scholarly journals 2450 MHz Microwave Ablation for Liver Metastases Under 3.0T Wide-bore Magnetic Resonance Guidance: a Pilot Study

2021 ◽  
Author(s):  
Kaihao Xu ◽  
Zhaonan Li ◽  
Yiming Liu ◽  
Zaoqu Liu ◽  
Chaoyan Wang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Magnetic Resonance ◽  
Liver Metastases ◽  
Microwave Ablation ◽  
Ablation Rate ◽  
Maximum Diameter ◽  
Technical Success ◽  
Local Tumor ◽  
Total Procedure Time ◽  
The Mean

Abstract Purpose: To investigate the feasibility and effectiveness of 3.0T wide-bore magnetic resonance (MR)-guided microwave ablation (MA) for liver metastases (LM).Patients and methods: From October 2018 to May 2020, 39 patients with 63 LM were treated with 3.0T wide-bore MR-guided 2450 MHz MA therapy. The procedure parameters, technical success, complications, biochemical indexes changes, local tumor response, local tumor progression (LTP) and overall survival were recorded and analyzed.Results: The mean tumor maximum diameter and total procedure time were 3.0 cm and 55.2 min, respectively. Technical success was 100% but 5 cases (12.8%) with grade-1 complications. Alanine transaminase, aspartate transaminase and total bilirubin showed slight a transient increase on day 3 (P<0.05) and returned to normal by day 30 (P>0.05). The complete ablation rate for ≦ 2.5 and >2.5 cm lesions were 100 % and 92.5 %, respectively, during the median followup of 12.0 months, LTP rate was 4.8 % (3/63), and the 6-, 12- and 18-month overall survival were 100%, 92.2%, 76.4% , respectively.Conclusion: 3.0T wide-bore MR-guided MA for LM is a safe and effective approach, especially for small LM.

A grading system for predicting the prognosis of gastric cancer with liver metastasis

2021 ◽  
Author(s):  
Soshi Hori ◽  
Michitaka Honda ◽  
Hiroshi Kobayashi ◽  
Hidetaka Kawamura ◽  
Koichi Takiguchi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Gastric Cancer ◽  
Overall Survival ◽  
Liver Metastasis ◽  
Confidence Interval ◽  
Liver Metastases ◽  
Hazard Ratio ◽  
Maximum Diameter ◽  
Grading System ◽  
Computed Tomography Images

Abstract Objective The prognosis of patients with liver metastases from gastric cancer is determined using tumor size and number of metastases; this is similar to the factors used for the prediction of liver metastases from colorectal cancer. The relationship between the degree of liver metastasis from gastric cancer and prognosis with reference to the classification of liver metastasis from colorectal cancer was investigated. Methods This was a multi-institutional historical cohort study. Among patients with stage IV gastric cancer, who visited the cancer hospitals in Fukushima Prefecture, Japan, between 2008 and 2015, those with simultaneous liver metastasis were included. Abdominal pretreatment computed tomography images were reviewed and classified into H1 (four or less liver metastases with a maximum diameter of ≤5 cm); H2 (other than H1 and H3) or H3 (five or more liver metastases with a maximum diameter of ≥5 cm). The hazard ratio for overall survival according to the H grade (H1, H2 and H3) was calculated using the Cox proportional hazards model. Results A total of 412 patients were analyzed. Patients with H1, H2 and H3 grades were 118, 162 and 141, respectively, and their median survival time was 10.2, 5.7 and 3.1 months, respectively (log-rank P &lt; 0.001). The adjusted hazard ratio for overall survival was H1: H2: H3 = reference: 1.39 (95% confidence interval: 1.04–1.85): 1.69 (95% confidence interval: 1.27–2.27). Conclusions The grading system proposed in this study was a simple and easy-to-use prognosis prediction index for patients with liver metastasis from gastric cancer.

scholarly journals METACHRONOUS COLORECTAL LIVER METASTASES HAS BETTER PROGNOSIS - IS IT TRUE?

