Giampiero Francica1, Maria Franca Meloni2, Ilario de Sio3, Amanda R Smolock4, Christopher L Brace4, Maddalena Diana Iadevaia3, Roberto Santambrogio5, Sandro Sironi6, Mariano Scaglione7, Fred T Lee4. 1. Department of Imaging, Interventional Ultrasound Unit, Pineta Grande Hospital, Castel Volturno, Italy. Electronic address: giampierofrancica@gmail.com. 2. Department of Diagnostic Radiology, Valduce Hospital, Como, Italy. 3. Department of Internal Medicine, School of Medicine, 2nd University of Napoli, Napoli, Italy. 4. Department of Radiology and Department of Biomedical Engineering, University of Wisconsin School of Medicine and Public Health, Medison, United States. 5. 2nd Surgery Department, Hepato-bilio-pancreatic and digestive Surgery Unit, San Paolo Hospital, Milano, Italy. 6. Department of Diagnostic Radiology, School of Medicine, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy. 7. Department of Imaging, Interventional Ultrasound Unit, Pineta Grande Hospital, Castel Volturno, Italy.
Abstract
OBJECTIVES: Direct puncture of subcapsular hepatocellular carcinoma (HCC) for tumor ablation has been considered high risk due to a perceived increased incidence of hemorrhage or tumor seeding. The purpose of this retrospective multicenter study was to identify the rate of tumor seeding, hemorrhage and local tumor progression (LTP) associated with direct puncture radiofrequency (RF) and microwave (MW) ablation of subcapsular HCC. METHODS: A multicenter, retrospective review of direct-puncture RF and MW performed on subcapsular HCC was conducted. Complications and local tumor progression were documented. Data was analyzed using Kaplan-Meier and log-rank tests. RESULTS: The study group consisted of 60 cirrhotic patients (M/F=43/17; mean age 69.6 years) with 67 subcapsular HCC (mean diameter 2.3 cm ± 1.0 cm) that were directly punctured for RF (n=40) or MW (n=27) under ultrasound (US) guidance. The mean follow-up period was 30.8 months. There were no hemorrhagic complications. The overall LTP rate was 13.4%. There was one case of tumor tract seeding in a patient who had undergone a percutaneous biopsy two weeks prior to RF. CONCLUSIONS: Thermal ablation of HCC by direct puncture appears safe and effective. There were no cases of intraperitoneal hemorrhage, and tumor seeding was seen in a single case in which a preceding percutaneous biopsy had been performed.
OBJECTIVES: Direct puncture of subcapsular hepatocellular carcinoma (HCC) for tumor ablation has been considered high risk due to a perceived increased incidence of hemorrhage or tumor seeding. The purpose of this retrospective multicenter study was to identify the rate of tumor seeding, hemorrhage and local tumor progression (LTP) associated with direct puncture radiofrequency (RF) and microwave (MW) ablation of subcapsular HCC. METHODS: A multicenter, retrospective review of direct-puncture RF and MW performed on subcapsular HCC was conducted. Complications and local tumor progression were documented. Data was analyzed using Kaplan-Meier and log-rank tests. RESULTS: The study group consisted of 60 cirrhotic patients (M/F=43/17; mean age 69.6 years) with 67 subcapsular HCC (mean diameter 2.3 cm ± 1.0 cm) that were directly punctured for RF (n=40) or MW (n=27) under ultrasound (US) guidance. The mean follow-up period was 30.8 months. There were no hemorrhagic complications. The overall LTP rate was 13.4%. There was one case of tumor tract seeding in a patient who had undergone a percutaneous biopsy two weeks prior to RF. CONCLUSIONS: Thermal ablation of HCC by direct puncture appears safe and effective. There were no cases of intraperitoneal hemorrhage, and tumor seeding was seen in a single case in which a preceding percutaneous biopsy had been performed.
Authors: Akeanong Worakitsitisatorn; David S Lu; Min Woo Lee; Nazanin H Asvadi; Amin Moshksar; Alexander D Yuen; Justin McWilliams; Steven S Raman Journal: Eur Radiol Date: 2019-12-10 Impact factor: 5.315
Authors: Aleksandar Radosevic; Rita Quesada; Clara Serlavos; Juan Sánchez; Ander Zugazaga; Ana Sierra; Susana Coll; Marcos Busto; Guadalupe Aguilar; Daniel Flores; Javier Arce; José María Maiques; Montserrat Garcia-Retortillo; José Antonio Carrion; Laura Visa; María Villamonte; Eva Pueyo; Enrique Berjano; Macarena Trujillo; Patricia Sánchez-Velázquez; Luís Grande; Fernando Burdio Journal: Sci Rep Date: 2022-01-10 Impact factor: 4.379