Ultrasound-guided radiofrequency thermal ablation of liver tumors: percutaneous, laparoscopic, and open surgical approaches

Machi, Junji; Uchida, Shinichi; Sumida, Kenneth N. M.; Limm, Whitney; Hundahl, Scott A.; Oishi, Andrew J.; Furumoto, N; Oishi, Robert H.

doi:10.1016/s1091-255x(01)80085-8

Cited by 187 publications

(127 citation statements)

References 24 publications

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“…PVE combined with a two-stage resection may be helpful in such circumstances [25]. However, for patients who cannot undergo liver resection because of extensive liver metastases and inadequate remnant liver volume, RFA can play an important role when combined with liver resection [26].…”

Section: Introductionmentioning

confidence: 99%

Assessment of Tumor Response and Resection Rates in Unresectable Colorectal Liver Metastases Following Neoadjuvant Chemotherapy with Cetuximab

Somashekhar

Ashwin

Zaveri

et al. 2015

Indian J Surg Oncol

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To investigate efficacy and safety of cetuximab combined with neo adjuvant chemotherapy regimen in patients with unresectable colorectal liver. This was a prospective trial with rate of Ro liver metastases resection as primary end point. Between January 2010 and December 2014, 46 patients with unresectable liver metastases from colon or rectum were enrolled. Patients received Cetuximab along with neoadjuvant chemotherapy where 34 (74 %) and 12 (26 %) patients received FOLFOX and FOLFIRI, respectively. They were assessed for response after 2-3 cycles by CT scan. Patients with resectable disease were offered liver surgery within 3-6 weeks of the last treatment cycle. The primary end point was resection rate of liver metastases, which was evaluated in all patients. Secondary end points were response rate according to Response evaluation criteria in solid tumors (RECIST) criteria, perioperative morbidity and mortality. An objective response was observed in 28 (60.9 %) patients. Seven (15.2 %) patients were reported radiologically to have a complete response (CR); 21 (45.7 %) patients had radiological partial response (PR). An additional 12 patients (26.1 %) demonstrated stable disease (SD) and only six patients (13.0 %) had disease progression (PD). Microscopically complete resections (R0 resection) was performed in all 28 patients (60.9 %). The most frequent toxicities were skin rash and diarrhoea. There was no operative mortality. Chemotherapy with cetuximab yields high response rates compared with historical controls, and leads to significantly increased resectability. Complete resection of previously unresectable colorectal liver metastases can be performed with minimal morbidity and mortality. This therapeutic strategy involves a multimodal approach.

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Section: Introductionmentioning

confidence: 99%

Assessment of Tumor Response and Resection Rates in Unresectable Colorectal Liver Metastases Following Neoadjuvant Chemotherapy with Cetuximab

Somashekhar

Ashwin

Zaveri

et al. 2015

Indian J Surg Oncol

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“…To date, RF ablation has been shown to be highly effective in achieving complete coagulation in tumors less than 3.0 cm in diameter (7). However, treatment of larger tumors has been more problematic, with malignancies greater than 4.0 cm in diameter associated with high rates of local tumor progression (8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Multiple-Electrode Radiofrequency Ablation Creates Confluent Areas of Necrosis: In Vivo Porcine Liver Results

Laeseke

Sampson²,

Haemmerich

et al. 2006

Radiology

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PURPOSE-To prospectively evaluate an impedance-based multiple-electrode RF ablation system for creation of confluent areas of hepatic coagulation in an in vivo porcine model. MATERIALS & METHODS-Pre-approval was obtained from our institutional research animal care and use committee. A prototype multiple-electrode RF system was created allowing switching between three electrically-independent electrodes at impedance spikes (30 Ω increase). Forty-two coagulation zones [single=18, cluster=12, multiple-electrode (three singles spaced 2 cm apart)=12] were created at laparotomy in fifteen ~90 kg female pigs. Half of the ablations were performed for 12 minutes and half for 16 minutes. Coagulation zones were excised and sliced (~3 mm) for measurements. ANOVA and two sample t-tests (Bonferroni's correction, α=.0033) were used to test for differences between groups.RESULTS-At 12 minutes, mean (±SD) multiple-electrode coagulation was significantly larger than single (minimum diameter: 2.8±0.6 vs. 1.6±0.6 cm; maximum diameter: 4.2±0.7 vs. 2.0± 0.5 cm; volume: 22.1±10.7 vs. 6.7±3.7 cm 3 ; P<.0033, all comparisons). Multiple-electrode maximum diameter was significantly larger than cluster at 12 minutes (4.2±0.7 vs. 2.9±0.3 cm, P=.02). At 16 minutes, multiple-electrode coagulation zones (minimum diameter: 3.2±0.6 cm; maximum diameter: 4.2±0.6 cm; volume: 29.1±8.3 cm 3 ) were significantly greater than single (minimum diameter: 1.7±0.5 cm; maximum diameter: 2.2±0.6 cm; volume: 7.1±3.5 cm 3 ; P<.0033, all comparisons) and cluster controls (minimum diameter: 2.3±0.3 cm, P=.007; maximum diameter: 3.2±0.4 cm, P=.005; volume: 13.1±3.0 cm 3 , P<.0033).

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“…The use of central bile duct cooling during RFA of periductal HCC was effective in preventing thermal injury of bile duct (62). However, the presence of the 'heatsink effect' may affect the complete ablation of the tumor near the major vessels, and therefore increase the chance of local recurrence after RFA (63,64).…”

Section: Radiofrequency Ablation (Rfa)mentioning

confidence: 99%

Bridging and downstaging therapy in patients suffering from hepatocellular carcinoma waiting on the list of liver transplantation

She¹,

Cheung²

2016

Transl. Gastroenterol. Hepatol.

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Hepatocellular carcinoma (HCC) is a common primary malignancy worldwide especially in the patients with the background of chronic liver disease. Liver transplantation (LT) is the only curative treatment effective for both malignancy as well as the cirrhosis and portal hypertension. Unfortunately, living donor is not always possible and the deceased graft is scarce. Neoadjuvant therapies, therefore, have been developed as a downstaging treatment to try to downstage the tumor within the transplant criteria, or as a bridging therapy to control the tumor growth in patients while waiting in the transplant list. This paper reviewed the common modalities used as bridging and downstaging therapies for patients suffering from HCC before undergoing LT.

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Ultrasound-guided radiofrequency thermal ablation of liver tumors: percutaneous, laparoscopic, and open surgical approaches

Cited by 187 publications

References 24 publications

Assessment of Tumor Response and Resection Rates in Unresectable Colorectal Liver Metastases Following Neoadjuvant Chemotherapy with Cetuximab

Assessment of Tumor Response and Resection Rates in Unresectable Colorectal Liver Metastases Following Neoadjuvant Chemotherapy with Cetuximab

Multiple-Electrode Radiofrequency Ablation Creates Confluent Areas of Necrosis: In Vivo Porcine Liver Results

Bridging and downstaging therapy in patients suffering from hepatocellular carcinoma waiting on the list of liver transplantation

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