2018 ◽  
Vol 55 (3) ◽  
pp. 258-263 ◽  
Author(s):  
Claudemiro QUIREZE JUNIOR ◽  
Andressa Machado Santana BRASIL ◽  
Lúcio Kenny MORAIS ◽  
Edmond Raymond Le CAMPION ◽  
Eliseu José Fleury TAVEIRA ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Liver Metastases ◽  
Hepatic Metastasis ◽  
Colorectal Liver Metastases ◽  
Public Health Problem ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
The Mean ◽  
Colorectal Hepatic Metastasis

ABSTRACT BACKGROUND: Liver metastases from colorectal cancer are an important public health problem due to the increasing incidence of colorectal cancer worldwide. Synchronous colorectal liver metastasis has been associated with worse survival, but this prognosis is controversial. OBJECTIVE: The objective of this study was to evaluate the recurrence-free survival and overall survival between groups of patients with metachronous and synchronous colorectal hepatic metastasis. METHODS: This was a retrospective analysis of medical records of patients with colorectal liver metastases seen from 2013 to 2016, divided into a metachronous and a synchronous group. The Cox regression model and the Kaplan-Meier method with log-rank test were used to compare survival between groups. RESULTS: The mean recurrence-free survival was 9.75 months and 50% at 1 year in the metachronous group and 19.73 months and 63.3% at 1 year in the synchronous group. The mean overall survival was 20.00 months and 6.2% at 3 years in the metachronous group and 30.39 months and 31.6% at 3 years in the synchronous group. Patients with metachronous hepatic metastasis presented worse overall survival in multivariate analysis. The use of biological drugs combined with chemotherapy was related to the best overall survival prognosis. CONCLUSION: Metachronous colorectal hepatic metastasis was associated with a worse prognosis for overall survival. There was no difference in recurrence-free survival between metachronous and synchronous metastases.

scholarly journals Percutaneous Radiofrequency Ablation Treatment of Hepatocellular Carcinoma in Caudate Lobe Using Expandable Electrodes

2021 ◽  
Vol 73 (8) ◽  
pp. 541-548
Author(s):  
Somrach Thamtorawat ◽  
Torpong Claimon ◽  
Satit Rojwatcharapibarn ◽  
Pradesh Ghirnire ◽  
Trongtum Tongdee ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Radiofrequency Ablation ◽  
Caudate Lobe ◽  
Local Tumor Progression ◽  
Primary Efficacy ◽  
Rf Ablation ◽  
Technical Success ◽  
Local Tumor ◽  
One Year

Objective: To evaluate the outcome of radiofrequency (RF) ablation using expandable electrodes in the treatment of hepatocellular carcinoma (HCC) located in the caudate lobe.Materials and Methods: Between January 2011 and April 2017, 29 consecutive patients with HCC at the caudate lobe were treated with RF ablation using expandable electrodes. The electrodes were placed on the targeted tumor under combined ultrasound and computed tomography (CT) guidance for each tumor in all the patients. Out of the 29 cases, 19 (65.5%) were accessed via the left hepatic lobe. The technical success, primary efficacy, local tumor progression, secondary efficacy, overall survival, and complications were evaluated. Univariate analysis was performed of the various prognostic factors for technical success, primary efficacy, and local tumor progression.Results: The technical success rate was 86.2%, primary efficacy was 89.7%, and secondary efficacy was 82.8%. The local tumor progression (LTP) rate was 12.3% at one year and 31.5% at two years. The median time of LTP was 6.9 months. The overall survival rate was 85.8% at one year and 57.1% at two years. Ten patients died during the follow-up period (mean 22.5 months; with a range of 3.6–53.2 months). A minor complication of asymptomatic biloma was found in one patient (3.5%). Small-sized tumors (≤2 cm) and Spiegel’s lobe location had significantly better treatment outcomes (p = 0.007 and 0.045, respectively).Conclusion: Radiofrequency ablation using expandable electrodes is feasible and safe in treating HCCs located in the caudate lobe, especially for small-sized tumors (≤2 cm).

