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Factors associated with increased risk of peritoneal seeding after radiofrequency ablation for hepatocellular carcinoma
Purpose To evaluate the incidence, risk factors, and prognosis associated with peritoneal seeding after percutaneous radiofrequency ablation (RFA) for HCC, focusing on viable tumors after previous locoregional treatment, including TACE and RFA. Methods Exactly 290 patients (mean age, 67.9 years ± 9....
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| Published in: | Abdominal imaging 2023-10, Vol.48 (10), p.3243-3252 |
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| container_title | Abdominal imaging |
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| creator | Ryu, Hwaseong Kim, Tae Un Lee, Jun Woo Jeon, Ung Bae Kim, Jin Hyeok Jang, Joo Yeon Yoon, Ki Tae Hong, Young Mi |
| description | Purpose
To evaluate the incidence, risk factors, and prognosis associated with peritoneal seeding after percutaneous radiofrequency ablation (RFA) for HCC, focusing on viable tumors after previous locoregional treatment, including TACE and RFA.
Methods
Exactly 290 patients (mean age, 67.9 years ± 9.74; 223 men) with 383 HCCs (mean size, 15.9 mm ± 5.49) who underwent RFA between June 2012 and December 2019 were included in this retrospective study. Among them, 158 had history of previous treatment (mean number, 1.3 ± 1.8) with 109 viable HCCs. Cumulative seeding after RFA was estimated using the Kaplan–Meier method. Independent factors affecting seeding were investigated using multivariable Cox proportional hazards regression analysis.
Results
Median follow-up was 1175 days (range: 28–4116). Seeding incidence was 4.1 (12/290) and 4.7% (17/383) per patient and tumor, respectively. The median time interval between RFA and detection of seeding was 785 days (range: 81–1961). Independent risk factors for seeding included subcapsular tumor location (hazard ratio [HR] 4.2; 95% confidence interval [CI] 1.4, 13.0;
p
= 0.012) and RFA for viable HCC after previous locoregional treatment (HR 4.5; 95% CI 1.7, 12.3;
p
= 0.003). Subgroup analysis for viable tumors, revealed no significant difference in cumulative seeding rates between the TACE and RFA groups (
p
= 0.078). Cumulative overall survival rates differed significantly between patients with and without seeding metastases (
p
|
| doi_str_mv | 10.1007/s00261-023-03987-x |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2832574280</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2861021502</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-ac523f5f7250dd99558332dd79e320a2890605cf7e659ba4ac98650898940b033</originalsourceid><addsrcrecordid>eNp9kUFvVCEUhUmjaZuxf8CFIXHj5tULDDxYmsaqSRM37Zrc4UFLfQMj8NL235c61RoXroDc75x7wiHkLYNTBjB-rABcsQG4GEAYPQ73B-SYC6UGAKlf_XU_Iie13gIAU5IxLg_JkRiFNgrWx-TuHF3LpVKsNbuIzU_0LrYbGpMrHmt_llh_0BzozpfYcvI40-r9FNM1xdB8oQWnmEPxPxef3APFzYwt5kRDLvTG77Bl5-d5mbFQh8XFlLf4hrwOOFd_8nyuyNX558uzr8PF9y_fzj5dDE6Msg3oJBdBhpFLmCZjpNRC8GkajRcckGsDCqQLo1fSbHCNzmglQRtt1rABIVbkw953V3LPV5vdxvoUB5PPS7VcCy7HNdfQ0ff_oLd5Kamn65RiwJnsv70ifE-5kmstPthdiVssD5aBfWrG7puxnbW_mrH3XfTu2XrZbP30R_K7hw6IPVD7KF378rL7P7aP9mqaTQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2861021502</pqid></control><display><type>article</type><title>Factors associated with increased risk of peritoneal seeding after radiofrequency ablation for hepatocellular carcinoma</title><source>Springer Nature</source><creator>Ryu, Hwaseong ; Kim, Tae Un ; Lee, Jun Woo ; Jeon, Ung Bae ; Kim, Jin Hyeok ; Jang, Joo Yeon ; Yoon, Ki Tae ; Hong, Young Mi</creator><creatorcontrib>Ryu, Hwaseong ; Kim, Tae Un ; Lee, Jun Woo ; Jeon, Ung Bae ; Kim, Jin Hyeok ; Jang, Joo Yeon ; Yoon, Ki Tae ; Hong, Young Mi</creatorcontrib><description>Purpose
To evaluate the incidence, risk factors, and prognosis associated with peritoneal seeding after percutaneous radiofrequency ablation (RFA) for HCC, focusing on viable tumors after previous locoregional treatment, including TACE and RFA.
