Erica S Alexander1, Farrah J Wolf2, Jason T Machan3, Kevin P Charpentier4, Michael D Beland5, Jason D Iannuccilli6, Richard H Haas7, Damian E Dupuy8. 1. Rhode Island Hospital, Department of Diagnostic Imaging, 593 Eddy Street, Providence, RI 02903, United States. Electronic address: erica_alexander@brown.edu. 2. Rhode Island Hospital, Department of Diagnostic Imaging, 593 Eddy Street, Providence, RI 02903, United States. Electronic address: fwolf@lifespan.org. 3. Rhode Island Hospital, Department of Diagnostic Imaging, 593 Eddy Street, Providence, RI 02903, United States. Electronic address: jmachan@lifespan.org. 4. Rhode Island Hospital, Department of Diagnostic Imaging, 593 Eddy Street, Providence, RI 02903, United States. Electronic address: kcharpentier@usasurg.org. 5. Rhode Island Hospital, Department of Diagnostic Imaging, 593 Eddy Street, Providence, RI 02903, United States. Electronic address: mbeland@lifespan.org. 6. Rhode Island Hospital, Department of Diagnostic Imaging, 593 Eddy Street, Providence, RI 02903, United States. Electronic address: jiannuccilli@lifespan.org. 7. Rhode Island Hospital, Department of Diagnostic Imaging, 593 Eddy Street, Providence, RI 02903, United States. Electronic address: rhaas@lifespan.org. 8. Rhode Island Hospital, Department of Diagnostic Imaging, 593 Eddy Street, Providence, RI 02903, United States. Electronic address: ddupuy@lifespan.org.
Abstract
PURPOSE: To retrospectively evaluate the safety and efficacy of microwave ablation (MWA) as treatment for single, focal hepatic malignancies. MATERIALS AND METHODS: Institutional review board approval was obtained for this HIPAA-compliant study. From December 2003 to May 2012, 64 patients were treated with MWA for a single hepatic lesion, in 64 sessions. Hepatocellular carcinoma (HCC) was treated in 25 patients (geometric mean tumor size, 3.33-cm; 95% CI, 2.65-4.18-cm; range, 1.0-12.0-cm), metastatic colorectal cancer (CRC) was treated in 27 patients (geometric mean tumor size, 2.7-cm; 95% CI, 2.20-3.40-cm; range, 0.8-6.0-cm), and other histological-types were treated in 12 patients (geometric mean tumor size, 3.79-cm; 95% CI, 2.72-5.26-cm; range, 1.7-8.0-cm). Kaplan-Meier (K-M) method was used to analyze time event data. Chi-square and correlation evaluated the relationship between tumor size and treatment parameters. RESULTS: Technical success rate was 95.3% (61/64). Treatment parameters were tailored to tumor size; as size increased more antennae were used (p<0.001), treatment with multiple activations increased (p<0.028), and treatment time increased (p<0.001). There was no statistically significant relationship between time to recurrence and tumor size, number of activations, number of antennae, and treatment time. At one-year, K-M analysis predicted a likelihood of local recurrence of 39.8% in HCC patients, 45.7% in CRC metastases patients, and 70.8% in patients with other metastases. Median cancer specific survivals for patients were 38.3 months for HCC patients, 36.3 months for CRC metastases, and 13.9 months for other histological-types. Complications occurred in 23.4% (15/64) of sessions. CONCLUSION: In our sample, tumor size did not appear to impact complete ablation rates or local recurrence rates for focal hepatic malignancies treated with MWA.
PURPOSE: To retrospectively evaluate the safety and efficacy of microwave ablation (MWA) as treatment for single, focal hepatic malignancies. MATERIALS AND METHODS: Institutional review board approval was obtained for this HIPAA-compliant study. From December 2003 to May 2012, 64 patients were treated with MWA for a single hepatic lesion, in 64 sessions. Hepatocellular carcinoma (HCC) was treated in 25 patients (geometric mean tumor size, 3.33-cm; 95% CI, 2.65-4.18-cm; range, 1.0-12.0-cm), metastatic colorectal cancer (CRC) was treated in 27 patients (geometric mean tumor size, 2.7-cm; 95% CI, 2.20-3.40-cm; range, 0.8-6.0-cm), and other histological-types were treated in 12 patients (geometric mean tumor size, 3.79-cm; 95% CI, 2.72-5.26-cm; range, 1.7-8.0-cm). Kaplan-Meier (K-M) method was used to analyze time event data. Chi-square and correlation evaluated the relationship between tumor size and treatment parameters. RESULTS: Technical success rate was 95.3% (61/64). Treatment parameters were tailored to tumor size; as size increased more antennae were used (p<0.001), treatment with multiple activations increased (p<0.028), and treatment time increased (p<0.001). There was no statistically significant relationship between time to recurrence and tumor size, number of activations, number of antennae, and treatment time. At one-year, K-M analysis predicted a likelihood of local recurrence of 39.8% in HCC patients, 45.7% in CRC metastasespatients, and 70.8% in patients with other metastases. Median cancer specific survivals for patients were 38.3 months for HCC patients, 36.3 months for CRC metastases, and 13.9 months for other histological-types. Complications occurred in 23.4% (15/64) of sessions. CONCLUSION: In our sample, tumor size did not appear to impact complete ablation rates or local recurrence rates for focal hepatic malignancies treated with MWA.
Authors: Neal Bhutiani; Prejesh Philips; Charles R Scoggins; Kelly M McMasters; Melissa H Potts; Robert C G Martin Journal: HPB (Oxford) Date: 2016-05-01 Impact factor: 3.647
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