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Article: Pilot study of high-intensity focused ultrasound ablation as a bridging therapy for hepatocellular carcinoma patients wait-listed for liver transplantation

TitlePilot study of high-intensity focused ultrasound ablation as a bridging therapy for hepatocellular carcinoma patients wait-listed for liver transplantation
Authors
KeywordsHigh-intensity focused ultrasound
Liver transplant
Waiting list
Hepatocellular carcinoma
Transarterial chemoembolization
Issue Date2014
PublisherAmerican Association for the Study of Liver Diseases. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jtoc/106570021
Citation
Liver Transplantation, 2014, v. 20 n. 8, p. 912-921 How to Cite?
AbstractObjective: To investigate the outcomes of high-intensity focused ultrasound (HIFU) ablation as a bridging therapy for patients with hepatocellular carcinoma (HCC) waitlisted for deceased-donor liver transplantation. Patients and Methods: Adult patients with unresectable and unablatable HCCs within the UCSF criteria waitlisted for deceased-donor liver transplantation were screened for suitability for HIFU ablation as a bridging therapy if they were not suitable for transarterial chemoembolization (TACE). Comparison of treatment outcomes was made between patients receiving HIFU ablation, TACE and best medical treatment (BMT). Results: Fifty-one patients were included in the analysis. Before the introduction of HIFU ablation, only 39.2% of patients received bridging therapy (TACE only, n=20). With HIFU ablation in use, the rate increased dramatically to 80.4% (TACE+HIFU, n=20+21). The overall dropout rate was 51% (n=26). Patients in the BMT group had a significantly higher dropout rate (p=0.027) and significantly poorer liver function as reflected by higher Model of End-stage Liver Disease scores and Child-Pugh grading. Clinically relevant ascites was found in 5 patients in the HIFU group and 2 patients in the BMT group but none in the TACE group (p=0.010 and 0.029). The TACE and HIFU groups had comparable percentages of tumor necrosis in livers excised (p=0.353), both significantly higher than that in the BMT group (p=0.010 and 0.020). Conclusions: HIFU ablation was safe even for HCC patients with Child-Pugh C disease. Its adoption increased the percentage of patients receiving bridging therapy from 39.2% to 80.4%.
Persistent Identifierhttp://hdl.handle.net/10722/196737
ISSN
2015 Impact Factor: 3.951
2015 SCImago Journal Rankings: 1.763
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChok, KSH-
dc.contributor.authorCheung, TT-
dc.contributor.authorLo, RCL-
dc.contributor.authorChu, KFS-
dc.contributor.authorTsang, SHY-
dc.contributor.authorChan, ACY-
dc.contributor.authorSharr, WW-
dc.contributor.authorFung, JYY-
dc.contributor.authorDai, JWC-
dc.contributor.authorChan, SC-
dc.contributor.authorFan, ST-
dc.contributor.authorLo, CM-
dc.date.accessioned2014-04-25T08:37:25Z-
dc.date.available2014-04-25T08:37:25Z-
dc.date.issued2014-
dc.identifier.citationLiver Transplantation, 2014, v. 20 n. 8, p. 912-921-
dc.identifier.issn1527-6465-
dc.identifier.urihttp://hdl.handle.net/10722/196737-
dc.description.abstractObjective: To investigate the outcomes of high-intensity focused ultrasound (HIFU) ablation as a bridging therapy for patients with hepatocellular carcinoma (HCC) waitlisted for deceased-donor liver transplantation. Patients and Methods: Adult patients with unresectable and unablatable HCCs within the UCSF criteria waitlisted for deceased-donor liver transplantation were screened for suitability for HIFU ablation as a bridging therapy if they were not suitable for transarterial chemoembolization (TACE). Comparison of treatment outcomes was made between patients receiving HIFU ablation, TACE and best medical treatment (BMT). Results: Fifty-one patients were included in the analysis. Before the introduction of HIFU ablation, only 39.2% of patients received bridging therapy (TACE only, n=20). With HIFU ablation in use, the rate increased dramatically to 80.4% (TACE+HIFU, n=20+21). The overall dropout rate was 51% (n=26). Patients in the BMT group had a significantly higher dropout rate (p=0.027) and significantly poorer liver function as reflected by higher Model of End-stage Liver Disease scores and Child-Pugh grading. Clinically relevant ascites was found in 5 patients in the HIFU group and 2 patients in the BMT group but none in the TACE group (p=0.010 and 0.029). The TACE and HIFU groups had comparable percentages of tumor necrosis in livers excised (p=0.353), both significantly higher than that in the BMT group (p=0.010 and 0.020). Conclusions: HIFU ablation was safe even for HCC patients with Child-Pugh C disease. Its adoption increased the percentage of patients receiving bridging therapy from 39.2% to 80.4%.-
dc.languageeng-
dc.publisherAmerican Association for the Study of Liver Diseases. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jtoc/106570021-
dc.relation.ispartofLiver Transplantation-
dc.subjectHigh-intensity focused ultrasound-
dc.subjectLiver transplant-
dc.subjectWaiting list-
dc.subjectHepatocellular carcinoma-
dc.subjectTransarterial chemoembolization-
dc.titlePilot study of high-intensity focused ultrasound ablation as a bridging therapy for hepatocellular carcinoma patients wait-listed for liver transplantationen_US
dc.typeArticleen_US
dc.identifier.emailLo, RC: loregina@hku.hk-
dc.identifier.emailFan, ST: stfan@hku.hk-
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hk-
dc.identifier.doi10.1002/lt.23892-
dc.identifier.pmid24753206-
dc.identifier.scopuseid_2-s2.0-84904962298-
dc.identifier.hkuros233253-
dc.identifier.isiWOS:000341196200008-
dc.publisher.placeUnited States-

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