scholarly journals Radiofrequency ablation combined with transarterial chemoembolization in treatment of hepatocellular carcinoma adjacent to the second hepatic hilus

2021 ◽  
Author(s):  
Meng-Li Chen ◽  
Hai-Liang Li ◽  
Chen-Yang Guo ◽  
Hao Zhang ◽  
Hang Yuan ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Tumor Progression ◽  
Transarterial Chemoembolization ◽  
Local Tumor Progression ◽  
Local Tumor ◽  
Period Range ◽  
Hepatic Hilus ◽  
Tumor Residue

Abstract Purpose To explore the efficacy and safety of using radiofrequency ablation (RFA) combined with transarterial chemoembolization (TACE) for treating hepatocellular carcinoma (HCC) adjacent to the second hepatic hilus. Methods Between February 2011 and June 2013, 17 patients with HCC underwent combination therapy of TACE and RFA under DSA and CT guidance at our institution. The 17 patients had a total of 23 hepatic tumors, 17 of which were adjacent to the second hepatic hilus. Results TACE combined with RFA was performed successfully in all 17 patients with no mortalities or major morbidities. During the 1-month follow-up, tumors of 15 patients (88.2%) were completely ablated after one therapy session and 2 patients had detectable tumor residue. During the follow-up time period (range 6–52 months), local tumor progression developed in 1 patient (1/17, 5.9%) and both local tumor progression and new tumors appeared in 1 patient (1/17, 5.9%). Also, new tumors developed in the untreated portions of the liver in 8 patients (8/17, 47.1%). No distant metastasis was found. Of the 17 patients, 6 (35.3%) died due to tumor progression (3/17, 17.6%), liver failure (2/17, 11.8%), or massive hemorrhage of the gastrointestinal tract (1/17, 5.9%). The overall survival rates were 94.1% (16/17), 82.4% (14/17), and 61.8% (11/17) at 12, 18, and 24 months, respectively, and the median survival time was 25 months (95% CI 18–27). Conclusion Treatment using combination of TACE and RFA is an effective and safe therapeutic strategy for treating HCC with tumor(s) adjacent to the second hepatic hilus.

scholarly journals Combination of radiofrequency ablation and transcatheter arterial chemoembolization to treat hepatocellular carcinoma: measurement of distance from needle tip to nodule for assessment of local tumor progression

2019 ◽  
Vol 47 (6) ◽  
pp. 2516-2523 ◽  
Author(s):  
Wang Haochen ◽  
Wang Jian ◽  
Song Li ◽  
Lv Tianshi ◽  
Tong Xiaoqiang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Factors ◽  
Radiofrequency Ablation ◽  
Tumor Progression ◽  
Minimum Distance ◽  
Transcatheter Arterial Chemoembolization ◽  
Three Dimensional ◽  
Local Tumor Progression ◽  
Local Tumor ◽  
Arterial Chemoembolization

Objective This study was performed to determine the relationship between the minimum distance from the radiofrequency ablation (RFA) needle tip to the tumor and local tumor progression (LTP) of hepatocellular carcinoma (HCC) nodules and identify prognostic factors for LTP. Methods We reviewed 197 patients (197 nodules) who underwent RFA after transcatheter arterial chemoembolization for HCC from January 2010 to January 2015. Three-dimensional registration of images was used to calculate the minimum distance from the tip to the tumor. We then divided the minimum distance into two groups: <2 and ≥2 mm. Contrast-enhanced computed tomography was performed after treatment. The LTP rate was calculated 1 and 3 years after RFA. We performed multivariate analysis to identify independent prognostic factors for LTP. Results The cumulative 1-year LTP rates in the <2- and ≥2-mm groups were 82.7% and 4.3%, respectively, and the cumulative 3-year LTP rates in the two groups were 94.8% and 10.8%, respectively. The minimum distance from the needle tip to the tumor was an independent prognostic factor for LTP. Conclusions A minimum distance of 2 mm from the needle tip to the tumor should be completely ablated along with the tumor.

