Oncology最新文献

{"title":"Infection Prophylaxis with Intravenous Immunoglobulin in Multiple Myeloma Patients Treated with Teclistamab.","authors":"Michael Sheu, Sofia Molina Garcia, Meera Patel, Ali Mushtaq, Thomas Rust, Muhammad Anns Asif, Faiz Anwer, Aneela Majeed","doi":"10.1159/000548964","DOIUrl":"10.1159/000548964","url":null,"abstract":"<p><p><p>Introduction: B-cell maturation antigen-targeting bispecific antibodies such as teclistamab have been associated with increased risk of infections as compared with conventional treatment regimens. This study explored the efficacy of intravenous immunoglobulin (IVIG) prophylaxis in reducing infection-related hospitalizations (IRHs) in MM patients who underwent treatment with teclistamab.</p><p><strong>Methods: </strong>This was a retrospective study of MM treated with teclistamab at Taussig Cancer Center from December 16, 2022, to March 31, 2024. The primary endpoint was incidence rate of IRHs per patient-day on-IVIG vs. off-IVIG.</p><p><strong>Results: </strong>Among the 44 patients included in the study, there were 19 infectious episodes that required inpatient hospitalization, occurring among 17 patients. Five infections occurred during 4,378 days during the \"on-IVIG\" period, compared to 14 infections occurring during 4,619 days for the \"off-IVIG\" period for an infectious incidence rate ratio between the two groups of 2.65 (p value = 0.027).</p><p><strong>Conclusion: </strong>Patients treated with bispecific antibodies such as teclistamab are highly susceptible to infections due to impaired humoral immunity and hypogammaglobulinemia. Our findings demonstrate a reduction in infection incidence in patients while receiving IVIG. These results support the use of IVIG as an effective prophylactic strategy to reduce infectious risk in this vulnerable patient population. </p>.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"746-750"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12707884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustained Virologic Response and Prognosis in Hepatitis C Virus-Related Hepatocellular Carcinoma: Lessons from Complementary Cohorts.","authors":"Edoardo G Giannini, Sara Labanca, Simona Marenco, Giulia Pieri, Francesco Calabrese, Andrea Pasta","doi":"10.1159/000550876","DOIUrl":"10.1159/000550876","url":null,"abstract":"","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"984-986"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Pathological Response and Favorable Survival after Presurgical Sequential Lenvatinib-Transarterial Chemoembolization for Resectable Hepatocellular Carcinoma.","authors":"Hideki Sasanuma, Yoshiyuki Meguro, Kentaro Shimodaira, Masatake Taniguchi, Yuki Kimura, Yuichi Aoki, Masanobu Taguchi, Naoya Kasahara, Kazue Morishima, Yuji Kaneda, Atsushi Miki, Kazuhiro Endo, Shunji Watanabe, Kohei Hamamoto, Yasunaru Sakuma, Naoki Morimoto, Hironori Yamaguchi, Naohiro Sata","doi":"10.1159/000550192","DOIUrl":"10.1159/000550192","url":null,"abstract":"<p><strong>Introduction: </strong>Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide. While curative resection offers the best chance for long-term survival, the high postoperative recurrence rate suggests a persistent need for effective perioperative therapies. We investigated a multimodal approach, combining sequential lenvatinib with transarterial chemoembolization (TACE), as a presurgical treatment (PST) for resectable HCC.</p><p><strong>Methods: </strong>This retrospective study included 19 patients with technically resectable HCC who underwent the PST protocol followed by surgery between March 2022 and September 2024. The protocol involved four phases: Pre-TACE lenvatinib administration (Pre-LEN), TACE, Post-TACE lenvatinib administration, and surgery. We assessed the feasibility, safety, and pathological response of the protocol. Liver function was evaluated using the albumin-bilirubin (ALBI) score, modified ALBI (mALBI) grade, and tumor response was assessed using the Response Evaluation Criteria in Cancer of the Liver (RECICL).</p><p><strong>Results: </strong>The PST protocol demonstrated high efficacy and safety. The median tumor reduction rate was 22.9%, and the median pathological tumor necrosis rate was 95%. The preoperative overall RECICL response was a complete response in 84.2% of patients. With a median follow-up of 22 months, the 2-year recurrence-free survival rate was 84.6%, and the overall survival rate was 100%. A significant association was found between mALBI grade and the decision to proceed with surgery at two time points: Pre-LEN (p = 0.023) and before surgery (p = 0.006).