Yıl: 2020 Cilt: 26 Sayı: 1 Sayfa Aralığı: 34 - 39 Metin Dili: İngilizce DOI: 10.5152/dir.2019.18543 İndeks Tarihi: 05-10-2020

Percutaneous Cryoablation of Subcapsular Hepatocellular Carcinoma: a Retrospective Study of 57 Cases

Öz:
PURPOSEThis study aims to evaluate the safety and effectiveness of the percutaneous cryoablation for subcapsular hepatocellular carcinoma (HCC).METHODSA total of 57 patients with subcapsular (<1 cm form the liver edge) HCCs (68 lesions), who were treated with CT-guided percutaneous cryoablation in the Department of Interventional Radiology of our hospital between July 1, 2016 and September 1, 2018, were retrospectively included. Complete ablation rate, local tumor progression (LTP) and treatment-related complications were evaluated. Furthermore, the degree of intraoperative and postoperative pain was measured with the visual analog scale (VAS), and laboratory findings were compared before and after the procedure.RESULTSAll patients successfully completed the treatment. The mean follow-up period was 12.8 months (range, 3–27 months), and the complete ablation rate was 97% (66/68). Local tumor progression occurred in 11 lesions (16.2%), and the 6-, 12- and 18-month cumulative LTP rates were 4.0%, 8.2% and 20.5%, respectively. Two patients (3.5%, 2/57) developed major complications, and 12patients had minor complications (22.8%, 12/57). The mean VAS score during the operation was 1.65 points (range, 1–3 points). Postoperative pain worsened in 3 patients, and the VAS scores reached 4–5. Transient changes in biochemical and hematologic markers were observed.CONCLUSIONPercutaneous cryoablation for subcapsular HCC is safe and effective; the procedure is simple and the patients suffer less pain.
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Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • Rawla P, Sunkara T, Muralidharan P, Raj JP. Update in global trends and aetiology of hepatocellular carcinoma. Contemp Oncol (Pozn) 2018; 22:141–150. [CrossRef]
  • de Baere T, Elias D, Dromain C, et al. Radiofrequency ablation of 100 hepatic metastases with a mean follow-up of more than 1 year. AJR Am J Roentgenol 2000; 175:1619–25. [CrossRef]
  • Choi H, Loyer EM, DuBrow RA, et al. Radio-frequency ablation of liver tumors: assessment of therapeutic response and complications. Radiographics 2001; 21:S41–54. [CrossRef]
  • Seror O, N'Kontchou G, Ganne N, Beaugrand M. A randomized trial comparing radiofrequency ablation and surgical resection for HCC conforming to the Milan criteria. Ann Surg 2011; 254:837. [CrossRef]
  • Ahmed M, Brace CL, Lee FT, Jr., Goldberg SN. Principles of and advances in percutaneous ablation. Radiology 2011; 258:351–369. [CrossRef]
  • Feng K, Yan J, Li X, et al. A randomized controlled trial of radiofrequency ablation and surgical resection in the treatment of small hepatocellular carcinoma. J Hepatol 2012; 57:794–802. [CrossRef]
  • Mulier S, Ruers T, Jamart J, Michel L, Marchal G, Ni Y. Radiofrequency ablation versus resection for resectable colorectal liver metastases: time for a randomized trial? An update. Dig Surg 2008; 25:445–460. [CrossRef]
  • van Amerongen MJ, Jenniskens SFM, van den Boezem PB, Futterer JJ, de Wilt JHW. Radiofrequency ablation compared to surgical resection for curative treatment of patients with colorectal liver metastases - a meta-analysis. HPB (Oxford) 2017; 19:749–756. [CrossRef]
  • Llovet JM, Vilana R, Bru C, et al. Increased risk of tumor seeding after percutaneous radiofrequency ablation for single hepatocellular carcinoma. Hepatology 2001; 33:1124–1129. [CrossRef]
  • Bonny C, Abergel A, Gayard P, et al. Radiofrequency ablation of hepatocellular carcinoma in patients with cirrhosis. Gastroenterol Clin Biol 2002; 26:735–741.
