Radiofrequency ablation in the treatment of hepatocellular carcinoma.

OBJECTIVE: The purpose of this article is to discuss the use, comparative efficacy, and research progress of radiofrequency ablation (RFA), alone or in combination with other therapies, for the treatment of hepatocellular carcinoma (HCC). METHOD: To search and summarize the basic and clinical studies of RFA in recent years. RESULTS: RFA is one of the radical treatment methods listed in the guidelines for the diagnosis and treatment of HCC. It has the characteristics of being minimally invasive and safe and can obtain good local tumor control, and it can improve the local immune ability, improve the tumor microenvironment and enhance the efficacy of chemotherapy drugs. It is commonly used for HCC treatment before liver transplantation and combined ALPPS and hepatectomy for HCC. In addition, the technology of RFA is constantly developing. The birth of noninvasive, no-touch RFA technology and equipment and the precise RFA concept have improved the therapeutic effect of RFA. CONCLUSION: RFA has good local tumor control ability, is minimally invasive, is safe and has other beneficial characteristics. It plays an increasingly important role in the comprehensive treatment strategy of HCC. Whether RFA alone or combined with other technologies expands the surgical indications of patients with HCC and provides more benefits for HCC patients needs to be determined.

Long noncoding RNA expression profiles in sub-lethal heat-treated hepatoma carcinoma cells.

BACKGROUND: Sub-lethal heat treatment characterizes a transition zone of radiofrequency ablation (RFA) which explains hepatocellular carcinoma (HCC) residual cancer occurrence in this area after RFA treatment. The biochemistry of residual cancer cell recurrence is poorly understood, but long noncoding RNAs (lncRNAs) may have aberrant expression that is associated with diverse cancers. Thus, we measured lncRNA gene expression in sub-lethally heat-treated HCC cells using microarray. METHOD: Differentially expressed lncRNA and mRNA were measured with an Agilent Human lncRNA + mRNA Array V4.0 (4 × 180 K format) containing 41,000 lncRNAs and 34,000 mRNAs. Bioinformatics analysis was used to assess differentially expressed lncRNA and mRNA. Seven lncRNA and seven mRNA were validated by qRT-PCR analysis in HCC cells. RESULTS: Genome-wide lncRNA and mRNA expression data in sub-lethal heat-treated SMMC-7721 HCC cells 558 lncRNA and 250 mRNA were significantly up-regulated and 224 lncRNA and 1031 mRNA down-regulated compared to normal cultured SMMC-7721 cells. We demonstrated for the first time that ENST00000570843.1, ENST00000567668.1, ENST00000582249.1, ENST00000450304.1, TCONS_00015544, ENST00000602478.1, TCONS_00001266 and ARC, IL12RB1, HSPA6 were upregulated, whereas STAT3, PRPSAP1, MCU, URB2 were down-regulated in sub-lethally heat-treated HCC cells. CONCLUSIONS: lncRNA expression data in sub-lethally heat-treated HCC cells will provide important insights about lncRNAs' contribution to HCC recurrence after RFA treatment.

Successful treatment of gastrointestinal stromal tumor with multiple liver metastases with radiofrequency ablation and imatinib: A case report.

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumor of the gastrointestinal tract, and typically metastasize to the liver. In patients with recurrent metastatic GISTs, no single treatment is effective. The current study reports a case of GIST with 27 metastases in the liver, which was successfully treated using radiofrequency ablation (RFA) combined with surgical resection and imatinib therapy. The patient remains tumor-free 36 months after the first RFA treatment. This case suggests that comprehensive therapy including surgical resection, RFA and imatinib, may be an effective strategy for the treatment of GIST with multiple liver metastases.

Radiofrequency ablation vs. surgical resection on the treatment of patients with small hepatocellular carcinoma: a system review and meta-analysis of five randomized controlled trials.

BACKGROUND/AIMS: To investigate the meta-analysis of randomized controlled trials(RCTs) of the efficacy and safety between radiofrequency ablation (RFA ) and surgical resection (SR) in treating small hepatocellular carcinoma (SHCC). METHODOLOGY: RCTs comparing RFA with SR for SHCC were collected from PubMed/Medline, Cochrane Library, EMBASE and CNKI data base. Odds ratios and 95% confidence intervals were calculated. RESULTS: Five RCTs with a total of 776 patients were included in this analysis. The 1-, 3-year overall survival rate and 1-year recurrence-free survival rate were of no difference between the RFA and SR . However, SR was shown to be superior to the RFA with the analysis of 5-year overall rate and 3-, 5-year recurrence-free survival rate. The 1-year recurrence rate was similar between the SR and RFA . However, the 2-, 3-year recurrence rate of RFA is significantly higher than SR . In addition, the SR presented a high complication rate. CONCLUSIONS: SR treatment led to a higher long-term survival rate and a lower long-term recurrence rate, while RFA led to a lower complication rate than SR. However, Further research was needed to investigate the efficacy of RFA because of the inadequate research data and the heterogeneity among the included studies.