Justin Kwan1, Chinthaka Appuhamy2, Gavin Hock Tai Lim3, Ivan Kuang Hsin Huang3, Lawrence Quek3, Uei Pua3. 1. Department of Diagnostic and Interventional Radiology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore. justinkwan07@gmail.com. 2. Neurotrauma Centre, National Hospital of Sri Lanka, E W Perera Mawatha, Colombo, 00700, Sri Lanka. 3. Department of Diagnostic and Interventional Radiology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.
Abstract
INTRODUCTION: To evaluate the safety and efficacy of percutaneous thermal ablation of liver tumours in a juxta-cardiac (JC) location. MATERIALS AND METHODS: From January 2010 to December 2014, out of 274 cases of hepatic ablation, 33 consecutive patients who received thermal ablation (radiofrequency or microwave) to left hepatic lobe tumours were included in this study. Patients were divided into two groups: JC or non-juxta-cardiac (NJC) (tumour margin ≤ 10 mm or > 10 mm from the cardiac border, respectively). Imaging follow-up was performed at 6-week and 3-monthly intervals. Technical success, 30-day complications and local tumour control/recurrence were recorded. Statistical analysis was performed with t test and Fisher's test. Univariate and multivariate survival analyses were performed using Cox regression. RESULTS: Patients comprised of 23 men and 10 women (mean age 67.0 years). Mean tumour size was 2.2 ± 0.9 cm (28 hepatocellular carcinoma and 5 metastases). Mean follow-up time was 21.2 months (range 2-72 months). There were no differences between the JC and NJC groups in the rates of complete ablation (86.7 vs 83.3% P = 1.0), tumour recurrence (20.0 vs 22.2%, P = 0.95) or complication rates (6.7 vs 11.1% P = 1.0). Metastatic lesions were associated with a higher rate of recurrent disease (hazard ratio 3.86, 95% CI 1.0-14.8%, P = 0.05). DISCUSSION: Percutaneous thermal ablation of JC tumours has similar rates of local tumour control and safety profile when compared to tumours in a NJC location. Tumours in a JC location should not be considered a contraindication for thermal ablation.
INTRODUCTION: To evaluate the safety and efficacy of percutaneous thermal ablation of liver tumours in a juxta-cardiac (JC) location. MATERIALS AND METHODS: From January 2010 to December 2014, out of 274 cases of hepatic ablation, 33 consecutive patients who received thermal ablation (radiofrequency or microwave) to left hepatic lobe tumours were included in this study. Patients were divided into two groups: JC or non-juxta-cardiac (NJC) (tumour margin ≤ 10 mm or > 10 mm from the cardiac border, respectively). Imaging follow-up was performed at 6-week and 3-monthly intervals. Technical success, 30-day complications and local tumour control/recurrence were recorded. Statistical analysis was performed with t test and Fisher's test. Univariate and multivariate survival analyses were performed using Cox regression. RESULTS:Patients comprised of 23 men and 10 women (mean age 67.0 years). Mean tumour size was 2.2 ± 0.9 cm (28 hepatocellular carcinoma and 5 metastases). Mean follow-up time was 21.2 months (range 2-72 months). There were no differences between the JC and NJC groups in the rates of complete ablation (86.7 vs 83.3% P = 1.0), tumour recurrence (20.0 vs 22.2%, P = 0.95) or complication rates (6.7 vs 11.1% P = 1.0). Metastatic lesions were associated with a higher rate of recurrent disease (hazard ratio 3.86, 95% CI 1.0-14.8%, P = 0.05). DISCUSSION: Percutaneous thermal ablation of JC tumours has similar rates of local tumour control and safety profile when compared to tumours in a NJC location. Tumours in a JC location should not be considered a contraindication for thermal ablation.