Methods
Exactly 290 patients (mean age, 67.9 years ± 9.74; 223 men) with 383 HCCs (mean size, 15.9 mm ± 5.49) who underwent RFA between June 2012 and December 2019 were included in this retrospective study. Among them, 158 had history of previous treatment (mean number, 1.3 ± 1.8) with 109 viable HCCs. Cumulative seeding after RFA was estimated using the Kaplan–Meier method. Independent factors affecting seeding were investigated using multivariable Cox proportional hazards regression analysis.
Results
Median follow-up was 1175 days (range: 28–4116). Seeding incidence was 4.1 (12/290) and 4.7% (17/383) per patient and tumor, respectively. The median time interval between RFA and detection of seeding was 785 days (range: 81–1961). Independent risk factors for seeding included subcapsular tumor location (hazard ratio [HR] 4.2; 95% confidence interval [CI] 1.4, 13.0;
p
= 0.012) and RFA for viable HCC after previous locoregional treatment (HR 4.5; 95% CI 1.7, 12.3;
p
= 0.003). Subgroup analysis for viable tumors, revealed no significant difference in cumulative seeding rates between the TACE and RFA groups (
p
= 0.078). Cumulative overall survival rates differed significantly between patients with and without seeding metastases (
p
< 0.001).
Conclusion
Peritoneal seeding after RFA is a rare, delayed complication. Subcapsular-located and viable HCC after previous locoregional treatment are potential risk factors for seeding. Seeding metastases could affect the prognosis of patients who cannot receive local therapy.
Graphical abstract</description><identifier>ISSN: 2366-0058</identifier><identifier>ISSN: 2366-004X</identifier><identifier>EISSN: 2366-0058</identifier><identifier>DOI: 10.1007/s00261-023-03987-x</identifier><identifier>PMID: 37389604</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Ablation ; Chemoembolization ; Confidence intervals ; Gastroenterology ; Health hazards ; Hepatobiliary ; Hepatocellular carcinoma ; Hepatology ; Imaging ; Liver cancer ; Medical prognosis ; Medicine ; Medicine & Public Health ; Metastases ; Metastasis ; Metastatic seeding ; Peritoneal seeding ; Peritoneum ; Prognosis ; Radio frequency ; Radiofrequency ablation ; Radiology ; Regression analysis ; Risk factors ; Statistical analysis ; Subgroups ; Survival ; Tumors</subject><ispartof>Abdominal imaging, 2023-10, Vol.48 (10), p.3243-3252</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-ac523f5f7250dd99558332dd79e320a2890605cf7e659ba4ac98650898940b033</citedby><cites>FETCH-LOGICAL-c375t-ac523f5f7250dd99558332dd79e320a2890605cf7e659ba4ac98650898940b033</cites><orcidid>0000-0003-1017-6926</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37389604$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ryu, Hwaseong</creatorcontrib><creatorcontrib>Kim, Tae Un</creatorcontrib><creatorcontrib>Lee, Jun Woo</creatorcontrib><creatorcontrib>Jeon, Ung Bae</creatorcontrib><creatorcontrib>Kim, Jin Hyeok</creatorcontrib><creatorcontrib>Jang, Joo Yeon</creatorcontrib><creatorcontrib>Yoon, Ki Tae</creatorcontrib><creatorcontrib>Hong, Young Mi</creatorcontrib><title>Factors associated with increased risk of peritoneal seeding after radiofrequency ablation for hepatocellular carcinoma</title><title>Abdominal imaging</title><addtitle>Abdom Radiol</addtitle><addtitle>Abdom Radiol (NY)</addtitle><description>Purpose
To evaluate the incidence, risk factors, and prognosis associated with peritoneal seeding after percutaneous radiofrequency ablation (RFA) for HCC, focusing on viable tumors after previous locoregional treatment, including TACE and RFA.
Methods
Exactly 290 patients (mean age, 67.9 years ± 9.74; 223 men) with 383 HCCs (mean size, 15.9 mm ± 5.49) who underwent RFA between June 2012 and December 2019 were included in this retrospective study. Among them, 158 had history of previous treatment (mean number, 1.3 ± 1.8) with 109 viable HCCs. Cumulative seeding after RFA was estimated using the Kaplan–Meier method. Independent factors affecting seeding were investigated using multivariable Cox proportional hazards regression analysis.
