Bipolar radiofrequency ablation of liver metastases during laparotomy. First clinical experiences with a new multipolar ablation concept

Ritz, J.‐P.; Lehmann, Kai S.; Reißfelder, Christoph; Albrecht, Thomas; Frericks, Bernd; Zurbuchen, Urte; Buhr, H. J.

doi:10.1007/s00384-005-0781-y

Cited by 35 publications

(34 citation statements)

References 42 publications

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“…The distances between the electrodes were ultrasonographically estimated for the multi-monopolar ME-RFA system and for the multi-bipolar ME-RFA system, and they were about 1.5-2.0 cm [9] and 2.0-3.0 cm [16], respectively. In the multi-monopolar ME-RFA system, the switching machine was set to the auto-mode, and all electrodes worked alternately and switched off automatically after any impendence surge.…”

Section: Me-rfa Systems and Treatment Proceduresmentioning

confidence: 99%

The Effectiveness of Multiple Electrode Radiofrequency Ablation in Patients with Hepatocellular Carcinoma with Lesions More than 3 cm in Size and Barcelona Clinic Liver Cancer Stage A to B2

Lin

Cheng

et al. 2015

Liver Cancer

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Outcomes of hepatocellular carcinoma (HCC) lesions >3.0 cm in size including Barcelona Clinic Liver Cancer (BCLC) stage B after radiofrequency ablation (RFA) with a single electrode remain unsatisfactory. This study aimed to investigate the outcomes of RFA with multiple electrodes (ME-RFA) for HCC tumors 3.1-7.0 cm in size and BCLC stage B. This retrospective study included 70 consecutive patients with 58 medium- (3.1-5.0 cm) and 17 large- (5.1-7.0 cm) sized HCCs after ME-RFA using a controller. Outcomes in terms of complete response, primary technique effectiveness, local tumor progression, and overall survival were investigated. After 1-4 applications of ME-RFA, the rates of complete response and PTE in medium-sized tumors were 79.3% and 91.4%, respectively, and in large tumors were 76.5% and 94.1%, respectively. Overall, the major complication rate was 5.7%. After a median 21-month follow-up period, both two- and three-year estimated overall survival rates were above 80%. There were no significant differences in overall survival and local tumor progression rates between medium- and large-size tumors and among BCLC stages A, B1 and B2. A complete response to ME-RFA was the only significant factor associated with improved survival (p=0.008). In conclusion, ME-RFA can effectively treat 3.1-7.0-cm sized HCCs with a comparable outcome between medium- and large-size tumors and among BCLA stages A to B2.

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Section: Me-rfa Systems and Treatment Proceduresmentioning

confidence: 99%

The Effectiveness of Multiple Electrode Radiofrequency Ablation in Patients with Hepatocellular Carcinoma with Lesions More than 3 cm in Size and Barcelona Clinic Liver Cancer Stage A to B2

Lin

Cheng

et al. 2015

Liver Cancer

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“…Recurrence appears to be mainly due to micrometastases that already exist at the time of resection [6], which may rapidly grow up to macrometastases. Thus, in-situ ablation procedures, such as laserinduced thermotherapy (LITT), are gaining in clinical importance in the primary and secondary treatment of liver tumors [7,8]. The largest series of patients worldwide with laser-ablated colorectal liver metastases (n ¼ 603) by Vogl et al [8] gives a 5-year survival rate of 37% despite relatively unfavorable prognostic factors.…”