</p><p><strong>Conclusion: </strong>Presurgical sequential lenvatinib-TACE therapy is a feasible and safe strategy for resectable HCC. This protocol achieved a high pathological response and favorable survival outcomes, suggesting that it may mitigate the risk of early recurrence. Our findings highlight the importance of mALBI grade monitoring for patient selection and provide a rationale for larger, prospective studies.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"914-924"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145878862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Splenic Characteristics Predict Rectal Cancer Chemotherapy Toxicity and Treatment Outcomes in Rectal Cancer Patients?","authors":"Lara Wirth, Alex Besson, Paige Hudson, Josephine Yeung, Justin M Yeung","doi":"10.1159/000551703","DOIUrl":"10.1159/000551703","url":null,"abstract":"<p><strong>Introduction: </strong>Rectal cancer requires multidisciplinary management, including chemotherapy treatment, for successful clinical outcomes. Splenic characteristics on computed tomography (CT) imaging have been proposed to reflect immune function. This study explores whether splenic size and density on pretreatment CT scans predicts chemotherapy dose-limiting toxicities (DLTs) and cancer outcomes in rectal cancer patients.</p><p><strong>Methods: </strong>A retrospective study of rectal cancer patients who received chemotherapy treatment with curative intent from February 2013 to March 2023 was conducted. Pretreatment CT scans were collected for measurement of splenic volume and density. Receiver operating characteristics analyses of splenic density and volume was performed to calculate the area under the curve (AUC). The AUC was used to determine association with overall survival (OS), disease-free survival (DFS), and DLT.</p><p><strong>Results: </strong>A total of 234 patients were included, and 98 (41.8%) patients were classified as having diffuse reduction of spleen density (DROSD). The DROSD group experienced significantly reduced DLTs (13.3% vs. 24.3%, p = 0.045). There was no significant association between OS or DFS with splenic volume or density.</p><p><strong>Conclusion: </strong>This study has shown that DROSD is an independent predictive factor for reduced DLT in rectal cancer patients undergoing chemotherapy treatment. Further research is needed to validate findings and elucidate underlying mechanisms.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1010-1017"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Changes in Body Weight and Body Mass Index in Patients with Chronic-Phase Chronic Myeloid Leukemia Treated with Tyrosine Kinase Inhibitors: A Retrospective Observational Study.","authors":"Awni Alshurafa, Mohammed Abdulgayoom, Rola Ghasoub, Wafa M Mohammed, Jamil R Wafi, Fatima Al Ali, Mohamed A Yassin","doi":"10.1159/000552769","DOIUrl":"10.1159/000552769","url":null,"abstract":"<p><p><p>Introduction: Tyrosine kinase inhibitors (TKIs) have transformed chronic-phase chronic myeloid leukemia (CML) into a chronic condition with excellent long-term survival. As outcomes improve, attention has shifted toward treatment-related metabolic effects and survivorship issues. Body weight and body mass index (BMI) are important indicators of metabolic health; however, the long-term effects of TKIs on these parameters remain incompletely characterized, particularly in real-world settings. This study evaluated longitudinal changes in body weight and BMI in adults with chronic-phase CML treated with TKIs.</p><p><strong>Methods: </strong>We conducted a retrospective longitudinal observational study at a tertiary care center between January 2016 and December 2023. Adult patients with chronic-phase CML who initiated TKI therapy and had baseline and follow-up weight measurements were included. Patients with major preexisting metabolic conditions or factors likely to confound weight were excluded. Body weight and BMI were assessed at predefined time points up to 7 years. Paired analyses evaluated within-patient changes over time, and stratified analyses were performed according to initial TKI and cumulative exposure patterns.