Results
Median follow-up was 1175 days (range: 28–4116). Seeding incidence was 4.1 (12/290) and 4.7% (17/383) per patient and tumor, respectively. The median time interval between RFA and detection of seeding was 785 days (range: 81–1961). Independent risk factors for seeding included subcapsular tumor location (hazard ratio [HR] 4.2; 95% confidence interval [CI] 1.4, 13.0;
p
= 0.012) and RFA for viable HCC after previous locoregional treatment (HR 4.5; 95% CI 1.7, 12.3;
p
= 0.003). Subgroup analysis for viable tumors, revealed no significant difference in cumulative seeding rates between the TACE and RFA groups (
p
= 0.078). Cumulative overall survival rates differed significantly between patients with and without seeding metastases (
p
< 0.001).
Conclusion
Peritoneal seeding after RFA is a rare, delayed complication. Subcapsular-located and viable HCC after previous locoregional treatment are potential risk factors for seeding. Seeding metastases could affect the prognosis of patients who cannot receive local therapy.
Graphical abstract</description><subject>Ablation</subject><subject>Chemoembolization</subject><subject>Confidence intervals</subject><subject>Gastroenterology</subject><subject>Health hazards</subject><subject>Hepatobiliary</subject><subject>Hepatocellular carcinoma</subject><subject>Hepatology</subject><subject>Imaging</subject><subject>Liver cancer</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Metastatic seeding</subject><subject>Peritoneal seeding</subject><subject>Peritoneum</subject><subject>Prognosis</subject><subject>Radio frequency</subject><subject>Radiofrequency ablation</subject><subject>Radiology</subject><subject>Regression analysis</subject><subject>Risk factors</subject><subject>Statistical analysis</subject><subject>Subgroups</subject><subject>Survival</subject><subject>Tumors</subject><issn>2366-0058</issn><issn>2366-004X</issn><issn>2366-0058</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kUFvVCEUhUmjaZuxf8CFIXHj5tULDDxYmsaqSRM37Zrc4UFLfQMj8NL235c61RoXroDc75x7wiHkLYNTBjB-rABcsQG4GEAYPQ73B-SYC6UGAKlf_XU_Iie13gIAU5IxLg_JkRiFNgrWx-TuHF3LpVKsNbuIzU_0LrYbGpMrHmt_llh_0BzozpfYcvI40-r9FNM1xdB8oQWnmEPxPxef3APFzYwt5kRDLvTG77Bl5-d5mbFQh8XFlLf4hrwOOFd_8nyuyNX558uzr8PF9y_fzj5dDE6Msg3oJBdBhpFLmCZjpNRC8GkajRcckGsDCqQLo1fSbHCNzmglQRtt1rABIVbkw953V3LPV5vdxvoUB5PPS7VcCy7HNdfQ0ff_oLd5Kamn65RiwJnsv70ifE-5kmstPthdiVssD5aBfWrG7puxnbW_mrH3XfTu2XrZbP30R_K7hw6IPVD7KF378rL7P7aP9mqaTQ</recordid><startdate>20231001</startdate><enddate>20231001</enddate><creator>Ryu, Hwaseong</creator><creator>Kim, Tae Un</creator><creator>Lee, Jun Woo</creator><creator>Jeon, Ung Bae</creator><creator>Kim, Jin Hyeok</creator><creator>Jang, Joo Yeon</creator><creator>Yoon, Ki Tae</creator><creator>Hong, Young Mi</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>JQ2</scope><scope>K7-</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1017-6926</orcidid></search><sort><creationdate>20231001</creationdate><title>Factors associated with increased risk of peritoneal seeding after radiofrequency ablation for hepatocellular carcinoma</title><author>Ryu, Hwaseong ; Kim, Tae Un ; Lee, Jun Woo ; Jeon, Ung Bae ; Kim, Jin Hyeok ; Jang, Joo Yeon ; Yoon, Ki Tae ; Hong, Young Mi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-ac523f5f7250dd99558332dd79e320a2890605cf7e659ba4ac98650898940b033</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Ablation</topic><topic>Chemoembolization</topic><topic>Confidence intervals</topic><topic>Gastroenterology</topic><topic>Health hazards</topic><topic>Hepatobiliary</topic><topic>Hepatocellular carcinoma</topic><topic>Hepatology</topic><topic>Imaging</topic><topic>Liver cancer</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Metastatic seeding</topic><topic>Peritoneal seeding</topic><topic>Peritoneum</topic><topic>Prognosis</topic><topic>Radio frequency</topic><topic>Radiofrequency ablation</topic><topic>Radiology</topic><topic>Regression analysis</topic><topic>Risk factors</topic><topic>Statistical analysis</topic><topic>Subgroups</topic><topic>Survival</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ryu, Hwaseong</creatorcontrib><creatorcontrib>Kim, Tae