Yang LM, Wang HJ, Li SL, Gan GH, Deng WW, Chang YS, Zhang LF. Efficacy of radiofrequency ablation combined with sorafenib for treating liver cancer complicated with portal hypertension and prognostic factors. World J Gastroenterol 2024; 30(11): 1533-1544 [PMID: 38617449 DOI: 10.3748/wjg.v30.i11.1533]
Corresponding Author of This Article
Li-Min Yang, MD, Associate Chief Physician, Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Erqi District, Zhengzhou 450052, Henan Province, China. ylmsunny6153@126.com
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Li-Min Yang, Hong-Juan Wang, Guan-Hua Gan, Wen-Wen Deng, Lian-Feng Zhang, Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
Shan-Lin Li, Department of Gastroenterology, Zhoukou Central Hospital of Henan Province, Zhoukou 466000, Henan Province, China
Yong-Sheng Chang, Department of Gastroenterology, The First Affiliated Hospital of Xinxiang Medical College, Xinxiang 453000, Henan Province, China
Co-corresponding authors: Li-Min Yang and Lian-Feng Zhang.
Author contributions: Yang LM and Zhang LF contributed equally to this work and are co-corresponding authors, including those involved in the design of the study, the acquisition and analysis of the data from the experiments, and the writing of the manuscript. Yang LM, Zhang LF and Wang HJ designed the experiment and conducted the clinical data collection; Li SL and Gan GH performed the postoperative follow-up and recorded the data; Deng WW and Chang YS conducted a number of collations and statistical analyses; all the authors read and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of the First Affiliated Hospital of Zhengzhou University, and the need to provide informed consent was waived.
Informed consent statement: After review by the Ethics Committee, a waiver of informed consent was granted for this subject.
Conflict-of-interest statement: The author(s) declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data sharing statement: All the data generated or analyzed during this study are included in this published article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Min Yang, MD, Associate Chief Physician, Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Erqi District, Zhengzhou 450052, Henan Province, China. ylmsunny6153@126.com
Received: January 5, 2024 Peer-review started: January 5, 2024 First decision: January 23, 2024 Revised: February 18, 2024 Accepted: March 8, 2024 Article in press: March 8, 2024 Published online: March 21, 2024 Processing time: 76 Days and 3 Hours
ARTICLE HIGHLIGHTS
Research background
Liver cancer, frequently arising from cirrhosis, presents with accompanying portal hypertension in a substantial portion of cases. Current treatments are limited due to the challenging nature of surgical interventions and poor physical tolerance of affected patients. Radiofrequency ablation (RFA) is a known therapeutic approach, but its application in liver cancer complicated by portal hypertension has been insufficiently explored.
Research motivation
Given the complexity and limited treatment options for patients with liver cancer and portal hypertension, investigating novel therapeutic strategies is crucial. Understanding the potential benefits of combining RFA with sorafenib in this context could offer improved efficacy and survival outcomes.
Research objectives
This study aimed to assess the effectiveness of RFA in combination with sorafenib for patients with liver cancer complicated by portal hypertension, discern prognostic factors, and evaluate their impact on patient outcomes. The study also sought to analyze the potential synergistic effects of both treatments and their impact on liver function and survival rates.
Research methods
A total of 100 patients were analyzed and categorized into a research group (RFA with sorafenib) and a control group (RFA alone). Short-term efficacy, liver function, portal hypertension, cancer markers, adverse reactions, and survival rates were assessed. Multivariate logistic regression analysis was employed to identify independent risk factors for poor patient prognosis.
Research results
The combined RFA and sorafenib treatment demonstrated a significantly higher total effective rate compared to RFA alone, effectively reducing portal vein pressure, improving liver function, and lowering liver cancer markers. Patients in the combined treatment group exhibited higher survival rates at 1-, 2-, and 3-year follow-ups, highlighting the potential long-term benefits of this approach.
Research conclusions
The combination of RFA and sorafenib yields promising results in treating liver cancer with portal hypertension, offering improved short- and long-term efficacy. Prognostic factors such as Child-Pugh grade, tumor size, history of hepatitis, and the use of sorafenib were identified as significant predictors of patient outcomes, providing valuable insights for clinical management.
Research perspectives
These findings underscore the potential clinical therapeutic value of combining RFA with sorafenib for liver cancer complicated by portal hypertension. However, further research with larger sample sizes is warranted to validate these outcomes and establish guidelines for optimizing treatment protocols and patient care.
