Impact of an ultrasound-guided radiofrequency ablation training program on the outcomes in patients with hepatocellular carcinoma

Takamatsu, Ryota; Okano, Akihiro; Yamakawa, Go; Mizukoshi, Kenta; Obayashi, Hitoshi; Ohana, Masaya

doi:10.1016/j.diii.2019.08.004

Cited by 10 publications

(5 citation statements)

References 23 publications

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“…Similar results might not be possible with a beginner. However, a recent study by Takai TR, et al 25 showed that a well-supervised ablation training program produced similar clinical outcomes and complication rates with no significant difference between the trainees and expertise group.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of percutaneous microwave ablation for hepatocellular carcinomas <4 cm in difficult location

Mukund

Ramalingam

Anandpara

et al. 2020

BJR

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Objective: Tumor location is a critical factor for determining technical success and local recurrence following percutaneous ablation of hepatocellular carcinomas (HCC). The purpose of this retrospective study was to evaluate the safety and outcome measures of percutaneous microwave ablation (pMWA) for HCCs < 4 cm in difficult locations. Methods: Retrospective review included 81 patients who underwent pMWA for HCCs < 4 cm. Fourty-three patients (30 males and 13 females; mean age, 61 years) with 53 HCCs located near the diaphragm, heart, gallbladder, kidney, gastrointestinal tract, large vessel and exophytic location were included under difficult location group. Thirty-eight patients (29 males and nine females; mean age, 60 years) with 48 HCCs in other locations were included under control group. Baseline demographics were recorded. Technical efficacy, local tumor progression (LTP) and complication rates were evaluated. Results: Mean follow up period was 3.4 months (range 1–7). There was no major complication in both the groups; two patients had a mild perihepatic hemorrhage in the difficult location group which was managed conservatively. There was no difference between the groups in the overall technical efficacy rate (84.9% vs 91.7%, p = 0.294), LTP rate (4.4% vs 2.2%. p = 0.57) or complication rate (4.6% vs 0%, p = 0.177). Conclusion: Our data suggest that there is no significant difference in technical efficacy, LTP or complication rates for MWA in both difficult and normal locations. Advances in knowledge: With proper patient selection, pre-procedural planning and appropriate technique, pMWA is feasible, safe and effective for small HCCs in difficult location with an acceptable range of complications.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of percutaneous microwave ablation for hepatocellular carcinomas <4 cm in difficult location

Mukund

Ramalingam

Anandpara

et al. 2020

BJR

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“…RFA is a safe and effective approach for treating small hepatic tumors, and is associated with a 5-year survival rate higher than 50% [22,23]. Imaging-based guidance has an important role in RFA for HCC by ensuring accuratein targeting of the lesion and in assessing the efficacy of the ablation.…”

Section: Discussionmentioning

confidence: 99%

Impact of Real-Time Contrast-Enhanced Ultrasound-Guided Radiofrequency Ablation on Progression-Free Survival in Patients with Hepatocellular Carcinoma: a Retrospective Case-Control Study

Shang¹,

Yang²,

Zhao³

et al. 2020

Journal of Nutritional Oncology

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Materials and Methods Patients population and study design We enrolled 149 patients (116 males and 33 females) who were diagnosed with HCC and underwent either CEUS-or conventional US-guided RFA. HCC was diagnosed based on either enhanced computed tomography (CT) or magnetic resonance imaging (MRI) scans, or Abstract: Objective To compare the value of contrast-enhanced ultrasound (CEUS) and conventional ultrasound (US) during radiofrequency ablation (RFA) for the treatment of hepatocellular carcinoma (HCC) ≥ 3.0 cm in diameter. Methods A total of 149 HCC patients treated with RFA guided by either CEUS or conventional US between January 2012 and June 2013 were retrospectively analyzed. Patients were divided into different groups based on the type of ultrasound guidance (CEUS or conventional US) and tumor volume (diameter < 3.0 or ≥ 3.0 cm). The progressionfree survival (PFS) and complete ablation rates were compared between groups, and risk factors for the PFS were investigated. Results Seventy four patients received CEUS-guided RFA, and conventional US was performed in 75 patients. Among patients with a tumor < 3.0 cm, the PFS and complete ablation rates were similar. However, for patients with a tumor ≥ 3.0 cm, those treated with CEUS had a significantly longer PFS (17.3 vs. 3.1 months, HR = 2.73; 95% CI, 1.28~5.81; P = 0.007) and higher complete ablation rates at 6-and 12-month post-treatment (87.5% vs. 57.7%, P = 0.042; 75.0% vs. 38.5%, P = 0.009, respectively) than those treated with conventional US-guided RFA. The type of treatment (P = 0.024) and maximum tumour size (P = 0.011) were both found to be independent factors associated with the PFS. Conclusion Compared with conventional US, CEUS is more effective for guiding RFA in patients with HCC ≥ 3.0 cm. CEUS-guided RFA could target HCC more accurately, and its ability to immediately detect any residual tumor during RFA might contribute to an increase in complete ablation rates and reduced progression.

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“…Therefore, ablation should be favored for small HCCs (i.e., < 3 cm) all the more so as liver ablation is usually a short procedure, with short hospital stay and very few complications [10]. In IR teams used to multi-bipolar RFA, the threshold can be extended up to 5 cm tumors with excellent oncological results [25,26].…”

Section: Percutaneous Thermal Ablationmentioning

confidence: 99%

Interventional oncology at the time of COVID-19 pandemic: Problems and solutions

Denys¹,

Guiu²,

Chevallier³

et al. 2020

Diagnostic and Interventional Imaging

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The COVID-19 pandemic has deeply impacted the activity of interventional oncology in hospitals and cancer centers. In this review based on official recommendations of different international societies, but also on local solutions found in different expert large-volume centers, we discuss the changes that need to be done for the organization, safety, and patient management in interventional oncology. A literature review of potential solutions in a context of scarce anesthesiologic resources, limited staff and limited access to hospital beds are proposed and discussed based on the literature data.

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Impact of an ultrasound-guided radiofrequency ablation training program on the outcomes in patients with hepatocellular carcinoma

Cited by 10 publications

References 23 publications

Efficacy and safety of percutaneous microwave ablation for hepatocellular carcinomas <4 cm in difficult location

Efficacy and safety of percutaneous microwave ablation for hepatocellular carcinomas <4 cm in difficult location

Impact of Real-Time Contrast-Enhanced Ultrasound-Guided Radiofrequency Ablation on Progression-Free Survival in Patients with Hepatocellular Carcinoma: a Retrospective Case-Control Study

Interventional oncology at the time of COVID-19 pandemic: Problems and solutions

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