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Published February 2020 | Version v1
Journal article Metadata-only

No-Touch Multi-bipolar Radiofrequency Ablation for the Treatment of Subcapsular Hepatocellular Carcinoma ≤ 5 cm Not Puncturable via the Non-tumorous Liver Parenchyma

Creators

  • 1. Hôpitaux universitaires Paris-Seine-Saint-Denis, Assistfance Publique Hôpitaux de Paris. Radiology Department, Hôpital Jean Verdier (APHP) (France)
  • 2. CHU Vaudois. Diagnostic and Interventional Radiology Department (Switzerland)
  • 3. Hôpitaux universitaires Paris-Seine-Saint-Denis, Assistance Publique Hôpitaux de Paris. Hepatology Department, Hôpital Jean Verdier (France)
  • 4. Institut National de la Santé et de la Recherche Médicale. Unité mixte de recherche 1162, Génomique Fonctionnelle des Tumeurs Solides (France)
  • 5. Université Paris 13, communauté d'universités et établissements Sorbonne Paris cité. Unité de Formation et de Recherche Santé Médecine et Biologie Humaine (France)

Description

Purpose

: The percutaneous ablation of subcapsular hepatocellular carcinoma (S-HCC) may involve a risk of complications such as hemorrhage and tumor seeding, mainly linked to the direct tumor puncture often inevitable with mono-applicator ablation devices. The purpose of this study was to assess the efficacy and safety of no-touch multi-bipolar radiofrequency ablation (NTMBP-RFA) for the treatment of S-HCC ≤ 5 cm not puncturable via the non-tumorous liver parenchyma.

Materials and methods

: Between September 2007 and December 2014, 58 consecutive patients (median age: 63 years [46–86], nine females) with 59 S-HCC ≤ 5 cm (median diameter: 25 mm [10–50 mm]), not puncturable via the non-tumorous liver parenchyma, were treated with NTMBP-RFA. Response and follow-up were assessed by CT or MRI. Complications were graded using the Cardiovascular and Interventional Radiological Society of Europe classification. Overall local tumor progression (OLTP)-free survival was assessed using the Kaplan–Meier method. A Cox proportional model evaluated the factors associated with OLTP. Signs of peritoneal or parietal tumor seeding were noted during follow-up imaging studies.

Results

: A complete ablation was achieved in 57/58 patients (98.3%) after one (n = 51) or two (n = 6) procedures. Three patients (5.2%) experienced complications (sepsis, cirrhosis decompensation; CIRSE grade 2 or 3). After a median follow-up period of 30.5 months [1–97], no patients had tumor seeding. The 1, 2 and 3-year OLTP-free survival rates were 98%, 94% and 91%, respectively. No factors were associated with OLTP.

Conclusion

: NTMBP-RFA is a safe and effective treatment for S-HCC not puncturable via the non-tumorous liver parenchyma.

Additional details

Identifiers

DOI
10.1007/s00270-019-02357-9;

Publishing Information

Journal Title
Cardiovascular and Interventional Radiology
Journal Volume
43
Journal Issue
2
Journal Page Range
p. 273-283
ISSN
0174-1551
CODEN
CAIRDG

INIS

Country of Publication
United States
Country of Input or Organization
International Atomic Energy Agency (IAEA)
INIS RN
55061359
Subject category
S62: RADIOLOGY AND NUCLEAR MEDICINE;
Descriptors DEI
ABLATION; CLASSIFICATION; COMPUTERIZED TOMOGRAPHY; EUROPE; FEMALES; HAZARDS; HEMORRHAGE; HEPATECTOMY; HEPATOMAS; LIVER; NMR IMAGING; PATIENTS; PERITONEUM; RADIOWAVE RADIATION; RELAXATION TIME; SURVIVAL CURVES
Descriptors DEC
BODY; CARCINOMAS; DIAGNOSTIC TECHNIQUES; DIGESTIVE SYSTEM; DISEASES; ELECTROMAGNETIC RADIATION; GLANDS; MEDICINE; MEMBRANES; NEOPLASMS; ORGANS; PATHOLOGICAL CHANGES; RADIATIONS; SEROUS MEMBRANES; SURGERY; SYMPTOMS; TOMOGRAPHY

Optional Information

Copyright
Copyright (c) 2019 © Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2019