  • Livraghi T, Solbiati L, Meloni MF, Gazelle GS, Halpern EF, Goldberg SN. Treatment of focal liver tumors with percutaneous radio-frequency ablation: complications encountered in a multicenter study. Radiology 2003; 226:441–451. [CrossRef]
  • Rhim H. Complications of radiofrequency ablation in hepatocellular carcinoma. Abdom Imaging 2005; 30:409–418. [CrossRef]
  • Jaskolka JD, Asch MR, Kachura JR, et al. Needle tract seeding after radiofrequency ablation of hepatic tumors. J Vasc Interv Radiol 2005; 16:485–491. [CrossRef]
  • Sartori S, Tombesi P, Macario F, et al. Subcapsular liver tumors treated with percutaneous radiofrequency ablation: a prospective comparison with nonsubcapsular liver tumors for safety and effectiveness. Radiology 2008; 248:670–679. [CrossRef]
  • Filippousis P, Sotiropoulou E, Manataki A, Konstantinopoulos O, Thanos L. Radiofrequency ablation of subcapsular hepatocellular carcinoma: single center experience. Eur J Radiol 2011; 77:299–304. [CrossRef]
  • Francica G, Meloni MF, de Sio I, et al. Radiofrequency and microwave ablation of subcapsular hepatocellular carcinoma accessed by direct puncture: Safety and efficacy. Eur J Radiol 2016; 85:739–743. [CrossRef]
  • Fujiwara H, Arai Y, Ishii H, Kanazawa S. Computed tomography-guided radiofrequency ablation for sub-diaphragm hepatocellular carcinoma: safety and efficacy of inducing an artificial pneumothorax. Acta Med Okayama 2016; 70:189–195.
  • Song I, Rhim H, Lim HK, Kim YS, Choi D. Percutaneous radiofrequency ablation of hepatocellular carcinoma abutting the diaphragm and gastrointestinal tracts with the use of artificial ascites: safety and technical efficacy in 143 patients. Eur Radiol 2009; 19:2630–2640. [CrossRef]
  • Rhim H, Lim HK. Radiofrequency ablation for hepatocellular carcinoma abutting the diaphragm: the value of artificial ascites. Abdom Imaging 2009; 34:371–380. [CrossRef]
  • Kang CM, Lee KH, Kim KM, Baik SH. "Dual-scopic" intraoperative radiofrequency ablation for the treatment of a hepatic metastatic tumor located beneath the diaphragm. Surg Laparosc Endosc Percutan Tech 2008; 18:202–206. [CrossRef]
  • Wang C, Wang H, Yang W, et al. Multicenter randomized controlled trial of percutaneous cryoablation versus radiofrequency ablation in hepatocellular carcinoma. Hepatology 2015; 61:1579–1590. [CrossRef]
  • Kim GM, Won JY, Kim MD, et al. Cryoablation of hepatocellular carcinoma with high-risk for percutaneous ablation: safety and efficacy. Cardiovasc Intervent Radiol 2016; 39:1447–1454. [CrossRef]
  • Kim R, Kang TW, Cha DI, et al. Percutaneous cryoablation for perivascular hepatocellular carcinoma: Therapeutic efficacy and vascular complications. Eur Radiol 2019; 29:654–662. [CrossRef]
  • Fairchild AH, Tatli S, Dunne RM, Shyn PB, Tuncali K, Silverman SG. Percutaneous cryoablation of hepatic tumors adjacent to the gallbladder: assessment of safety and effectiveness. J Vasc Interv Radiol 2014; 25:1449–1455. [CrossRef]
  • Korean Liver Cancer Study G, National Cancer Center K. 2014 Korean Liver Cancer Study Group-National Cancer Center Korea practice guideline for the management of hepatocellular carcinoma. Korean J Radiol 2015; 16:465–522. [CrossRef]
  • Kim YJ, Raman SS, Yu NC, Busuttil RW, Tong M, Lu DS. Radiofrequency ablation of hepatocellular carcinoma: can subcapsular tumors be safely ablated? AJR Am J Roentgenol 2008; 190:1029–1034. [CrossRef]
  • Kang TW, Lim HK, Lee MW, Kim YS, Choi D, Rhim H. First-line radiofrequency ablation with or without artificial ascites for hepatocellular carcinomas in a subcapsular location: local control rate and risk of peritoneal seeding at long-term follow-up. Clin Radiol 2013; 68:e641–651. [CrossRef]
  • Komorizono Y, Oketani M, Sako K, et al. Risk factors for local recurrence of small hepatocellular carcinoma tumors after a single session, single application of percutaneous radiofrequency ablation. Cancer 2003; 97:1253–1262. [CrossRef]
  • Ng KK, Lam CM, Poon RT, Ai V, Tso WK, Fan ST. Thermal ablative therapy for malignant liver tumors: a critical appraisal. J Gastroenterol Hepatol 2003; 18:616–629. [CrossRef]