scholarly journals Artificial Pneumothorax Improves Radiofrequency Ablation of Pulmonary Metastases of Hepatocellular Carcinoma close to Mediastinum

2020 ◽  
Author(s):  
Taiyang Zuo ◽  
Wenli Lin ◽  
Fengyong Liu ◽  
Jinshun Xu
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Tumor Progression ◽  
Pulmonary Metastases ◽  
Progression Free Survival ◽  
Local Tumor Progression ◽  
Technical Success ◽  
Local Tumor ◽  
Contrast Enhanced Ct ◽  
Artificial Pneumothorax

Abstract Background: To investigate the feasibility, safety and efficacy of percutaneous radiofrequency ablation (RFA) of pulmonary metastases from hepatocellular carcinoma (HCC) contiguous with the mediastinum using the artificial pneumothorax technique.Method: A total of 40 lesions in 32 patients with pulmonary metastases from HCC contiguous with the mediastinum accepted RFA treatment from August 2014 to May 2018 via the artificial pneumothorax technique. After ablation, clinical outcomes were followed up by contrast enhanced CT. Technical success, local tumor progression (LTP), intrapulmonary distant recurrence (IDR), and adverse events were evaluated. Overall survival (OS) and local tumor progression free survival (LTPFS) were recorded for each patient. Results: The tumor size was 1.4 ± 0.6 cm in diameter. RFA procedures were all successfully performed without intra-ablative complications. Technical success was noted in 100% of the patients. 5 cases of LTP and 8 cases of IDR occurred following the secondary RFA for treatment. Slight pain was reported in all patients. No major complications were observed. The 1, 2, and 3-year LTPFS rates were 90.6%, 81.2%, and 71.8%, and the 1, 2, and 3-year OS rates were 100%, 100% and 87.5%, respectively.Conclusion: Artificial pneumothorax adjuvant RFA is a feasible, safe, and efficient method for treatment of pulmonary metastases from HCC contiguous with the mediastinum.

scholarly journals Percutaneous radiofrequency ablation with a multiple-electrode switching system for medium-sized hepatocellular carcinomas

2020 ◽  
Author(s):  
Yunhua Tan ◽  
Xuesong Li ◽  
Qiang Wang ◽  
Kun Li ◽  
Kuansheng Ma
Keyword(s):  
Radiofrequency Ablation ◽  
Tumor Progression ◽  
Local Tumor Progression ◽  
Switching System ◽  
Local Tumor ◽  
Short Term ◽  
Ablation Volume ◽  
Hepatocellular Carcinomas ◽  
Multiple Electrode

OBJECTIVE: To retrospectively evaluate the safety and short-term therapeutic efficacy of radiofrequency ablation (RFA) with a multiple-electrode switching system (MESS) to treat medium-sized (3.1-5.0 cm) hepatocellular carcinomas (HCCs). SUMMARY OF BACKGROUND DATA: Conventional monopolar RFA is limited in achieving local control for tumors larger than 3 cm. Therefore, MESS-RFA was developed, and can create a sufficiently large ablation volume including the target tumor and a 5−10 mm safety margin in medium-sized tumors METHODS: We performed a total of 168 RFAs with a MESS on 166 patients. The patients were treated under ultrasonographic guidance by percutaneous switching system RFA with a multichannel RF generator and two or three internally cooled electrodes. Technical effectiveness, local progression, and remote recurrence of HCC were determined. RESULTS: For the 166 isolated HCC tumors, the complete ablation rate of MESS-RFA was 98.79% (164/166). Mean ablation time per procedure was 12.33±3.01 min; mean ablation diameter was 5.79±0.61 cm. The complication rate was 2.41%. During follow-up (averaging 16.54 months), local tumor progression occurred in 15/166 patients (9.03%) with technical effectiveness, while new HCCs were detected in 40/166 patients (24.09%). Multivariate analyses revealed that local tumor progression was only associated with serum AFP levels above 100 ng/ml as a risk factor. CONCLUSION: MESS-RFA for achieving sufficient ablation volume is safe and efficient. This method also showed relatively successful therapeutic effectiveness on short-term follow up in the treatment of medium-sized HCCs.

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