier, France
| | - Carole Allimant
- Department of Radiology, St-Eloi University Hospital, Montpellier, France
| | - Valentina Schembri
- Department of Radiology, St-Eloi University Hospital, Montpellier, France
| | - Antonio Basile
- Radiodiagnostic and Radiotherapy Unit, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | | | - José Ursic-Bedoya
- Department of Liver Surgery, St-Eloi University Hospital, Montpellier, France
| | - Boris Guiu
- Department of Radiology, St-Eloi University Hospital, Montpellier, France
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Minier C, Hermida M, Allimant C, Escal L, Pierredon-Foulongne MA, Belgour A, Piron L, Taourel P, Cassinotto C, Guiu B. Software-based assessment of tumor margins after percutaneous thermal ablation of liver tumors: A systematic review. Diagn Interv Imaging 2022; 103:240-250. [PMID: 35246412 DOI: 10.1016/j.diii.2022.02.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/01/2022] [Accepted: 02/08/2022] [Indexed: 12/21/2022]
Abstract
PURPOSE The purpose of this study was to make a systematic review of clinical studies evaluating software-based tumor margin assessment after percutaneous thermoablation (PTA) of liver tumors. MATERIALS AND METHODS A systematic literature search was performed through Pubmed/MEDLINE, Embase and the Cochrane Library. Original studies published in English that reported on software-based assessment of ablation margins (AM) following PTA of liver tumors were selected. Studies were analyzed with respect to design, number of patients and tumors, tumor type, PTA technique, tumor size, target registration error, study outcome(s) (subtypes: feasibility, comparative, clinical impact, predictive or survival), and follow-up period. RESULTS Twenty-nine articles (one multi-center and two prospective studies) were included. The majority were feasibility (26/29, 89.7%) or predictive (23/29, 79.3%) studies. AM was a risk factor of local tumor progression (LTP) in 25 studies (25/29, 86.2%). In nine studies (9/29, 31%) visual assessment overestimated AM compared with software-aided assessment. LTP occurred at the location of the thinnest margin in nine studies (9/29, 31%). Time for registration and analysis was heterogeneously reported, ranging between 5-30 min. Mean target registration error was reported in seven studies (7/29, 24.1%) at 1.62 mm (range: 1.20-2.23 mm). Inter-operator reproducibility was high (kappa range: 0.686-1). Ascites, liver deformation and inconspicuous tumor were major factors of co-registration error. CONCLUSION Available studies present a low level of evidence overall, since most of them are feasibility, retrospective and single-center studies.
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Affiliation(s)
- Chloé Minier
- Department of Radiology, St-Eloi University Hospital, 34090, Montpellier, France
| | - Margaux Hermida
- Department of Radiology, St-Eloi University Hospital, 34090, Montpellier, France
| | - Carole Allimant
- Department of Radiology, St-Eloi University Hospital, 34090, Montpellier, France
| | - Laure Escal
- Department of Radiology, St-Eloi University Hospital, 34090, Montpellier, France
| | | | - Ali Belgour
- Department of Radiology, St-Eloi University Hospital, 34090, Montpellier, France
| | - Lauranne Piron
- Department of Radiology, St-Eloi University Hospital, 34090, Montpellier, France
| | - Patrice Taourel
- Department of Radiology, Lapeyronie University Hospital, 34090, Montpellier, France
| | | | - Boris Guiu
- Department of Radiology, St-Eloi University Hospital, 34090, Montpellier, France.
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Guiu B, Garin E, Allimant C, Edeline J, Salem R. TARE in Hepatocellular Carcinoma: From the Right to the Left of BCLC. Cardiovasc Intervent Radiol 2022; 45:1599-1607. [PMID: 35149884 DOI: 10.1007/s00270-022-03072-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/23/2022] [Indexed: 02/06/2023]
Abstract
The Barcelona Clinic Liver Cancer (BCLC) system is the most commonly used staging system for hepatocellular carcinoma (HCC) in Western countries. BCLC aims to categorize patients into five stages with different prognoses and to allocate treatment according to these stages based on the best possible contemporary evidence. Transarterial radioembolization (TARE) has recently entered at the left of the BCLC algorithm (i.e., BCLC 0-A), mainly because of negative phase III trials in BCLC C stage. TARE has shown a steady increase in nationwide studies over the past 20 years and has even been adopted in some tertiary centers as the primary HCC treatment across all BCLC stages. We aimed to review the history of TARE in HCC, starting from advanced HCC and gradually expanding to earlier stages at the left of the BCLC system.
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Affiliation(s)
- Boris Guiu
- Department of Radiology, St-Eloi University Hospital, 80 Avenue Augustin Fliche, 34295, Montpellier, France.
| | - Etienne Garin
- Department of Nuclear Medicine, Centre de Lutte Contre le Cancer Eugène Marquis, 35000, Rennes, France
| | - Carole Allimant
- Department of Radiology, St-Eloi University Hospital, 80 Avenue Augustin Fliche, 34295, Montpellier, France
| | - Julien Edeline
- Department of Oncology, Centre de Lutte Contre le Cancer Eugène Marquis, 35000, Rennes, France
| | - Riad Salem
- Section of Interventional Radiology, Department of Radiology, Northwestern University, Chicago, IL, 60611, USA
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