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- Publisher Website: 10.1002/lt.23892
- Scopus: eid_2-s2.0-84904962298
- PMID: 24753206
- WOS: WOS:000341196200008
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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
Title | Pilot study of high-intensity focused ultrasound ablation as a bridging therapy for hepatocellular carcinoma patients wait-listed for liver transplantation |
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Authors | |
Keywords | High-intensity focused ultrasound Liver transplant Waiting list Hepatocellular carcinoma Transarterial chemoembolization |
Issue Date | 2014 |
Publisher | American 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? |
Abstract | Objective: 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 Identifier | http://hdl.handle.net/10722/196737 |
ISSN | 2023 Impact Factor: 4.7 2023 SCImago Journal Rankings: 1.700 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Chok, KSH | - |
dc.contributor.author | Cheung, TT | - |
dc.contributor.author | Lo, RCL | - |
dc.contributor.author | Chu, KFS | - |
dc.contributor.author | Tsang, SHY | - |
dc.contributor.author | Chan, ACY | - |
dc.contributor.author | Sharr, WW | - |
dc.contributor.author | Fung, JYY | - |
dc.contributor.author | Dai, JWC | - |
dc.contributor.author | Chan, SC | - |
dc.contributor.author | Fan, ST | - |
dc.contributor.author | Lo, CM | - |
dc.date.accessioned | 2014-04-25T08:37:25Z | - |
dc.date.available | 2014-04-25T08:37:25Z | - |
dc.date.issued | 2014 | - |
dc.identifier.citation | Liver Transplantation, 2014, v. 20 n. 8, p. 912-921 | - |
dc.identifier.issn | 1527-6465 | - |
dc.identifier.uri | http://hdl.handle.net/10722/196737 | - |
dc.description.abstract | Objective: 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.language | eng | - |
dc.publisher | American 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.ispartof | Liver Transplantation | - |
dc.subject | High-intensity focused ultrasound | - |
dc.subject | Liver transplant | - |
dc.subject | Waiting list | - |
dc.subject | Hepatocellular carcinoma | - |
dc.subject | Transarterial chemoembolization | - |
dc.title | Pilot study of high-intensity focused ultrasound ablation as a bridging therapy for hepatocellular carcinoma patients wait-listed for liver transplantation | en_US |
dc.type | Article | en_US |
dc.identifier.email | Lo, RC: loregina@hku.hk | - |
dc.identifier.email | Fan, ST: stfan@hku.hk | - |
dc.identifier.email | Lo, CM: chungmlo@hkucc.hku.hk | - |
dc.identifier.doi | 10.1002/lt.23892 | - |
dc.identifier.pmid | 24753206 | - |
dc.identifier.scopus | eid_2-s2.0-84904962298 | - |
dc.identifier.hkuros | 233253 | - |
dc.identifier.isi | WOS:000341196200008 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 1527-6465 | - |