</p><p><strong>Results: </strong>A total of 175 patients were included in the analytic cohort (82.9% male; mean age 39.2 ± 11.7 years). The marked male predominance and younger age reflect the demographic context of CML care in Qatar. Mean baseline weight was 68.2 ± 14.4 kg, and baseline BMI was 24.6 ± 3.9 kg/m2. Weight increased significantly from baseline at 6 months (+4.27 kg), 12 months (+6.00 kg), 18 months (+6.63 kg), and 24 months (+6.41 kg) (all p < 0.001). At the last follow-up, the mean weight gain was 6.12 kg (p < 0.001), with 56.9% of patients achieving ≥5% weight gain. The temporal pattern showed rapid weight gain during the first 6-12 months, followed by stabilization through 2-3 years with persistent elevation thereafter. Weight and BMI increases were observed across all first-line TKIs and cumulative exposure groups, without statistically significant differences between agents.</p><p><strong>Conclusion: </strong>In this real-world cohort of adults with chronic-phase CML, TKI therapy was associated with early and sustained increases in body weight and BMI, largely occurring within the first year of treatment. These changes likely reflect a combination of treatment-related metabolic effects and reversal of cancer-associated catabolism. Given the long life expectancy of patients with CML, routine metabolic surveillance, early lifestyle interventions, and prospective studies incorporating metabolic biomarkers, body composition, edema assessment, treatment response, and toxicity outcomes should be incorporated into long-term CML survivorship research and care. </p>.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1145-1154"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13395384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148205599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FLAG-Based versus Standard 7+3 Induction Therapy in Adults with Newly Diagnosed Acute Myeloid Leukemia: A Systematic Review and Meta-Analysis.","authors":"Mohammed Abdulgayoom, Soha Aboukhalaf, Mahmoud Osman, Nada H Soliman, Samreen Mumtaz Rahmoon, Marrita Rabadi, Nuha Fituri, Abdulrahman F Al-Mashdali, Rasha Kaddoura, Shehab F Mohamed","doi":"10.1159/000552987","DOIUrl":"10.1159/000552987","url":null,"abstract":"<p><p><p>Background: The standard induction regimen for newly diagnosed acute myeloid leukemia (AML) in eligible patients remains cytarabine-daunorubicin (7+3), although FLAG-based regimens are increasingly used in high-risk disease.</p><p><strong>Methods: </strong>We performed a PRISMA 2020-compliant systematic review and meta-analysis comparing FLAG-based induction with standard 7+3 in adults with newly diagnosed AML. Five retrospective cohort studies, including 534 patients, were analyzed.</p><p><strong>Results: </strong>FLAG-based induction was associated with a significantly higher overall response rate than 7+3 (OR: 1.83, 95% CI: 1.03-3.22), without a significant difference in 30-day mortality (OR 0.56, 95% CI: 0.12-2.69) or 60-day mortality (OR: 0.79, 95% CI: 0.29-2.14). Survival outcomes were heterogeneous and could not be pooled: median overall survival (OS) was similar in 1 cohort, whereas 2 studies reported improved OS with FLAG-based induction; disease-free survival/relapse-free survival outcomes were inconsistently reported. FLAG-based induction was associated with higher receipt of consolidation therapy, while bridging to allogeneic transplantation did not differ significantly. Cytogenetic and molecular risk data were variably defined and incompletely reported, precluding reliable pooled subgroup analyses.</p><p><strong>Conclusions: </strong>Overall, FLAG-based induction improves response rates without a clear increase in early mortality or selected reported safety outcomes; however, its impact on survival remains uncertain and appears influenced by post-remission strategies. Prospective randomized trials are needed to better define its role in frontline AML therapy. </p>.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1155-1168"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13436924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variations in Characteristics and Clinical Outcomes of Esophageal Squamous Cell Carcinoma among Asian American.","authors":"Xiaoxia Yu, Lixia Xu, Shuwen Zhang, Ping Pan, Ying Xia","doi":"10.1159/000544841","DOIUrl":"10.1159/000544841","url":null,"abstract":"<p><strong>Introduction: </strong>Research on esophageal squamous cell carcinoma (ESCC) in Asian American (AsA) populations frequently aggregates data, thereby overlooking the considerable diversity inherent within this demographic. The aim of this study was to investigate the variations in ESCC characteristics and clinical outcomes among AsA.