Arthur Petit1, Arnaud Hocquelet2, Gisèle N'kontchou3, Eloi Varin1, Nicolas Sellier1, Olivier Seror1,4,5, Olivier Sutter6,7. 1. Radiology Department, Hôpital Jean Verdier (APHP), Hôpitaux universitaires Paris-Seine-Saint-Denis, Assistfance Publique Hôpitaux de Paris, Avenue du 14 juillet, 93140, Bondy, France. 2. Diagnostic and Interventional Radiology Department, CHU Vaudois, Lausanne, Switzerland. 3. Hepatology Department, Hôpital Jean Verdier, Hôpitaux universitaires Paris-Seine-Saint-Denis, Assistance Publique Hôpitaux de Paris, Bondy, France. 4. Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Paris 13, communauté d'universités et établissements Sorbonne Paris cité, Paris, France. 5. Unité mixte de recherche 1162, Génomique Fonctionnelle des Tumeurs Solides, Institut National de la Santé et de la Recherche Médicale, Paris, France. 6. Radiology Department, Hôpital Jean Verdier (APHP), Hôpitaux universitaires Paris-Seine-Saint-Denis, Assistfance Publique Hôpitaux de Paris, Avenue du 14 juillet, 93140, Bondy, France. olivier.sutter@aphp.fr. 7. Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Paris 13, communauté d'universités et établissements Sorbonne Paris cité, Paris, France. olivier.sutter@aphp.fr.
Abstract
PURPOSE: The percutaneous ablation of subcapsular hepatocellular carcinoma (S-HCC) may involve a risk of complications such as hemorrhage and tumor seeding, mainly linked to the direct tumor puncture often inevitable with mono-applicator ablation devices. The purpose of this study was to assess the efficacy and safety of no-touch multi-bipolar radiofrequency ablation (NTMBP-RFA) for the treatment of S-HCC ≤ 5 cm not puncturable via the non-tumorous liver parenchyma. MATERIALS AND METHODS: Between September 2007 and December 2014, 58 consecutive patients (median age: 63 years [46-86], nine females) with 59 S-HCC ≤ 5 cm (median diameter: 25 mm [10-50 mm]), not puncturable via the non-tumorous liver parenchyma, were treated with NTMBP-RFA. Response and follow-up were assessed by CT or MRI. Complications were graded using the Cardiovascular and Interventional Radiological Society of Europe classification. Overall local tumor progression (OLTP)-free survival was assessed using the Kaplan-Meier method. A Cox proportional model evaluated the factors associated with OLTP. Signs of peritoneal or parietal tumor seeding were noted during follow-up imaging studies. RESULTS: A complete ablation was achieved in 57/58 patients (98.3%) after one (n = 51) or two (n = 6) procedures. Three patients (5.2%) experienced complications (sepsis, cirrhosis decompensation; CIRSE grade 2 or 3). After a median follow-up period of 30.5 months [1-97], no patients had tumor seeding. The 1, 2 and 3-year OLTP-free survival rates were 98%, 94% and 91%, respectively. No factors were associated with OLTP. CONCLUSION: NTMBP-RFA is a safe and effective treatment for S-HCC not puncturable via the non-tumorous liver parenchyma.
PURPOSE: The percutaneous ablation of subcapsular hepatocellular carcinoma (S-HCC) may involve a risk of complications such as hemorrhage and tumor seeding, mainly linked to the direct tumor puncture often inevitable with mono-applicator ablation devices. The purpose of this study was to assess the efficacy and safety of no-touch multi-bipolar radiofrequency ablation (NTMBP-RFA) for the treatment of S-HCC ≤ 5 cm not puncturable via the non-tumorous liver parenchyma. MATERIALS AND METHODS: Between September 2007 and December 2014, 58 consecutive patients (median age: 63 years [46-86], nine females) with 59 S-HCC ≤ 5 cm (median diameter: 25 mm [10-50 mm]), not puncturable via the non-tumorous liver parenchyma, were treated with NTMBP-RFA. Response and follow-up were assessed by CT or MRI. Complications were graded using the Cardiovascular and Interventional Radiological Society of Europe classification. Overall local tumor progression (OLTP)-free survival was assessed using the Kaplan-Meier method. A Cox proportional model evaluated the factors associated with OLTP. Signs of peritoneal or parietal tumor seeding were noted during follow-up imaging studies. RESULTS: A complete ablation was achieved in 57/58 patients (98.3%) after one (n = 51) or two (n = 6) procedures. Three patients (5.2%) experienced complications (sepsis, cirrhosis decompensation; CIRSE grade 2 or 3). After a median follow-up period of 30.5 months [1-97], no patients had tumor seeding. The 1, 2 and 3-year OLTP-free survival rates were 98%, 94% and 91%, respectively. No factors were associated with OLTP. CONCLUSION:NTMBP-RFA is a safe and effective treatment for S-HCC not puncturable via the non-tumorous liver parenchyma.
Authors: F G M Poch; C A Neizert; B Geyer; O Gemeinhardt; S M Niehues; J L Vahldiek; K K Bressem; K S Lehmann Journal: Sci Rep Date: 2021-07-06 Impact factor: 4.379
Authors: F G M Poch; C A Neizert; B Geyer; O Gemeinhardt; L Bruder; S M Niehues; J L Vahldiek; K K Bressem; M E Kreis; K S Lehmann Journal: Sci Rep Date: 2020-10-01 Impact factor: 4.379