Dataset Information

Radiofrequency Ablation vs. Surgical Resection for Small Early-Stage Primary Intrahepatic Cholangiocarcinoma.

ABSTRACT: Aim: We aimed to compare the survival outcomes of radiofrequency ablation (RFA) and surgical resection (SR) for patients with small early-stage primary intrahepatic cholangiocarcinoma (ICC). Methods: Patients with small (?5 cm) and early-stage ICC were screened from the Surveillance, Epidemiology, and End Results (SEER) database. Overall survival (OS) and cancer-specific survival (CSS) rates between the SR and RFA patients were evaluated. The results were verified using an inverse probability-weighting model (IPTW). Results: In total, 184 patients with small T1 stage ICC that received RFA or SR treatment were identified. The OS rates at 1, 3, and 5 years were 87.4, 73.3, and 61.5% for patients who underwent SR, respectively, and 89.9, 42.4, and 23.9%, respectively, for patients who received RFA. CSS rates at 1, 3, and 5 years were 91.5, 73.8, and 66.1%, respectively, for the SR group and 93.5, 53.4, and 30.0%, respectively, for the RFA group. The OS and CSS rates were evaluated to be significantly better in the SR group than in the RFA group after the multivariate Cox regression and IPTW analysis. Subsequently, the survival benefit of SR was also observed in the subgroup of patients with <4.5 or <4 cm early-stage ICC when compared with RFA. Conclusion: Our results indicated that the SR provided a significantly better prognosis than RFA in patients with small and early-stage ICC. SR as the first-line treatment of primary early-stage ICC is still recommended. However, prospective randomized controlled trials with larger sample sizes are required to compare these modalities in the treatment of ICC.

SUBMITTER: Xiang X

PROVIDER: S-EPMC7550467 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Radiofrequency Ablation vs. Surgical Resection for Small Early-Stage Primary Intrahepatic Cholangiocarcinoma.

Xiang Xin X Hu Daixing D Jin Zheng Z Liu Pan P Lin Huapeng H

Frontiers in oncology 20200929

<b>Aim:</b> We aimed to compare the survival outcomes of radiofrequency ablation (RFA) and surgical resection (SR) for patients with small early-stage primary intrahepatic cholangiocarcinoma (ICC). <b>Methods:</b> Patients with small (≤5 cm) and early-stage ICC were screened from the Surveillance, Epidemiology, and End Results (SEER) database. Overall survival (OS) and cancer-specific survival (CSS) rates between the SR and RFA patients were evaluated. The results were verified using an inverse ...[more]

PMID: 33134161

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Project description:Background: Radiofrequency ablation (RFA) is a curative modality for hepatocellular carcinoma (HCC) patients who are not suitable for resection. It remains controversial whether a surgical or percutaneous approach is more appropriate for HCC. Method: A search was performed on the PubMed, Web of Science, Embase, and Cochrane Library databases from the date of database inception until April 17, 2021. Studies reporting outcomes of comparisons between surgical RFA (SRFA) and percutaneous RFA (PRFA) were included in this study. The meta-analysis was performed using the Review Manager 5.3 and Stata 12.0 software. Result: A total of 10 retrospective studies containing 12 cohorts, involving 740 patients in the PRFA group and 512 patients in the SRFA group, were selected. Although the tumor size in PRFA group was smaller than the SRFA group (p = 0.007), there was no significant difference in complete ablation rate between the SRFA and PRFA groups (95.63% and 97.33%, respectively; Odds ratio [OR], 0.56; 95% confidence intervals [CI], 0.26-1.24; p = 0.15). However, the SRFA group showed a significantly lower local tumor recurrence than the PRFA group in the sensitivity analysis (28.7% in the PRFA group and 21.79% in the SRFA group, respectively; OR, 1.84; 95% CI, 1.14-2.95; p = 0.01). Pooled analysis data showed that the rate of severe perioperative complications did not differ significantly between the PRFA and SRFA groups (14.28% and 12.11%, respectively; OR, 1.30; 95% CI, 0.67-2.53; p = 0.44). There was no significant difference in the 1-, 3-, and 5-year overall survival rates, as well as the 1- and 3-year disease-free survival (DFS) between the PRFA and SRFA groups. The 5-year DFS of the PRFA group was significantly lower than the SRFA group (hazard ratio 0.73; 95% CI 0.54-0.99). Conclusion: Based on our meta-analysis, the surgical route was superior to PRFA in terms of local control rate. Furthermore, the surgical approach did not increase the risk of major complications.

Project description:Background: Approximately 20% resectable non-small cell lung cancer (NSCLC) patients are treated non-surgically due to various reasons. The aim of the present study was to compare the effectiveness of radiofrequency ablation (RFA) and stereotactic body radiotherapy (SBRT) in patients with stage IA NSCLC who were ineligible for surgery using the surveillance, epidemiology and end-results (SEER) Database. Methods: Using the SEER registry, we identified a total of 6,195 IA NSCLC patients who received SBRT or RFA between 2004 and 2015 because of ineligibility for surgical resection due to various reasons. Complete clinical information was available in all these patients. Overall survival (OS) and cancer-specific survival (CSS) were compared between RFA and SBRT groups by using propensity score matching (PSM), inverse probability of treatment weight (IPTW), and overlap weighting analysis. Additionally, an exploratory analysis was conducted to determine the effectiveness of RFA treatment based on the subsets of clinically relevant patients. Results: Of the 6,195 nonsurgical IA NSCLC patients, 191 patients (3.1%) received RFA and the other 6,004 patients (96.9%) received SBRT. The one-, three- and five-year OS in the unmatched RFA and SBRT groups were 83.3%, 48.5%and 29.1% vs. 83.8%, 48.3% and 27.4%, respectively, there was similar results in the PSM, IPTW, overlap weighing analysis. Nonsurgical IA NSCLC patients receiving RFA seemed to have better five-year survival than those receiving SBRT, though the difference was not statistically significant (OS, HR; 0.986; 95% CI, 0.827-1.175, P=0.8738; CSS, HR; 0.965; 95% CI, 0.765-1.219, P=0.7663). We found that the odds of receiving RFA decreased with larger tumor size (>2, <3 cm, OR; 0.303; 95% CI, 0.191-0.479; >3 cm, OR; 0.153; 95% CI, 0.093-0.251) compared with tumor size <1 cm. In subgroup analysis, patients receiving RFA seemed to have better OS than those receiving SBRT, though the difference was not statistically significant. This specific trend was even more obvious in patients with tumors <1cm in diameter (P=0.1577). Conclusion: In comparison with SBRT, RFA did not seem to adversely affect CSS and OS of IA NSCLC patients who were not suitable for surgical treatment. In addition, RFA seemed to offer better survival to IA NSCLC patients, especially those with tumors <1 cm.

Dataset Information

Radiofrequency Ablation vs. Surgical Resection for Small Early-Stage Primary Intrahepatic Cholangiocarcinoma.

Publications

Radiofrequency Ablation vs. Surgical Resection for Small Early-Stage Primary Intrahepatic Cholangiocarcinoma.

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