</p><p><strong>Methods: </strong>Patients diagnosed with ESCC were identified through the Surveillance, Epidemiology, and End Results (SEER) 17 database. The AsA cohort was categorized into specific subgroups: Chinese, Japanese, Filipino, Korean, Vietnamese, South Asian (Asian Indian or Pakistani), and other Asian. The Kaplan-Meier method was employed to estimate unadjusted overall survival (OS), while Cox proportional hazards models were utilized to assess adjusted OS.</p><p><strong>Results: </strong>A total of 9,252 patients were included, with the cohort comprising 1,100 Asian, 2,135 Black, 951 Hispanic, and 5,066 White individuals. AsA patients demonstrated the highest unadjusted OS (p < 0.001). The Vietnamese subgroup exhibited the highest proportion of male patients at 92.1%. South Asian patients showed the highest unadjusted OS among the distinct Asian subgroups, with survival rates of 56% at 1 year (95% confidence interval [CI]: 49-64), 31% at 3 years (95% CI: 25-40), and 23% at 5 years (95% CI: 17-32). After adjusting, only Chinese and South Asian patients displayed significantly improved OS compared to the White reference group (p < 0.05).</p><p><strong>Conclusion: </strong>Considerable disparities in ESCC characteristics and outcomes exist among AsA populations. Socioeconomic, genetic, and epigenetic factors may influence these differences. Further research is essential to clarify the mechanisms of this discrepancy.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"51-62"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Learning and Radiomics for Gastric Cancer Lymph Node Metastasis: Automated Segmentation and Multi-Machine Learning Study from Two Centers.","authors":"Hui Shang, Yue Fang, Yuyang Zhao, Nan Mi, Zhendong Cao, Yi Zheng","doi":"10.1159/000544179","DOIUrl":"10.1159/000544179","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study was to develop an automated method for segmenting spleen computed tomography (CT) images using a deep learning model. This approach is intended to address the limitations of manual segmentation, which is known to be susceptible to interobserver variability. Subsequently, a prediction model of gastric cancer (GC) lymph node metastasis was constructed in conjunction with radiomics and deep learning features, and a nomogram was generated to explore the clinical guiding significance.</p><p><strong>Methods: </strong>This study enrolled 284 patients with pathologically confirmed GC from two centers. We employed a deep learning model, U-Mamba, to obtain fully automatic segmentation of the spleen CT images. Subsequently, radiomics features and deep learning features were extracted from the entire spleen CT images, and significant features were identified through dimensionality reduction. The clinical features, radiomic features, and deep learning features were organized and integrated, and five machine learning methods were employed to develop 15 predictive models. Ultimately, the model exhibiting superior performance was presented in the form of a nomogram.</p><p><strong>Results: </strong>A total of 12 radiomics features, 17 deep learning features, and 2 clinical features were deemed valuable. The DRC model demonstrated superior discriminative capacity relative to other models. A nomogram was constructed based on the logistic clinical model to facilitate the usage and verification of the clinical model.</p><p><strong>Conclusion: </strong>Radiomics and deep learning features derived from automated spleen segmentation to construct a nomogram demonstrate efficacy in predicting lymph node metastasis in GC. Concurrently, fully automated segmentation provides a novel and reproducible approach for radiomics research.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"63-78"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Reported Outcome-Based Symptom Management Improves Quality of Life in Postoperative Gastroesophageal Cancer Patients: A Randomized Controlled Trial.","authors":"Shusheng Wu, Jiayu Niu, Conglan Ding, Lihong Ke, Mengge Li, Ying Yan, Huijun Xu, Xiaoxiu Hu, Wenju Chen, Huiqin Luo, Liyuan Fan, Huimin Li, Lulu Cao, Yifu He","doi":"10.1159/000545529","DOIUrl":"10.1159/000545529","url":null,"abstract":"<p><strong>Introduction: </strong>Following resection for gastroesophageal cancer, patients may experience symptoms like reflux, anorexia, and weight loss that can significantly impact their quality of life (QoL). Patient-reported outcomes (PROs) are becoming more important for symptom monitoring. Nevertheless, there is limited knowledge on symptom management post-gastroesophageal cancer resection.