Recurrent intrahepatic cholangiocarcinoma: single‐center experience using repeated hepatectomy and radiofrequency ablation

Kamphues, Carsten; Seehofer, Daniel; Eisele, R; Denecke, Timm; Pratschke, Johann; Neumann, Ulf; Neuhaus, P.

doi:10.1007/s00534-009-0256-6

Cited by 61 publications

(55 citation statements)

References 22 publications

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“…Even after curative resection for ICC, patient survival rates remain low, with 5-year survival rates of 15-36% [16][17][18]. The poor prognosis is largely due to the high rate of recurrence after resection [19]; up to 70% of the patients develop local or distant recurrence after surgery [19][20][21]. Predictors of poor outcome include positive resection margin, lymphatic and vascular invasion, periductal infiltrating diseases, and pre-operative CA19-9 level.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, patients with ICC are typically at an advanced stage at the time of diagnosis because of the lack of symptoms until late in disease progression, and are not candidates for surgery. Some patients are unable or unwilling to undergo surgery or have limited functioning hepatic tissue [16][17][18][19][20][21][22][23]. The prognosis of ICC patients who received liver transplantation treatment is not satisfactory.…”

Section: Discussionmentioning

confidence: 99%

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Percutaneous ultrasound-guided thermal ablation for intrahepatic cholangiocarcinoma

Y²,

Lu³

et al. 2012

The British Journal of Radiology

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Objective: The objective of this study was to evaluate the treatment efficacy and overall survival (OS) of percutaneous ultrasound-guided thermal ablation by means of microwave ablation or radiofrequency ablation for intrahepatic cholangiocarcinoma (ICC). Methods: 18 patients with 25 ICC nodules underwent ultrasound-guided thermal ablation with curative intention. 8 patients were primary cases and 10 were recurrent cases after curative resection. The local treatment response, complications and survivals were analysed. Results: Complete ablation was achieved in 23 (92.0%, 23/25) nodules (diameter, 0.7-4.3 cm; mean, 2.5¡0.9 cm) and incomplete ablation was found in 2 (8.0%, 2/25) larger tumours (6.4 and 6.9 cm in diameter). No death associated with the treatment was found. The major complication rate was 5.5% (1/18). The follow-up periods ranged from 1.3 to 86.2 months (mean, 20.5¡26.3 months; median, 8.7 months). OS rates for all patients at 6, 12, 36 and 60 months were 66.7%, 36.3%, 30.3% and 30.3%, respectively. By univariate analysis, the patient source (primary or recurrent case) was found to be a significant prognostic factor for OS rates (p50.001). The patient source (p50.001) and the number of nodules (p50.038) were found to be significant prognostic factors for recurrence-free survival. OS rates for the primary ICC at 6, 12, 36 and 60 months were 87.5%, 75.0%, 62.5% and 62.5%, respectively. Conclusion: Percutaneous ultrasound-guided thermal ablation is a safe and effective therapeutic technique for ICC. Acceptable survival can be achieved in primary ICCs, whereas the prognosis of recurrent ICCs is relatively poor.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Percutaneous ultrasound-guided thermal ablation for intrahepatic cholangiocarcinoma

Y²,

Lu³

et al. 2012

The British Journal of Radiology

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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%

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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“…Considerable interest has been paid to various treatment options against ICC recurrence such as surgical treatment,6, 7, 8 chemotherapy,9 radiation therapy,7 radiofrequency ablation (RFA),10, 11 and transarterial chemotherapy 12, 13 with various degrees of success. In recent reports, aggressive surgical treatment for ICC recurrence led to good patient survival after recurrence, with a 3‐year overall survival (OS) rate of 25%,14 40%,6 and 100% 7.…”

Section: Introductionmentioning

confidence: 99%

Surgical management of recurrent intrahepatic cholangiocarcinoma: predictors, adjuvant chemotherapy, and surgical therapy for recurrence: A multi‐institutional study by the Kyushu Study Group of Liver Surgery

Yamashita

Shirabe²,

Beppu³

et al. 2017

Annals of Gastroent Surgery

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Objectives of the present study were to identify predictors of the recurrence of intrahepatic cholangiocarcinoma (ICC), and to evaluate the survival benefit of adjuvant chemotherapy and surgical treatment for ICC recurrence. A multi‐institutional retrospective study was carried out in 356 patients with ICC who underwent curative surgery at one of 14 institutions belonging to the Kyushu Study Group of Liver Surgery. A total of 214 patients (60%) had recurrence. Predictors of ICC recurrence were as follows: positive for pathological intrahepatic metastasis (im), positive for lymph node metastasis (n), positive for pathological lymphatic infiltration (ly), pathological bile duct invasion (b), and tumor size ≥4.4 cm. Adjuvant chemotherapy was given to 120 patients (34%) and, in the patients with im or tumor size ≥4.4 cm, adjuvant chemotherapy showed a survival benefit. Only 37 patients (17%) underwent surgical treatment for ICC recurrence. The surgical treatment resulted in a good 5‐year survival rate (44%), which is similar to the rate obtained by the first operation for primary ICC. Prognosis of patients with primary im after the second operation was significantly worse (5‐year survival 18%) compared to patients without primary im. Primary im+ should be considered a contraindication for surgical treatment for ICC recurrence.

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Recurrent intrahepatic cholangiocarcinoma: single‐center experience using repeated hepatectomy and radiofrequency ablation

Abstract: According to the present data, repeated liver resection and radiofrequency ablation are feasible in select patients with recurrent IHC. Both procedures can be regarded as safe and might lead to a prolongation of patient survival.

Cited by 61 publications

References 22 publications

Percutaneous ultrasound-guided thermal ablation for intrahepatic cholangiocarcinoma

Percutaneous ultrasound-guided thermal ablation for intrahepatic cholangiocarcinoma

Ablative therapies for intrahepatic cholangiocarcinoma

Surgical management of recurrent intrahepatic cholangiocarcinoma: predictors, adjuvant chemotherapy, and surgical therapy for recurrence: A multi‐institutional study by the Kyushu Study Group of Liver Surgery

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