Computed tomography-guided percutaneous microwave ablation of hepatocellular carcinoma in challenging locations: safety and efficacy of high-power microwave platforms

Filippiadis, Dimitrios; Spiliοpoulos, Stavros; Konstantos, Chrysostomos; Reppas, Lazaros; Kelekis, Alexis; Brountzos, Elias; Kelekis, Nikolaos

doi:10.1080/02656736.2017.1370728

Cited by 37 publications

(26 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Compared with RFA, MWA is associated with increased ablation temperatures, increased ablation zones, and a reduction in the heat-sink effect for HCC [31,32]. Besides, MWA is reported to induce lower risk of unintended injury for lesions abutting visceral organs [33]. However, recent randomized, controlled, phase 2 trial, comparing the efficacy and safety between RFA and MWA, demonstrated that microwave ablation was not superior to radiofrequency ablation in terms of procedure time, local tumor progression, frequency of complications, or overall survival [34]; and some researchers demonstrated that RFA could be considered for HCC lesions adjacent to visceral organs without compromising the efficacy of the procedure or increasing the frequency of complications [35].…”

Section: Discussionmentioning

confidence: 99%

Safety and technical feasibility of percutaneous ablation for lymph node metastases of hepatocellular carcinoma

Yuan

Xing

Zheng

et al. 2019

International Journal of Hyperthermia

View full text Add to dashboard Cite

Purpose: This study aimed to assess the safety and technical feasibility of percutaneous ablation therapy for lymph node (LN) metastases of hepatocellular carcinoma (HCC). Material and Methods: A total of 31 consecutive HCC patients with LN metastases who were treated with ablation were included in this retrospective study. Percutaneous ablation was performed under local anesthesia and computed tomography-guidance. The primary endpoint was technique success; secondary endpoints were overall survival (OS), progression-free survival (PFS), and local progressionfree survival (LPFS). Survival curves were constructed using Kaplan-Meier method. Results: The median diameter of metastatic LNs was 30 mm (range, 10-77 mm). The 1-, 3-, and 5-year OS rates were 74.6%, 50.3%, and 50.3%, respectively. The 1-, 3-, and 5-year PFS rates were 24.7%, 0%, and not available for calculation (NA), respectively. The 1-, 3-, and 5-year LPFS rates were 78.7%, 69.9%, and 69.9%, respectively. The technique success and technical effectiveness rates were 100% and 64.5%, respectively. The technical effectiveness rates were 65.4% (17/26) and 60% (3/5) in abdominal LN metastases and distant LN metastases, respectively. Only one patient (1/31, 3.2%) had major complications (massive pleural effusion and severe pneumonia) related to ablation. Minor complications related to ablation included mild abdominal pain (10/31, 32.3%) and self-limiting hematoma (2/ 31, 6.5%). No ablation-related death occurred. Conclusion: Percutaneous ablation appears to be a safe and feasible method for treatment of metastatic LNs in patients with HCC.

show abstract

Section: Discussionmentioning

confidence: 99%

Safety and technical feasibility of percutaneous ablation for lymph node metastases of hepatocellular carcinoma

Yuan

Xing

Zheng

et al. 2019

International Journal of Hyperthermia

View full text Add to dashboard Cite

show abstract

“…This concept has been further explored to develop a probe for transurethral treatment of prostate cancer allowing full or focal gland ablation under MR-guidance [247]. The imaging [154,155,189,193,214] LI: Liver [50,70,82,83,101,145,146,159,163,193,196,[215][216][217][218][219] LU: Lung [87,88,99,114,138,144,157,169,190] PA: [86,93,95,137,158,185,[193][194][195] [150][151][152][153]191] Open circles represent explorative (small/few phase I/II) use and solid black circles represent many/large phase I/II trials, retrospective analyses or phase III evidence.…”

