Advantages of Laparoscopic Radiofrequency Ablation Over Percutaneous Radiofrequency Ablation in Hepatocellular Carcinoma

Eun, Hyuk Soo; Lee, Byung Seok; Kwon, In Sun; Yun, Gee Young; Lee, Eaum Seok; Joo, Jong Seok; Sung, Jae Kyu; Moon, Hee Seok; Kang, Sun Hyung; Kim, Ju Seok; Shin, Hae Jin; Kim, Tae Kyun; Chun, Kwangsik; Kim, Seok Hyun

doi:10.1007/s10620-017-4688-6

Cited by 28 publications

(35 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Laparoscopic-RFA (L-RFA) represents an alternative when P-RFA is not feasible and laparotomy is contraindicated or is too invasive. The specific indications for L-RFA are represented by: severe impairment of the coagulation tests, large tumors (but < 3.5 cm) or multiple lesions requiring repeated punctures, superficial lesions adjacent to visceral structures, deep-situated lesions with a very difficult or impossible percutaneous approach, shortterm recurrence of HCC following percutaneous loco-regional therapies [5][6][7]. For HCC patients unfit for surgery, the efficacy of L-RFA appeared to be superior to P-RFA in terms of survival in the study conducted by Eun et al [6].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Contrast-Enhanced Ultrasonography for Real Time Monitoring of Laparoscopic Radiofrequency Ablation for Hepatocellular Carcinoma: an Observational Pilot Study

Bartoș

Bartoş

Spârchez

et al. 2019

JGLD

View full text Add to dashboard Cite

Background and Aims: Laparoscopic radio-frequency ablation (L-RFA) for hepatocellular carcinoma (HCC) is used for unresectable tumors, with difficult location, unfitted for a percutaneous ablation technique. L-RFA has a high incidence of local recurrence. Even if intraoperative-ultrasound is standardized for staging and RFA probe guidance, the role of laparoscopic contrast-enhanced ultrasound (L-CEUS) for the real time monitoring of L-RFA efficacy has not been previously reported. We evaluated in a pilot observational study the efficacy of L-CEUS to assess the necrotic post-ablative area in difficult to treat HCC. Methods: Eight consecutive patients diagnosed with HCC (peripherally located) on liver cirrhosis were referred for L-RFA between May 2016 and December 2018. For L-RFA a SturBurst XL (AngioDinamics®) internally cooled electrode was used, being placed under ultrasound guidance. L-CEUS was used to assess the necrotic post-ablative area. The median follow up period was 18 months. Results: L-CEUS real time monitoring of the L-RFA efficacy indicated residual neoplastic tissue in 4 cases (50%). The procedure was repeated by reinserting the needle in the suspected areas indicated by L-CEUS. Complete tumor ablation was achieved in all treated patients. After a median follow-up of 18 months no recurrence of HCC was observed in 7 patients (87.5%). Conclusions: L-CEUS was a reliable procedure for the immediate assessment of L-RFA efficacy; half of the ablated HCC nodules required a second ablation session. This approach might decrease the local recurrences, but its role must be further investigated in larger cohorts.

show abstract

Section: Introductionmentioning

confidence: 99%

Laparoscopic Contrast-Enhanced Ultrasonography for Real Time Monitoring of Laparoscopic Radiofrequency Ablation for Hepatocellular Carcinoma: an Observational Pilot Study

Bartoș

Bartoş

Spârchez

et al. 2019

JGLD

View full text Add to dashboard Cite

show abstract

“…A previous study comparing laparoscopic RFA to percutaneous RFA in Korea similarly showed an advantage to the laparoscopic approach for HCC 29 . Although the method of ablation (laparoscopic or percutaneous) was not a significant determinant of overall or recurrence‐free survival on multivariate analysis, it was a significant determinant of overall survival after propensity score matching was performed between the two groups 29 . Furthermore, laparoscopic RFA significantly reduced the hazards ratio for death and decreased intrahepatic and local recurrences 29 …”

Section: Discussionmentioning

confidence: 95%

Minimally invasive microwave ablation provides excellent long‐term outcomes for otherwise inaccessible hepatocellular cancer