</p><p><strong>Methods: </strong>A single-center, randomized controlled trial was conducted on postoperative patients with gastroesophageal cancer. Participants were randomly assigned to the PRO group and usual care (the control group), with a 1:1 ratio. The PRO-based symptom management included symptom assessment, monitoring, and personalized interventions such as lifestyle guidance, nutritional support, and drug therapy. An electronic system was developed on the Research Electronic Data Capture (REDCap) platform to monitor and assess patients' symptoms, QoL, and provide diagnosis and treatment. The study focused on five key symptom events: anorexia, reflux, depression, nutritional risk, and underweight. In the PRO group, assessments were conducted every 3-4 weeks for a minimum of 16 weeks. Interventions for this group primarily involved counseling, patient education, and medication prescriptions based on individual symptoms. The control group's symptoms and QoL were assessed only at baseline and week 16. The primary outcome measure was the total number of symptoms at 16 weeks, with secondary outcomes including the incidence of symptoms at the same time point. QoL was also evaluated as part of the study.</p><p><strong>Results: </strong>Between April 2021 and May 2022, a total of 124 patients were divided into two groups: 60 in the PRO group and 64 in the control group. The PRO group exhibited notably fewer overall symptoms at the 16-week mark compared to the control group (1.20 ± 1.16 vs. 2.50 ± 1.47), along with a lower prevalence of nutritional risk (63.3% vs. 81.3%), anorexia (18.3% vs. 60.9%), reflux (13.3% vs. 57.8%), and depression (5.0% vs. 20.3%). The QoL scores were markedly higher in the PRO group. Furthermore, the PRO group displayed lower nutritional status, reflux, and depression scale trends, as well as higher anorexia trends when compared to the control group.</p><p><strong>Conclusions: </strong>PRO-based symptom management led to superior symptom control and enhanced QoL in postoperative gastroesophageal cancer patients when compared to standard care.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"201-211"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Fusion Imaging and Cone-Beam Computed Tomography-Guided Radiofrequency Ablation for Hepatocellular Carcinoma Poorly Visualized on Ultrasonography.","authors":"Keizo Kato, Hiroshi Abe, Makiko Ika, Yuhi Sakamoto, Mizuki Takeuchi, Shingo Komazaki, Shinichiro Takeda, Sadahiro Ito, Shohei Shimizu, Ryota Matsuo","doi":"10.1159/000546427","DOIUrl":"10.1159/000546427","url":null,"abstract":"<p><strong>Introduction: </strong>Radiofrequency ablation (RFA) generally involves the insertion of a radiofrequency electrode into the hepatocellular carcinoma (HCC) nodule under ultrasonography (US) guidance. However, the procedure is often not feasible for patients whose HCC is undetectable on conventional US. Advances in imaging technology, such as fusion imaging (FI) and cone-beam computed tomography (CBCT), may enhance treatment precision and efficacy for these challenging cases. This study assessed the efficacy of RFA guided by FI and CBCT in managing HCC poorly visualized on US.</p><p><strong>Methods: </strong>HCC nodules were classified into GOOD (clearly delineated), POOR (poorly delineated), and NONE (undetectable) based on US visualization. All nodules underwent RFA guided by FI and CBCT either in combination with transcatheter arterial chemoembolization (TACE) or without TACE. The technical success rate and local tumor progression post-RFA were evaluated using dynamic contrast-enhanced imaging. Between-group differences were analyzed retrospectively.</p><p><strong>Results: </strong>A total of 420 patients with 595 HCC nodules were enrolled. Complete ablation rates were 91.4%, 94.9%, and 86.2% in the GOOD, POOR, and NONE groups, respectively. For nodules with over 50% lipiodol accumulation, the complete ablation rates were 91.5%, 96.5%, and 88.8%; for those with less than 50% lipiodol accumulation, they were 95.5%, 100%, and 62.5%; and for those without lipiodol accumulation, they were 89.5%, 77.8%, and 82.4% in the GOOD, POOR, and NONE groups, respectively. Significant factors associated with complete ablation included larger nodule size and lipiodol accumulation. Cumulative local tumor progression rates at 1 year were 4.5%, 0%, and 3.8%, with no significant differences among groups.</p><p><strong>Conclusion: </strong>FI and CBCT guidance effectively achieve local control for HCC, including nodules poorly visualized on US, with outcomes comparable to US-visible nodules, especially for those with lipiodol accumulation.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"270-282"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}