Gastric polypoid lesions detected on magnetic resonance cholangiopancreatography

2021 ◽  
Author(s):  
Mitsuru Matsuki ◽  
Isao Numoto ◽  
Takefumi Hamakawa ◽  
Kazunari Ishii ◽  
Tomoyuki Otani
Keyword(s):  
Magnetic Resonance ◽  
Contrast Agent ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Maximum Diameter ◽  
Fundic Gland ◽  
Oral Contrast ◽  
Hyperplastic Polyps ◽  
Oral Contrast Agent ◽  
Fundic Gland Polyps ◽  
The Mean

Abstract Background: On magnetic resonance cholangiopancreatography (MRCP) using a negative oral contrast agent, the gastric lumen appear dark, and gastric polypoid lesions can be seen. To our knowledge, there are no reports examining gastric polypoid lesions detected on MRCP.We exained the characteristics of gastric polypoid lesions detected on MRCP and discussed the management of the lesions.Material and Methods: MRCP images using a negative oral contrast agent were retrospectively evaluated in 1128 cases, and gastric polypoid lesions detected were investigated.Results: Gastric polypoid lesions were detected in 17 of the 1128 cases (1.5%) on MRCP. The mean patient age and gender were 66.7 years (range: 48-85 years) and 7 males / 10 females. A single lesion was detected in 4 cases, 2 to 4 lesions were detected in 6 cases, 5 to 10 lesions in 3 cases, and 11 or more in 4 cases. In 4 cases, the upper, middle, and lower portions of the stomach were occupied with polypoid lesions, in 4 cases, the upper and middle portions were occupied, in 1 case, the middle and lower portions were occupied, and in 8 cases, only the upper portion was occupied. One lesion was detected in 4 cases, 2 to 4 lesions were detected in 6 cases, 5 to 10 lesions in 3 cases, and 11 or more in 4 cases. The mean maximum diameter of the polypoid lesions was 7.8 mm (range: 4-16 mm). An upper endoscopy and forceps biopsy were performed in 9 of the 17 cases. The histological diagnosis was fundic gland polyps in 6 cases and hyperplastic polyps in 3 cases.Conclusion: Gastric polypoid lesions can rarely be detected on MRCP. The polypoid lesions were histologically fundic gland polyps or hyperplastic polyps. In the future, we will prospectively review more cases and examine indication of upper gastrointestinal endoscopy to gastric polypoid lesions detected on MRCP.

scholarly journals Percutaneous stereotactic image-guided microwave ablation for malignant liver lesions

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Stéphanie Perrodin ◽  
Anja Lachenmayer ◽  
Martin Maurer ◽  
Corina Kim-Fuchs ◽  
Daniel Candinas ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Disease Progression ◽  
Microwave Ablation ◽  
Colorectal Liver Metastases ◽  
Disease Free Survival ◽  
Ablation Rate ◽  
Ampullary Carcinoma ◽  
Computer Assisted ◽  
Assisted Navigation ◽  
Image Guided

Abstract Thermal ablation has proven beneficial for hepatocellular carcinoma and possibly for colorectal liver metastases, but data is lacking for other liver metastases. Computer-assisted navigation can increase ablation efficacy and broaden its indications. We present our experience with percutaneous stereotactic image-guided microwave ablation (SMWA) for non-colorectal liver metastases (NCRLM), in form of a retrospective study including all SMWA for NCRLM from 2015 to 2017. Indication for SMWA was determined at a multidisciplinary tumorboard. End-points include recurrence, overall and liver-specific disease progression and complications. Twenty-three patients underwent 25 interventions for 40 lesions, including 17 neuroendocrine tumor, nine breast cancer, four sarcoma, two non-small cell lung cancer, three duodenal adenocarcinoma, one esophageal adenocarcinoma, one pancreatic adenocarcinoma, one ampullary carcinoma, one prostate carcinoma, and one renal cell carcinoma metastases. Median follow-up was 15 months (2–32). Incomplete ablation rate was 2.5% (1/40), local recurrence rate 10% (4/40). Three patients (12%) had minor complications. Overall disease progression was 73.9% (17/23), median disease-free survival 7 months (0–26) and overall survival 18 months (2–39). SIMWA is feasible, safe and minimally invasive for NCRLM in selected patients. While it might offer an alternative to resection or palliative strategies, the oncological benefit needs to be evaluated in a larger patient cohort.

