Radiofrequency Ablation in the Management of Unresectable Intrahepatic Cholangiocarcinoma

Fu, Ying; Yang, Wei; Wu, Wei; Yan, Kun; Xing, Bao Cai; Chen, Min Hua

doi:10.1016/j.jvir.2012.01.081

Cited by 81 publications

(81 citation statements)

References 33 publications

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“…Probably, some peripheral ICCs have clinical characteristics similar to HCC; however, we want to emphasize the clear differences between peripheral ICC and HCC demonstrated in this study. Therefore, we should be careful in applying radiofrequency ablation in peripheral ICC (28).…”

Section: Discussionmentioning

confidence: 99%

Clinical Significances of Preoperative Classification of Intrahepatic Cholangiocarcinoma: Different Characteristics of Perihilar vs. Peripheral ICC

Yamashita

Wang

Kurihara

et al. 2016

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Abstract. Background: The aim of this study was to evaluate the clinical significance of preoperative classification of intrahepatic cholangiocarcinoma (ICC) into perihilar and peripheral types using dynamic computed tomography (CT). Patients and MethodsEven though intrahepatic cholangiocarcinoma (ICC) is a relatively rare disease, it is the second most common primary liver malignant tumor after hepatocellular carcinoma (HCC), and has a relatively highly prevalence in Asia and the U.S.A., with over 1/100,000 population ratio (1). In addition, the incidence of ICC has rapidly increased by 165% in the last 30 years in the U.S.A., and surgical resection remains the only treatment available with curative intent (2). However, surgical results for ICC remain unsatisfactory with a five-year survival rate of 58%, even in R0 resected cases (3). Lymph node metastasis has been reported to be the most significant poor prognostic factor for ICC, and extended lymphadenectomy does not have a survival impact (3-5). While lymphatic invasion is the major mode of cancer spreading for ICC (6), intrahepatic metastasis caused by venous spread is another important mode of spreading (4, 5).ICCs are composed of heterogenous carcinomas arising from different anatomical liver sites. ICC arises from the epithelial cells of the biliary tree, from either intrahepatic large bile ducts or smaller bile ducts, such as the septal and interlobular ducts. Ebata et al. clearly defined as perihilar cholangiocarcinoma, a tumor involving the hilar bile duct with a liver mass (7). We proposed the classification of ICC based on the pathological findings in perihilar large duct type and peripheral small duct type subtypes (8, 9). Perihilar ICC arises from the peribiliary gland, and peripheral ICC from the canals of Hering (9); the two subtypes have different molecular and clinicopathological characteristics and patient prognoses (8, 9). However, pathological classification currently contributes only whether or not to plan adjuvant chemotherapy. Therefore, it is important to construct a preoperative classification that can be used to modify surgical plans and so on to improve patients' prognosis for ICC. 6563

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Section: Discussionmentioning

confidence: 99%

Clinical Significances of Preoperative Classification of Intrahepatic Cholangiocarcinoma: Different Characteristics of Perihilar vs. Peripheral ICC

Yamashita

Wang

Kurihara

et al. 2016

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“…Therefore, in most previous studies, the efficacies of ablation therapies were mainly investigated among patients with unresectable ICC or recurrent ICC after surgery (12)(13)(14)(15)(16)(17)(18)(19)(20)(21) only used in limited cases. RFA is usually performed under ultrasound guidance, and sufficient ablative margins of at least 0.5 to 1.0 cm surrounding tumors are required to secure the complete ablation of tumor nodules.…”

Section: Indication and Technical Considerationmentioning

confidence: 99%

“…However, the local tumor progression rate after RFA was relatively high, ranging from 8% to 50% (12)(13)(14)(15)17,19,20), and the pooled rate in a meta-analysis was reported to be 21% (95% CI, 13-30%) (11). The rate of major complication observed after RFA was 8% in the evaluable population, as shown in Table 1.…”

Section: Effectiveness Of Rfamentioning

confidence: 99%

Ablative therapies for intrahepatic cholangiocarcinoma

Shindoh¹

2017

Hepatobiliary Surg. Nutr.

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Intrahepatic cholangiocarcinoma (ICC) is the second most common primary hepatic malignancy.Although surgical resection has been a cornerstone in the management of ICC, the efficacies of several nonsurgical management strategies have been actively investigated and somewhat preferable outcomes have been reported for ablation therapies in selected cases. Nevertheless, because of the rarity of these tumors and the small number of studies, the clinical significance and actual role of ablation therapies in a multidisciplinary approach for ICC remain unclear. In this article, the reported outcomes of ablation therapies for ICC will be summarized and their potential indications will be discussed.

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“…In most of the studies included (17)(18)(19)(20)(21)(22), RF ablation was performed under ultrasound (US) guidance, with the patient under conscious sedation or general anesthesia. Depending on the tumor size, a single electrode was used for smaller lesions (o2-3 cm) and a clustered or multiple overlapping insertions of a single electrode was used for larger masses (43-3.5 cm).…”

Section: Technical Aspectsmentioning

confidence: 99%

Radiofrequency Ablation in the Treatment of Unresectable Intrahepatic Cholangiocarcinoma: Systematic Review and Meta-Analysis

Kim

Won

et al. 2015

Journal of Vascular and Interventional Radiology

112

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Radiofrequency Ablation in the Management of Unresectable Intrahepatic Cholangiocarcinoma

Cited by 81 publications

References 33 publications

Clinical Significances of Preoperative Classification of Intrahepatic Cholangiocarcinoma: Different Characteristics of Perihilar vs. Peripheral ICC

Clinical Significances of Preoperative Classification of Intrahepatic Cholangiocarcinoma: Different Characteristics of Perihilar vs. Peripheral ICC

Ablative therapies for intrahepatic cholangiocarcinoma

Radiofrequency Ablation in the Treatment of Unresectable Intrahepatic Cholangiocarcinoma: Systematic Review and Meta-Analysis

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