The Early Histologic Changes Following Electrocoagulation

Lounsberry, William; Goldschmidt, Volker; Linke, Charles A.; Walder, Harold J.; Chrzan, Donald

doi:10.1016/s0022-5347(17)65169-3

Cited by 57 publications

(31 citation statements)

References 11 publications

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“…Those authors showed no significant difference between perivascular and non-perivascular hcc in terms of rates of complete ablation, local tumour progression, morbidity, and mortality 48 . Their findings contrast with the results of a study by Lu et al 49 of 31 perivascular hcc tumours, which suggested that the efficacy of rfa is affected by the location of the tumour, which was also suggested in studies by McGahan et al 35 and Lounsberry et al 36 . Theories suggest that cirrhotic tissue could enable better thermal ablation through the "oven effect" 50 , which posits that the increased thickness of cirrhotic tissue around the nodule works as a thermal insulator, avoiding dispersion of the heat generated around the rfa electrode.…”

Section: 21contrasting

confidence: 65%

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The Role of Interventional Radiology in the Management of Hepatocellular Carcinoma

Molla

Almenieir

Simoneau³

et al. 2014

Current Oncology

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Section: 21contrasting

confidence: 65%

“…The maximum temperature obtained and the duration of exposure to the heat affect the cell-kill zone 35,36 , but a major limitation is the possibility of a heat-sink effect produced by large vessels (>3 mm) near the ablation zone. The blood current can prevent complete necrosis of nearby tumour cells, potentially leading to positive margins.…”

Section: 21mentioning

confidence: 99%

The Role of Interventional Radiology in the Management of Hepatocellular Carcinoma

Molla

Almenieir

Simoneau³

et al. 2014

Current Oncology

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“…When tumor cells are heated to temperatures above 45°to 50°C for more than 3 minutes, intracellular protein denaturation and melting of lipid bilayers results in direct tumor cell death. [7][8][9][10] RFA uses alternating current passed across needle electrode arrays placed directly into the tumor. Ionic stimulation induced by the alternating current in tissue surrounding the electrode array produces gradual frictional heating, and the tissue temperatures rise to 80°to 110°C, which results in coagulative necrosis of the tissue in proximity to the electrode.…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency Ablation of Hepatocellular Cancer in 110 Patients With Cirrhosis

et al. 2000

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ObjectiveTo determine the treatment efficacy, safety, local tumor control, and complications related to radiofrequency ablation (RFA) in patients with cirrhosis and unresectable hepatocellular carcinoma (HCC). Summary Background DataMost patients with HCC are not candidates for resection because of tumor size, location, or hepatic dysfunction related to cirrhosis. RFA is a technique that permits in situ destruction of tumors by means of local tissue heating. MethodsOne hundred ten patients with cirrhosis and HCC (Child class A, 50; B, 31; C, 29) were treated during a prospective study using RFA. Patients were treated with RFA using an open laparotomy, laparoscopic, or percutaneous approach with ultrasound guidance to place the RF needle electrode into the hepatic tumors. All patients were followed up at regular intervals to detect treatment-related complications or recurrence of disease. ResultsAll 110 patients were followed up for at least 12 months after RFA (median follow-up 19 months). Percutaneous or intraoperative RFA was performed in 76 (69%) and 34 patients (31%), respectively. A total of 149 discrete HCC tumor nodules were treated with RFA. The median diameter of tumors treated percutaneously (2.8 cm) was smaller than that of lesions treated during laparotomy (4.6 cm). Local tumor recurrence at the RFA site developed in four patients (3.6%); recurrent HCC subsequently developed in other areas of the liver in all four. New liver tumors or extrahepatic metastases developed in 50 patients (45.5%), but 56 patients (50.9%) had no evidence of recurrence. There were no treatment-related deaths, but complications developed in 14 patients (12.7%) after RFA.

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“…When tumor cells are heated above 45-50°C, intracellular proteins are denatured and cell membranes are destroyed through dissolution and melting of lipid bilayers [7,8]. Radiofrequency ablation (RFA) is a localized thermal treatment technique designed to produce tumor destruction by heating tumor tissue to temperatures that exceed 60°C.…”

Section: Introductionmentioning

confidence: 99%

Radiofrequency Ablation of Malignant Liver Tumors

2001

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The majority of patients with primary or metastatic hepatic tumors are not candidates for resection because of tumor size, location near major intrahepatic blood vessels precluding a margin-negative resection, multifocality, or inadequate hepatic function related to coexistent cirrhosis. Radiofrequency ablation (RFA) is an evolving technology being used to treat patients with unresectable primary and metastatic hepatic cancers. RFA produces coagulative necrosis of tumor through local tissue heating. Liver tumors are treated percutaneously, laparoscopically, or during laparotomy using ultrasonography to identify tumors and guide placement of the RFA needle electrode. For tumors smaller than 2.0 cm in diameter, one or two deployments of the monopolar multiple array needle electrode are sufficient to produce complete coagulative necrosis of the tumor. However, with increasing size of the tumor, there is a concomitant increase in the number of deployments of the needle electrode and the overall time necessary to produce complete coagulative necrosis of the tumor. In general, RFA is a safe, well-tolerated, effective treatment for unresectable hepatic malignancies less than 6.0 cm in diameter. Effective treatment of larger tumors awaits the development of more powerful, larger array monopolar and bipolar RFA technologies.

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The Early Histologic Changes Following Electrocoagulation

Cited by 57 publications

References 11 publications

The Role of Interventional Radiology in the Management of Hepatocellular Carcinoma

The Role of Interventional Radiology in the Management of Hepatocellular Carcinoma

Radiofrequency Ablation of Hepatocellular Cancer in 110 Patients With Cirrhosis

Radiofrequency Ablation of Malignant Liver Tumors

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