Altman

Coughlan

Shukla

et al. 2020

Journal of Surgical Oncology

View full text Add to dashboard Cite

Background and Objectives: Thermal ablation can be used as a bridge to transplant or with curative intent for hepatocellular carcinoma (HCC). We report our experience with laparoscopic ablation of HCC in patients deemed inaccessible by the percutaneous approach.Methods: We performed a retrospective review of surgical ablations from 2009 to 2017. Patient demographics, disease and treatment characteristics, and outcomes were abstracted from the medical record. Kaplan-Meier modeling was performed for survival and recurrence.Results: Thirty-three patients were included with a median age of 62 (interquartile range [IQR], 57-67). Most patients were male (76%) and Caucasian (70%). Ninety-seven percent had underlying cirrhosis. Median model for end stage liver disease-sodium was 9.5 (IQR,(8)(9)(10)(11)(12). The median maximal diameter of ablated lesions was 2.6 cm (IQR, 1.8-3.0). Thirty-nine lesions were ablated; 97% were completed laparoscopically. The median maximal diameter of the ablation zone was 4.8 cm (IQR, 3.8-5.7) with a median difference of ablation zone to the tumor of 2.0 cm (IQR, 1.5-2.75). Twelve patients received additional treatment. Median disease-free survival was 66.7 months and median follow-up 42.9 months. Disease recurrence occurred in 13 patients (39%)systemic recurrence in 6%, intrahepatic recurrence in 27% and local recurrence in 6%.Conclusion: Laparoscopic thermal ablation of HCC is safe and provides good oncologic outcomes for otherwise inaccessible tumors. K E Y W O R D S disease recurrence, hepatocellular carcinoma, laparoscopic surgery, minimally invasive surgery, thermal ablation

show abstract

“…The lesions were assessed one and eight weeks after PRFA by CT or MRI. We defined complete ablation as hypoattenuation of the target area and the surrounding liver parenchyma, which was confirmed by radiology[ 12 ].…”

Section: Methodsmentioning

confidence: 99%

“…PRFA therapy is effective for controlling local tumours with improved survival and is the current standard for early-stage HCC requiring ablative treatments[ 4 - 11 ]. Although studies have demonstrated the superiority of LRFA to PRFA for patient survival[ 12 ], LRFA is more invasive than PRFA with higher risks of complications and requires general anaesthesia[ 13 ]. When percutaneous ablation treatments cannot be used, HR is a suitable alternative for the treatment of small HCC[ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous radiofrequency ablation is superior to hepatic resection in patients with small hepatocellular carcinoma

Zhang

Sun

et al. 2020

WJCC

View full text Add to dashboard Cite

BACKGROUND It is not known whether percutaneous radiofrequency ablation (PRFA) has the same treatment efficacy and fewer complications than laparoscopic resection in patients with small centrally located hepatocellular carcinoma (HCC). AIM To compare the effectiveness of PRFA with classical laparoscopic resection in patients with small HCC and document the safety parameters. METHODS In this retrospective study, 85 patients treated with hepatic resection (HR) and 90 PRFA-treated patients were enrolled in our hospital from July 2016 to July 2019. Treatment outcomes, including major complications and survival data, were evaluated. RESULTS The results showed that minor differences existed in the baseline characteristics between the patients in the two groups. PRFA significantly increased cumulative recurrence-free survival (hazard ratio 1.048, 95%CI: 0.265–3.268) and overall survival (hazard ratio 0.126, 95%CI: 0.025–0.973); PRFA had a lower rate of major complications than HR (7.78% vs 20.0%, P < 0.05), and hospital stay was shorter in the PRFA group than in the HR group (7.8 ± 0.2 d vs 9.5 ± 0.3 d, P < 0.001). CONCLUSION Based on the data obtained, we conclude that PRFA was superior to HR and may reduce complications and hospital stay in patients with small HCC.

show abstract

Advantages of Laparoscopic Radiofrequency Ablation Over Percutaneous Radiofrequency Ablation in Hepatocellular Carcinoma

Abstract: LRFA appears to be superior to PRFA in terms of survival. LRFA may help reduce mortality in HCC patients.

Cited by 28 publications

References 33 publications

Laparoscopic Contrast-Enhanced Ultrasonography for Real Time Monitoring of Laparoscopic Radiofrequency Ablation for Hepatocellular Carcinoma: an Observational Pilot Study

Laparoscopic Contrast-Enhanced Ultrasonography for Real Time Monitoring of Laparoscopic Radiofrequency Ablation for Hepatocellular Carcinoma: an Observational Pilot Study

Minimally invasive microwave ablation provides excellent long‐term outcomes for otherwise inaccessible hepatocellular cancer

Percutaneous radiofrequency ablation is superior to hepatic resection in patients with small hepatocellular carcinoma

Contact Info

Product

Resources

About