scholarly journals The 5-year overall survival of cervical cancer in stage IIIC-r was little different to stage I and II: a retrospective analysis from a single center

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
E Yang ◽  
Shuying Huang ◽  
Xuting Ran ◽  
Yue Huang ◽  
Zhengyu Li
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Lymph Nodes ◽  
Stage I ◽  
Stage Ii ◽  
Maximum Diameter ◽  
Clinical Practices ◽  
Stage Iiic ◽  
Pelvic Lymph Nodes ◽  
The Mean

Abstract Background The 2018 International Federation of Gynecology and Obstetrics (FIGO) staging guideline for cervical cancer includes stage IIIC recognized by preoperative radiology (IIIC-r) to state there are lymph nodes metastases (LNM) identified by imaging tools. We aim to explore the reasonability and limitations of stage IIIC-r and try to explore the potential reasons. Methods Electronic medical records were used to identify patients with cervical cancer. According to the new staging guidelines, patients were reclassified and assigned into five cohorts: stage I, stage II, stage IIIC-r, LNM confirmed by pathology (IIIC-p) and LNM detected by radiology and confirmed by pathology (IIIC r + p). Five-year overall survivals were estimated for each cohort. The diagnosis accuracy of computed tomography (CT), magnetic resonance imaging (MRI) and diameter of detected lymph nodes were also evaluated. Results A total of 619 patients were identified. The mean follow-up months were 65 months (95% CI 64.43–65.77) for all patients. By comparison, the 5-year overall survival rates were not statistically different (p = 0.21) among stage IIIC-r, stage I and stage II. While, the rates were both statistical different (p<0.001) among stage IIIC-p, IIIC r + p and stage I and stage II. The sensitivities of CT and MRI in detecting LNM preoperatively were 51.2 and 48.8%. The mean maximum diameter of pelvic lymph nodes detected by CT cohort was 1.2 cm in IIIC-r cohort, and was 1.3 cm in IIIC r + p cohort. While, the mean maximum diameter of pelvic lymph nodes detected by MRI was 1.2 cm in IIIC-r cohort, and was 1.48 cm in IIIC r + p cohort. When the diagnosis efficacy of the diameter of pelvic lymph nodes in detecting LNM were evaluated, the area under the receiver operating characteristic curve (ROC curve) was 0.58 (p = 0.05). Conclusions It seems that the FIGO 2018 staging guideline for cervical cancer is likely to has certain limitations for the classification of those with LNM. CT or MRI, however, has limitations on detecting LNM. It would be better to use more accurate imaging tools to identify LNM in the clinical practices.

scholarly journals Surgical management and prognostic factors in liver metastases from kidney cancer

2020 ◽  
Vol 25 (1) ◽  
pp. 18-26
Author(s):  
I. S. Proskuryakov ◽  
Yu. I. Patyutko ◽  
A. G. Kotelnikov ◽  
D. V. Podluzhny ◽  
A. N. Polyakov ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Surgical Treatment ◽  
Liver Metastases ◽  
Kidney Cancer ◽  
Univariate Analysis ◽  
Hepatic Metastases ◽  
Long Term Results ◽  
Maximum Diameter

Aim. To evaluate short- and long-term results of surgical treatment of the liver metastases from kidney cancer, to identify prognostic factors.Materials and methods. The retrospective study included 67 patients who underwent surgical treatment for liver metastases from kidney cancer from 1990 to 2019. A total of 71 operations on the liver were performed (53 economical resections, 15 extensive resections, 3 radiofrequency thermoablation). Four of them were repeated for the development of metastases in the liver remant.Results. Postoperative morbidity was 30%. There was one (1,5%) intraoperative death. Within 90 days after surgery, all patients were alive. The 5-year overall survival was 64%, median was 73 months. Univariate analysis revealed factors that significantly worsened overall survival: stage III and IV kidney cancer at the time of nephrectomy; nonclear cell histological type of metastases; synchronous liver metastases; intraoperative blood loss more than 2000 ml. Gender, age (≥ 65 years) at the time of surgery, number of metastases, maximum diameter of the metastases, presence of extrahepatic disease and major liver resection did not have a statistically significant impact on overall survival.Conclusions. Surgical treatment allows to achieve long-term overall survival of patients with liver metastases from kidney cancer. Higher indicators of overall survival were noted in the clear-cell variant of kidney cancer, stage I–II, and the metachronic nature of hepatic metastases. Patients with large (≥4 cm) and multiple resectable liver metastases, having solitary and single metastases in other organs, provided that they are radically removed, can also be considered as candidates for surgical treatment.