Section: Introductionmentioning

confidence: 99%

Laser‐induced thermotherapy (LITT) elevates mRNA expression of connective tissue growth factor (CTGF) associated with reduced tumor growth of liver metastases compared to hepatic resection

et al. 2006

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Background and Objectives: Proliferation and synthesis of hepatocellular tissue after tissue damage are promoted by specific growth factors such as hepatic tissue growth factor (HGF) and connective growth factor (CTGF). Laser-induced thermotherapy (LITT) for the treatment of liver metastases is deemed to be a parenchyma-saving procedure compared to hepatic resection. The aim of this study was to compare the impact of LITT and hepatic resection on intrahepatic residual tumor tissue and expression levels of mRNA HGF/CTGF within liver and tumor tissue. Study Design/Materials and Methods: Two independent adenocarcinomas (CC531) were implanted into 75 WAG rats, one in the right (untreated tumor) and one in the left liver lobe (treated tumor). The left lobe tumor was treated either by LITT or partial hepatectomy. The control tumor was submitted to in-situ hybridization of HGF and CTGF 24-96 hours and 14 days after intervention. Results: Volumes of the untreated tumors prior to intervention were 38 AE 8 mm 3 in group I (laser), 39 AE 7 mm 3 in group II (resection), and 42 AE 12 mm 3 in group III (control) and did not differ significantly (P > 0.05). Fourteen days after the intervention the mean tumor AE SEM volume of untreated tumor in group I (laser) [223 AE 36] was smaller than in group II (resection) [1233.28 AE 181.52; P < 0.001], and in group III (control) [978.92 AE 87.57; P < 0.003]. Forty-eight hours after the intervention intrahepatic mRNA expression level of HGF in group II (resection) was almost twofold higher than in group I (laser) [7.2 AE 1.0 c/mf vs. 3.9 AE 0.4 c/mf; P < 0.01]. Fourteen days after the intervention intrahepatic mRNA expression level of CTGF in group I (laser) was higher than in group II (resection) [13.89 AE 0.77 c/mf vs. 9.09 AE 0.78 c/mf; P < 0.003]. Conclusions: LITT leads to a decrease of residual tumor growth in comparison to hepatic resection. Accelerated tumor growth after hepatic resection is associated with higher mRNA level of HGF and reduced tumor growth after LITT with higher mRNA level of CTGF. The increased CTGF-mediated regulation of ECM may cause reduced residual tumor growth after LITT.

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“…Bipolar RF device has expanded treatment to lesions of 5 cm in diameter though early studies on its efficacy have been contradictory [50,51]. In a more recent study by Baldwin et al on a small cohort with mean lesion size of 3.6 ± 1.3 cm, only 1 of 22 patients developed recurrence at the site of ablation [52].…”

Section: Tumour Sizementioning

confidence: 99%

Resection and Ablation for Colorectal Liver Metastases

Ng¹

2013

J Gastrointest Dig Syst

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The surgical approach combining resection and ablation allows for a greater number of patients with colorectal liver metastases who would otherwise be considered to have unresectable disease to be given an opportunity to undergo a curative attempt surgery. Ablation results in local destruction of tumour and is often employed in lesions that are in locations which are not easily resectable. This may involve the use of radiofrequency ablation that causes thermal destruction or cryotherapy that freezes tumours. This review examined the literature reporting resection and ablation of colorectal liver metastases.

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Bipolar radiofrequency ablation of liver metastases during laparotomy. First clinical experiences with a new multipolar ablation concept

Abstract: Bipolar radiofrequency using the novel multipolar ablation concept permits a safe and effective therapy for the induction of large volumes of coagulation in the local treatment of liver metastases.

Cited by 35 publications

References 42 publications

The Effectiveness of Multiple Electrode Radiofrequency Ablation in Patients with Hepatocellular Carcinoma with Lesions More than 3 cm in Size and Barcelona Clinic Liver Cancer Stage A to B2

The Effectiveness of Multiple Electrode Radiofrequency Ablation in Patients with Hepatocellular Carcinoma with Lesions More than 3 cm in Size and Barcelona Clinic Liver Cancer Stage A to B2

Laser‐induced thermotherapy (LITT) elevates mRNA expression of connective tissue growth factor (CTGF) associated with reduced tumor growth of liver metastases compared to hepatic resection

Resection and Ablation for Colorectal Liver Metastases

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