  • Nakashima Y, Nakashima O, Tanaka M, Okuda K, Nakashima M, Kojiro M. Portal vein invasion and intrahepatic micrometastasis in small hepatocellular carcinoma by gross type. Hepatol Res 2003; 26:142–147. [CrossRef]
  • Okusaka T, Okada S, Ueno H, et al. Satellite lesions in patients with small hepatocellular carcinoma with reference to clinicopathologic features. Cancer 2002; 95:1931–1937. [CrossRef]
  • Bolondi L, Gaiani S, Celli N, Piscaglia F. Tumor dissemination after radiofrequency ablation of hepatocellular carcinoma. Hepatology 2001; 34:608. [CrossRef]
  • Livraghi T, Lazzaroni S, Meloni F, Solbiati L. Risk of tumour seeding after percutaneous radiofrequency ablation for hepatocellular carcinoma. Br J Surg 2005; 92:856–858. [CrossRef]
  • de Sio I, Castellano L, De Girolamo V, et al. Tumor dissemination after radiofrequency ablation of hepatocellular carcinoma. Hepatology 2001; 34:609–610. [CrossRef]
  • Wang CP, Wang H, Qu JH, et al. Tumour seeding after percutaneous cryoablation for hepatocellular carcinoma. World J Gastroenterol 2012; 18:6587–6596. [CrossRef]
APA Fuming W, Ma J, Linlin W, Na L, Rong L, jijin Y (2020). Percutaneous Cryoablation of Subcapsular Hepatocellular Carcinoma: a Retrospective Study of 57 Cases. , 34 - 39. 10.5152/dir.2019.18543
Chicago Fuming Wang,Ma Jianbing,Linlin Wu,Na Li,Rong Luo,jijin Yang Percutaneous Cryoablation of Subcapsular Hepatocellular Carcinoma: a Retrospective Study of 57 Cases. (2020): 34 - 39. 10.5152/dir.2019.18543
MLA Fuming Wang,Ma Jianbing,Linlin Wu,Na Li,Rong Luo,jijin Yang Percutaneous Cryoablation of Subcapsular Hepatocellular Carcinoma: a Retrospective Study of 57 Cases. , 2020, ss.34 - 39. 10.5152/dir.2019.18543
AMA Fuming W,Ma J,Linlin W,Na L,Rong L,jijin Y Percutaneous Cryoablation of Subcapsular Hepatocellular Carcinoma: a Retrospective Study of 57 Cases. . 2020; 34 - 39. 10.5152/dir.2019.18543
Vancouver Fuming W,Ma J,Linlin W,Na L,Rong L,jijin Y Percutaneous Cryoablation of Subcapsular Hepatocellular Carcinoma: a Retrospective Study of 57 Cases. . 2020; 34 - 39. 10.5152/dir.2019.18543
IEEE Fuming W,Ma J,Linlin W,Na L,Rong L,jijin Y "Percutaneous Cryoablation of Subcapsular Hepatocellular Carcinoma: a Retrospective Study of 57 Cases." , ss.34 - 39, 2020. 10.5152/dir.2019.18543
ISNAD Fuming, Wang vd. "Percutaneous Cryoablation of Subcapsular Hepatocellular Carcinoma: a Retrospective Study of 57 Cases". (2020), 34-39. https://doi.org/10.5152/dir.2019.18543
APA Fuming W, Ma J, Linlin W, Na L, Rong L, jijin Y (2020). Percutaneous Cryoablation of Subcapsular Hepatocellular Carcinoma: a Retrospective Study of 57 Cases. Diagnostic and Interventional Radiology, 26(1), 34 - 39. 10.5152/dir.2019.18543
Chicago Fuming Wang,Ma Jianbing,Linlin Wu,Na Li,Rong Luo,jijin Yang Percutaneous Cryoablation of Subcapsular Hepatocellular Carcinoma: a Retrospective Study of 57 Cases. Diagnostic and Interventional Radiology 26, no.1 (2020): 34 - 39. 10.5152/dir.2019.18543
MLA Fuming Wang,Ma Jianbing,Linlin Wu,Na Li,Rong Luo,jijin Yang Percutaneous Cryoablation of Subcapsular Hepatocellular Carcinoma: a Retrospective Study of 57 Cases. Diagnostic and Interventional Radiology, vol.26, no.1, 2020, ss.34 - 39. 10.5152/dir.2019.18543
AMA Fuming W,Ma J,Linlin W,Na L,Rong L,jijin Y Percutaneous Cryoablation of Subcapsular Hepatocellular Carcinoma: a Retrospective Study of 57 Cases. Diagnostic and Interventional Radiology. 2020; 26(1): 34 - 39. 10.5152/dir.2019.18543
Vancouver Fuming W,Ma J,Linlin W,Na L,Rong L,jijin Y Percutaneous Cryoablation of Subcapsular Hepatocellular Carcinoma: a Retrospective Study of 57 Cases. Diagnostic and Interventional Radiology. 2020; 26(1): 34 - 39. 10.5152/dir.2019.18543
IEEE Fuming W,Ma J,Linlin W,Na L,Rong L,jijin Y "Percutaneous Cryoablation of Subcapsular Hepatocellular Carcinoma: a Retrospective Study of 57 Cases." Diagnostic and Interventional Radiology, 26, ss.34 - 39, 2020. 10.5152/dir.2019.18543
ISNAD Fuming, Wang vd. "Percutaneous Cryoablation of Subcapsular Hepatocellular Carcinoma: a Retrospective Study of 57 Cases". Diagnostic and Interventional Radiology 26/1 (2020), 34-39. https://doi.org/10.5152/dir.2019.18543