Pietro Gatti1, Antonio Giorgio2, Emanuela Ciracì1, Italia Roberto1, Alessandro Anglani3, Spano Sergio4, Fernando Rizzello5, Valentina Giorgio6, Stefano Semeraro7. 1. Internal Medicine Division, Ostuni Hospital, Ostuni, BR, Italy. 2. Interventional Ultrasound Unit, Tortorella Clinical Hospital, Salerno, Italy. 3. Radiodiagnostic Unit, Ostuni Hospital, Ostuni, BR, Italy. 4. Interventional Radiology Unit, Perrino Hospital, Brindisi, Italy. 5. Anesthesiology and Reanimation Unit, Ostuni Hospital, Ostuni, BR, Italy. 6. Pediatric Gastroenterology Unit, Policlinico Gemelli, Sacred Heart University, Rome, Italy. 7. Internal Medicine Division, Ostuni Hospital, Ostuni, BR, Italy. stefsem@libero.it.
Abstract
PURPOSE: Hepatocellular carcinoma (HCC) is the most common form of liver cancer. In advanced cancer stages (metastatic disease and/or vascular invasion), the generally accepted standard of care is systemic therapy using sorafenib as first-line treatment and, recently, regorafenib and nivolumab as second-line treatment, but the quality of life and the prognosis of patients remain very poor. Our paper reports a case of US-guided radiofrequency ablation (RFA) of both intraparenchymal HCC and inferior vena cava tumor thrombus. METHODS: We treated a patient with HCC associated with tumor thrombus extending into vena cava after failure of sorafenib therapy using US-guided radiofrequency ablation (RFA). RESULTS: A good radiological and clinical response was observed in association with excellent tolerability. The patient has been followed up for 15 months from the ablation, is alive, and is in a good clinical condition without evidence of tumor recurrence. CONCLUSION: This is the first case in which this minimally invasive percutaneous procedure has been successfully used to treat an HCC thrombus entering the vena cava.
PURPOSE:Hepatocellular carcinoma (HCC) is the most common form of liver cancer. In advanced cancer stages (metastatic disease and/or vascular invasion), the generally accepted standard of care is systemic therapy using sorafenib as first-line treatment and, recently, regorafenib and nivolumab as second-line treatment, but the quality of life and the prognosis of patients remain very poor. Our paper reports a case of US-guided radiofrequency ablation (RFA) of both intraparenchymal HCC and inferior vena cava tumor thrombus. METHODS: We treated a patient with HCC associated with tumor thrombus extending into vena cava after failure of sorafenib therapy using US-guided radiofrequency ablation (RFA). RESULTS: A good radiological and clinical response was observed in association with excellent tolerability. The patient has been followed up for 15 months from the ablation, is alive, and is in a good clinical condition without evidence of tumor recurrence. CONCLUSION: This is the first case in which this minimally invasive percutaneous procedure has been successfully used to treat an HCC thrombus entering the vena cava.
Authors: Antonio Giorgio; Antonella Di Sarno; Giorgio de Stefano; Nunzia Farella; Umberto Scognamiglio; Manuela de Stefano; Valentina Giorgio Journal: AJR Am J Roentgenol Date: 2009-10 Impact factor: 3.959
Authors: Sander Florman; Michael Weaver; Paul Primeaux; Mary Killackey; Rafael Sierra; Santiago Gomez; Salima Haque; Fredric Regenstein; Luis Balart Journal: Am Surg Date: 2009-11 Impact factor: 0.688
Authors: Josep M Llovet; Sergio Ricci; Vincenzo Mazzaferro; Philip Hilgard; Edward Gane; Jean-Frédéric Blanc; Andre Cosme de Oliveira; Armando Santoro; Jean-Luc Raoul; Alejandro Forner; Myron Schwartz; Camillo Porta; Stefan Zeuzem; Luigi Bolondi; Tim F Greten; Peter R Galle; Jean-François Seitz; Ivan Borbath; Dieter Häussinger; Tom Giannaris; Minghua Shan; Marius Moscovici; Dimitris Voliotis; Jordi Bruix Journal: N Engl J Med Date: 2008-07-24 Impact factor: 91.245