scholarly journals Anal cancer - impact of interstitial brachytherapy

2021 ◽  
Vol 5 (1) ◽  
pp. 001-004
Author(s):  
M Kubecova ◽  
J Vranova ◽  
M Sejdova ◽  
K Reginacova
Keyword(s):  
Overall Survival ◽  
Anal Cancer ◽  
Tumor Regression ◽  
Complete Regression ◽  
External Radiotherapy ◽  
Concomitant Chemotherapy ◽  
Local Tumor ◽  
The Mean ◽  
The Impact

We evaluated a total of 115 patients diagnosed with anal cancer, who were treated at our clinic from 1995 to 2012. Their average age was 61 years, most often were diagnosed in stages II and III, in most cases it was a squamous cell carcinoma located in the anal canal. The mean follow-up was 83 months (minimum 1 month and maximum 240 months). We combined external radiotherapy with boost of brachytherapy or boost of external radiotherapy and possibly a combination of both boosts. Half of the patients received concomitant chemotherapy. We specifically evaluated local tumor regression, overall survival and the impact to therapeutic effect of the chosen irradiation technique. Complete regression was achieved in 92 patients, partial regression in 21 patients. Overall survival, regardless of stage, was 80% 3-year, 74% 5-year and 67% 10-year. The age of patients, the size of their own primary tumor and the therapeutic method used had a statistically significant effect on survival - especially the importance of brachytherapy was irreplaceable.

scholarly journals Effectiveness and Safety of Thermal Ablation in the Treatment of Primary Hyperparathyroidism: A Multicenter Study

2021 ◽  
Author(s):  
Ying Wei ◽  
Cheng-zhong Peng ◽  
Shu-rong Wang ◽  
Jun-feng He ◽  
Li-li Peng ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Thermal Ablation ◽  
Reduction Rate ◽  
Maximum Diameter ◽  
Cure Rate ◽  
Technical Success ◽  
Technical Success Rate ◽  
The Mean ◽  
Cure Rates

Abstract Purpose To evaluate the effectiveness and safety of thermal ablation for primary hyperparathyroidism (pHPT). Materials and Methods From January 2015 to March 2020, data pertaining to patients who received thermal ablation for pHPT at 4 centers were retrospectively analyzed. The median follow-up duration was 18.1months (IQR: 6.5-42.2 months). A cure referred to the reestablishment of normal values of serum calcium and intact parathyroid hormone (iPTH) throughout the entire follow-up period, at least more than 6 months. The technical success, effectiveness, and safety of treatment were analyzed. Results 119 patients (mean age, 57.2 ± 16.3 years; 81 female) with 134 parathyroid nodules were enrolled. The mean maximum diameter of the parathyroid glands was 1.6 ± 0.9 cm. Ninety-six patients underwent microwave ablation (MWA), and 23 patients underwent radiofrequency ablation (RFA). The technical success rate was 98.3% and the cure rate was 89.9%. Significant differences were found in the maximum diameter between the cured patients and the patients who did not undergo ablation of the target lesions. Except the cases with pHPT nodules&lt;0.6cm in diameter, the cure rate was 95%. There were no difference in cure rates at 6 months between the MWA and RFA (MWA vs. RFA, 90.6% vs. 87.0%; χ2=0.275, p = 0.699). The volume reduction rate of the ablation zone was 94.6% at 12 months. The complication rate was 6.7% (8/119). Except one patient with persistent voice impairment, other symptoms were spontaneously resolved within six months. Conclusion Thermal ablation was effective and safe for pHPT.

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