Symptoms and General Pathology

All Conditions

Neoplasms

Rare Diseases

Recurrence

Cholangiocarcinoma

Disease Attributes

Adenocarcinoma

Carcinoma

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

Bile Duct Cancer

Intrahepatic Cholangiocarcinoma

Hepatectomy for patients with recurrent intrahepatic cholanigocarcinoma

hepatectomy

The investigators retrospectively reviewed the participants suffering from recurrent intrahepatic cholangiocarcinoma after curative resection and aimed to explore the predictive factors for recurrence and clarify the potential benefit of repeat hepatectomy or/with metastasectomy.

Surgery for Recurrent Intrahepatic Cholangiocarcinoma

Surgery for Recurrent Intrahepatic Cholangiocarcinoma: a Promise or an Excess?

Including overall survival and disease free survival

Chang Gung Memorial Hospital

Digestive System Diseases

Carcinoma, Hepatocellular

Liver Neoplasms

Gastrointestinal Neoplasms

Digestive System Neoplasms

Gastrointestinal Diseases

Liver Diseases

Central Nervous System Depressants

All Drugs and Chemicals

Antineoplastic Agents

Hematinics

Coagulants

Dermatologic Agents

Anesthetics

Carboplatin

Epirubicin

Chlorotrianisene

Liver Extracts

Hemostatics

Mitomycins

Mitomycin

Coal Tar

Fibrin Tissue Adhesive

Ethiodized Oil

TACE was performed according to the following protocol: All patients underwent a distal super-selective catheterization of the hepatic arteries using a coaxial technique and micro-catheters (2.9 Fr, Terumo Corporation, Tokyo, Japan). Then, the same three chemotherapeutic agents at the same dosages were used throughout this study, regardless of tumor number and size. Hepatic artery infusion chemotherapy was performed using carboplatin 300 mg. After that, chemolipiodolization was performed using epirubicin 50 mg, and mitomycin C 8 mg mixed with 5 mL of lipiodol. If the territory of the chemolipiodolized artery did not show stagnant flow, pure lipiodol was then injected. RFA was performed after TACE in 2 months by using a commercially available system (RF 2000; Radio-Therapeutics Mountain View, CA), and a needle electrode with a 15 Ga insulated cannula with 10 hook-shaped expandable electrode tines with a diameter of 3.5 cm at expansion (LeVeen; RadioTherapeutics).

Re-resection was carried out under general anesthesia using a right subcostal incision with a midline extension. Intra-operative ultrasonography was performed routinely to evaluate the tumor burden, liver remnant and the possibility of a negative resection margin. We performed anatomical resection aiming at a resection margin of at least 1 cm. Pringle's maneuver was routinely used with a clamp and unclamp time of 10 minutes and 5 minutes, respectively. Hemostasis of the raw liver surface was done with suturing and application of fibrin glue.

TACE first, followed by RFA within 2 months

TACE+RFA

repeat hepatectomy for recurrent small HCC

re-resection

minshan chen, M.D.

yaojun zhang, M.D.

Hepatocellular carcinoma (HCC) is the fifth most common cancer in the world. Partial hepatectomy is still considered as the conventional therapy for HCC. Intrahepatic recurrence of HCC after partial hepatectomy is common and was reported to be more than 77% within 5 years after surgery. Repeat hepatectomy is an effective treatment for intrahepatic HCC recurrence, with a 5-year survival rate of 19.4-56%. This is comparable to the survival after initial hepatectomy for HCC. Unfortunately, repeat hepatectomy could be carried out only in a small proportion of patients with HCC recurrence (10.4-31%), either because of the poor functional liver reserve or because of widespread intrahepatic recurrence. In the past two decades, percutaneous radiofrequency ablation (PRFA) has emerged as a new treatment modality and has attracted great interest because of its effectiveness and safety for small HCC (≤ 5.0 cm). Studies using PRFA to treat recurrent HCC after partial hepatectomy reported a 3-year survival rate of 62-68%, which is comparable to those achieved by surgery. PRFA is particularly suitable to treat recurrent HCC after partial hepatectomy because these tumors are usually detected when they are small and PRFA causes the least deterioration of liver function in the patients. Our previous retrospective study demonstrated that RFA was comparable to re-resection for recurrent HCC, and our recent RCT showed that RFA combined with TACE is superior to RFA for HCC ≤7.0cm. So our hypothesis is that RFA combined with TACE is superior to re-resection for recurrent small HCC. The aim of this retrospective study is to compare the outcome of reresection with TACE+RFA for small recurrent HCC after partial hepatectomy.

TACE+RFA Versus Re-resection for Recurrent Small Hepatocellular Carcinoma

Radiofrequency Ablation Combined With Transcatheter Arterial Chemoembolization Versus Re-resection for Recurrent Hepatocellular Carcinoma

Sun Yat-sen University

professor

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Surgery for Recurrent Intrahepatic Cholangiocarcinoma	NCT04072250	Cholangiocarcin... Recurrence Chol... Re-hepatectomy	hepatectomy	18 Years - 75 Years	Chang Gung Memorial Hospital
TACE+RFA Versus Re-resection for Recurrent Small Hepatocellular Carcinoma	NCT01833286	Hepatocellular ... Surgery Ablation	TACE+RFA re-resection	18 Years - 75 Years	Sun Yat-sen University
TACE+RFA Versus Re-resection for Recurrent Small Hepatocellular Carcinoma	NCT01833286	Hepatocellular ... Surgery Ablation	TACE+RFA re-resection	18 Years - 75 Years	Sun Yat-sen University

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