Efficacy and safety of CT-guided percutaneous thermal ablation for hepatocellular carcinoma adjacent to the second porta hepatis

Abstract

Purpose: This study assessed the efficacy and safety of computed tomography (CT)-guided percutaneous thermal ablation for hepatocellular carcinoma adjacent to the second porta hepatis. Methods: From January 2011 to June 2018, 59 consecutive patients (51 men and 8 women aged 29-85 years) with 65 tumors (mean maximum tumor diameter: 20.5 ± 1.2 mm; range: 5-50 cm) adjacent to the second porta hepatis underwent percutaneous CT-guided thermal ablation. The complete ablation rate, local progression-free survival (LPFS), progression-free survival (PFS), prognostic factors for local progression, and safety of this technique were assessed. Results: No more than three sessions were performed to complete a patient's treatment. Technical success was achieved for all tumors. In the median follow-up of 18.5 months, local tumor progression occurred in 32.2% (19/59) of patients, while tumor progression occurred in 71.2% (42/59). The median LPFS was 37.4 months. The 1-, 2-, and 3-year LPFS rates were 86.2%, 66.5%, and 66.5%, respectively. The median PFS was 11.0 months. The 1-, 2-, and 3-year PFS rates were 47.9%, 27.0%, and 20.2%, respectively. The tumor size (P ¼ .007) and distance between the tumor and inferior vena cava (P ¼ 0.018) were the independent prognostic factors for local tumor progression. Conclusion: We showed that CT-guided percutaneous microwave ablation and radiofrequency ablation are effective and safe treatments for tumors adjacent to the second porta hepatis, particularly in patients with lesions less than 3 cm and a distance between the tumor and inferior vena cava of more than 5 mm.

Early recurrence after radiofrequency ablation for hepatocellular carcinoma: a multicenter retrospective study on definition, patterns and risk factors

“…If residual tumor tissue was still present, additional RFA procedures were immediately performed to achieve complete ablation in one procedure [20]. A minimal ablative margin > 0.5 cm beyond the tumor in all directions or/and absence of arterial contrast enhancement and portal venous washout within the ablation zone suggestive of residual tumor one month after ablation was/were considered as complete ablation [25,26,29,30]. Patients were followedup every 3 months in the first year after RFA and every six months in the subsequent years until tumor recurrence or death.…”

Cone beam computed tomography-guided microwave ablation for hepatocellular carcinoma under the hepatic dome: a retrospective case-control study

“…With the development of instruments and therapeutic schemes, MWA is increasingly used in many medical institutions worldwide to treat small and large HCCs and other solid tumors (12)(13)(14). In China, US is the most common image guidance tool for ablation, followed by CT.…”

Current perspectives on microwave ablation of liver lesions in difficult locations

“…[ 24 ] A study investigating the safety of MWA lesions near porta hepatis among 65 patients found that CT-guided MWA is an effective and safe treatment for tumors adjacent to the porta hepatis, particularly for lesions <3 cm. [ 25 ]…”