Section: Local Heating Techniquesmentioning

confidence: 99%

Heating technology for malignant tumors: a review

Kok

Cressman

Ceelen

et al. 2020

International Journal of Hyperthermia

257

188

View full text Add to dashboard Cite

The therapeutic application of heat is very effective in cancer treatment. Both hyperthermia, i.e., heating to 39-45 C to induce sensitization to radiotherapy and chemotherapy, and thermal ablation, where temperatures beyond 50 C destroy tumor cells directly are frequently applied in the clinic. Achievement of an effective treatment requires high quality heating equipment, precise thermal dosimetry, and adequate quality assurance. Several types of devices, antennas and heating or power delivery systems have been proposed and developed in recent decades. These vary considerably in technique, heating depth, ability to focus, and in the size of the heating focus. Clinically used heating techniques involve electromagnetic and ultrasonic heating, hyperthermic perfusion and conductive heating. Depending on clinical objectives and available technology, thermal therapies can be subdivided into three broad categories: local, locoregional, or whole body heating. Clinically used local heating techniques include interstitial hyperthermia and ablation, high intensity focused ultrasound (HIFU), scanned focused ultrasound (SFUS), electroporation, nanoparticle heating, intraluminal heating and superficial heating. Locoregional heating techniques include phased array systems, capacitive systems and isolated perfusion. Whole body techniques focus on prevention of heat loss supplemented with energy deposition in the body, e.g., by infrared radiation. This review presents an overview of clinical hyperthermia and ablation devices used for local, locoregional, and whole body therapy. Proven and experimental clinical applications of thermal ablation and hyperthermia are listed. Methods for temperature measurement and the role of treatment planning to control treatments are discussed briefly, as well as future perspectives for heating technology for the treatment of tumors.

show abstract

“…Ablation of intraparenchymal liver tumors generally requires a safety margin of 5-10 mm [10]. However, HCC abutting important organs has been regarded as a "challenging location" and, thus, requires enlarged ablation margins [11]. At the same time, it is easy to cause gastrointestinal, gallbladder, and septal perforation by thermal ablation for HCC at the above locations.…”

Section: Introductionmentioning

confidence: 99%

Computed tomography-guided radiofrequency ablation combined with transarterial embolization assisted by a three-dimensional visualization ablation planning system for hepatocellular carcinoma in challenging locations: a preliminary study

Huang

Zuo

et al. 2020

Abdom Radiol

View full text Add to dashboard Cite

Objective To assess the clinical efficacy and safety of computed tomography-guided radiofrequency ablation(CT-RFA) combined with transarterial embolization(TAE) assisted by a three-dimensional visualization ablation planning system(3DVAPS) for hepatocellular carcinoma(HCC) in challenging locations. Methods Data from 62 treatment-naive patients with hepatocellular carcinoma(HCC), with 83 lesions in challenging locations, and who met the Milan criteria and underwent CT-RFA between June 2013 and June 2016 were reviewed. Patients were divided into one of two groups according to different treatment modalities: study group (TAE combined with RFA assisted by 3DVAPS [n = 32]); and control (RFA only [n = 30]). Oncological outcomes included ablation-related complications, local tumor progression (LTP), and overall survival (OS). Univariate and multivariate Cox proportional hazards regression analyses were performed to assess risk factors associated with LTP and OS. Results HCC lesions (mean size, 1.9 ± 1.0 mm in diameter) abutting the gastrointestinal tract (n = 25), heart and diaphragm (n = 21), major vessels (n = 13), and gallbladder (n = 3) were treated. A significant difference was detected in LTP between the two groups (P = 0.034), with no significant difference in OS between the two groups (P = 0.193). There were no severe complications related to ablation. Univariate analysis revealed that sex (P = 0.046) and child-turcotte-pugh (CTP) grade (P<0.001) were risk factors for OS, whereas CTP grade and treatment method (P<0.001) were risk factors for LTP. Multivariate analysis revealed that CTP grade B (P = 0.005) was independently associated with poor OS, and RFA alone (P<0.001) was independently associated with poor LTP. Conclusion CT-RFA combined with TAE assisted by a 3DVAPS provided ideal clinical efficiency for HCC in challenging locations and was a highly safe treatment modality.

show abstract

Computed tomography-guided percutaneous microwave ablation of hepatocellular carcinoma in challenging locations: safety and efficacy of high-power microwave platforms

Abstract: CT-guided percutaneous microwave ablation for hepatocellular carcinoma tumours in challenging locations and up to 5 cm in diameter can be performed with high efficacy and safety rates.

Cited by 37 publications

References 35 publications

Safety and technical feasibility of percutaneous ablation for lymph node metastases of hepatocellular carcinoma

Safety and technical feasibility of percutaneous ablation for lymph node metastases of hepatocellular carcinoma

Heating technology for malignant tumors: a review

Computed tomography-guided radiofrequency ablation combined with transarterial embolization assisted by a three-dimensional visualization ablation planning system for hepatocellular carcinoma in challenging locations: a preliminary study

Contact Info

Product

Resources

About