Un</creatorcontrib><creatorcontrib>Lee, Jun Woo</creatorcontrib><creatorcontrib>Jeon, Ung Bae</creatorcontrib><creatorcontrib>Kim, Jin Hyeok</creatorcontrib><creatorcontrib>Jang, Joo Yeon</creatorcontrib><creatorcontrib>Yoon, Ki Tae</creatorcontrib><creatorcontrib>Hong, Young Mi</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Health & 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1</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest advanced technologies & aerospace journals</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Abdominal imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ryu, Hwaseong</au><au>Kim, Tae Un</au><au>Lee, Jun Woo</au><au>Jeon, Ung Bae</au><au>Kim, Jin Hyeok</au><au>Jang, Joo Yeon</au><au>Yoon, Ki Tae</au><au>Hong, Young Mi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors associated with increased risk of peritoneal seeding after radiofrequency ablation for hepatocellular carcinoma</atitle><jtitle>Abdominal imaging</jtitle><stitle>Abdom Radiol</stitle><addtitle>Abdom Radiol (NY)</addtitle><date>2023-10-01</date><risdate>2023</risdate><volume>48</volume><issue>10</issue><spage>3243</spage><epage>3252</epage><pages>3243-3252</pages><issn>2366-0058</issn><issn>2366-004X</issn><eissn>2366-0058</eissn><abstract>Purpose
To evaluate the incidence, risk factors, and prognosis associated with peritoneal seeding after percutaneous radiofrequency ablation (RFA) for HCC, focusing on viable tumors after previous locoregional treatment, including TACE and RFA.
Methods
Exactly 290 patients (mean age, 67.9 years ± 9.74; 223 men) with 383 HCCs (mean size, 15.9 mm ± 5.49) who underwent RFA between June 2012 and December 2019 were included in this retrospective study. Among them, 158 had history of previous treatment (mean number, 1.3 ± 1.8) with 109 viable HCCs. Cumulative seeding after RFA was estimated using the Kaplan–Meier method. Independent factors affecting seeding were investigated using multivariable Cox proportional hazards regression analysis.
Results
Median follow-up was 1175 days (range: 28–4116). Seeding incidence was 4.1 (12/290) and 4.7% (17/383) per patient and tumor, respectively. The median time interval between RFA and detection of seeding was 785 days (range: 81–1961). Independent risk factors for seeding included subcapsular tumor location (hazard ratio [HR] 4.2; 95% confidence interval [CI] 1.4, 13.0;
p
= 0.012) and RFA for viable HCC after previous locoregional treatment (HR 4.5; 95% CI 1.7, 12.3;
p
= 0.003). Subgroup analysis for viable tumors, revealed no significant difference in cumulative seeding rates between the TACE and RFA groups (
p
= 0.078). Cumulative overall survival rates differed significantly between patients with and without seeding metastases (
p
< 0.001).
Conclusion
Peritoneal seeding after RFA is a rare, delayed complication. Subcapsular-located and viable HCC after previous locoregional treatment are potential risk factors for seeding. Seeding metastases could affect the prognosis of patients who cannot receive local therapy.
Graphical abstract</abstract><cop>New York</cop><pub>Springer US</pub><pmid>37389604</pmid><doi>10.1007/s00261-023-03987-x</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-1017-6926</orcidid></addata></record> |
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| ispartof | Abdominal imaging, 2023-10, Vol.48 (10), p.3243-3252 |
| issn | 2366-0058 2366-004X 2366-0058 |
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| source | Springer Nature |
| subjects | Ablation Chemoembolization Confidence intervals Gastroenterology Health hazards Hepatobiliary Hepatocellular carcinoma Hepatology Imaging Liver cancer Medical prognosis Medicine Medicine & Public Health Metastases Metastasis Metastatic seeding Peritoneal seeding Peritoneum Prognosis Radio frequency Radiofrequency ablation Radiology Regression analysis Risk factors Statistical analysis Subgroups Survival Tumors |
| title | Factors associated with increased risk of peritoneal seeding after radiofrequency ablation for hepatocellular carcinoma |
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