Research Papers:

Impact of cavitron ultrasonic surgical aspirator (CUSA) and bipolar radiofrequency device (Habib-4X) based hepatectomy for hepatocellular carcinoma on tumour recurrence and disease-free survival

Kai-Wen Huang, Po-Huang Lee, Tomokazu Kusano, Isabella Reccia, Kumar Jayant _ and Nagy Habib

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Oncotarget. 2017; 8:93644-93654. https://doi.org/10.18632/oncotarget.21271

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Kai-Wen Huang1,2,3, Po-Huang Lee1, Tomokazu Kusano4, Isabella Reccia4, Kumar Jayant4 and Nagy Habib4

1Department of Surgery & Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan

2Centre of Mini-invasive Interventional Oncology, National Taiwan University Hospital, Taipei, Taiwan

3Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan

4Department of Surgery and Cancer, Imperial College London, London, UK

Correspondence to:

Kumar Jayant, email: [email protected]

Keywords: hepatocellular cancer, liver resection

Received: March 14, 2017     Accepted: September 08, 2017     Published: September 26, 2017


Background: The aim of this study was to evaluate the oncological outcomes of hepatocellular carcinoma patients undergoing liver resection using cavitron ultrasonic surgical aspirator (CUSA) or radiofrequency (RF) based device Habib-4X.

Study Design: We prospectively analyzed the data of 280 patients who underwent liver resection for hepatocellular carcinoma at our institution from 2010–2012 with follow up till August 2016. The CUSA was used in the 163 patients whilst Habib-4X in 117 patients. The end points of analysis were oncological outcomes as disease recurrence, disease-free survival (DFS) and overall survival (OS) were estimated by the Kaplan–Meier method, which has been compared with all other existing literature on the survival study.

Results: Compared with CUSA the reported incidence of recurrence was significantly lower, in Habib-4X group; p < 0.01. The median DFS was significantly better in Habib-4X group than CUSA group (50.80 vs 45.87 months, p = 0.03). The median OS was better in Habib-4X group than CUSA group (60.57 vs 57.17 months, p = 0.12) though the lesser difference in OS between the groups might be explained by the use of palliative therapies as TACE, percutaneous RFA, etc. in case of recurrence.

Conclusions: RF based device Habib-4X, is safe and effective device for resection of hepatocellular carcinoma, in comparison to CUSA with better oncological outcomes, i.e., significantly lesser tumour recurrence and better DFS. This could be explained on the basis of systemic and local immunomodulatory effect involving induction of kupffer cells and effector CD-8 T cells that help in minimizing postoperative complications and bring more advantageous oncological outcomes.

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