Enlargement of thermal ablation zone by the combination of ethanol injection and radiofrequencyn ablation in excised bovine liver

Watanabe, Seishiro; Kurokohchi, Kazutaka; Masaki, Tsutomu; Miyauchi, Y.; Funaki, Toshiharu; Inoue, Hirokazu; Himoto, Takashi; Kita, Yuko; Uchida, Naoshige; Touge, Tetsuo; Tatsukawa, Toshiaki; Kuriyama, Shigeki

doi:10.3892/ijo.24.2.279

Cited by 22 publications

(16 citation statements)

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“…Several studies have shown that the RFA-PEI combination strategy can create a larger ablative zone than RFA alone [35–39]. The efficacy of this treatment can be explained as follows: (a) PEI can reduce the heat-sink effect by destroying tumor vessels and enhancing thermal conduction in the tumor tissues; (b) ethanol heated by RFA results in better therapeutic efficiency than cool ethanol; and (c) diffusion of ethanol into areas where RF energy is inefficient improves the efficiency [40].…”

Section: Rfa-combined Multimodal Therapiesmentioning

confidence: 99%

Radiofrequency ablation-combined multimodel therapies for hepatocellular carcinoma: Current status

2016

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Radiofrequency ablation (RFA) is widely accepted as a first-line interventional oncology approach for hepatocellular carcinoma (HCC) and has the advantages of high treatment efficacy and low complication risk. Local control rates equivalent to hepatic resection can be reached by RFA alone when treating small HCCs (<2 cm) in favorable locations. However, local tumor progression and recurrence rates with RFA monotherapy increase sharply when treating larger lesions (>3 cm). To address this clinical problem, recent efforts have focused on multimodel management of HCC by combining RFA with different techniques, including percutaneous ethanol injection, transarterial chemo-embolization, targeted molecular therapy, nanoparticle-mediated therapy, and immunotherapy. The combination strategy indeed leads to better outcomes in comparison to RFA alone. In this article, we review the current status of RFA-combined multimodal therapies in the management of HCC.

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Section: Rfa-combined Multimodal Therapiesmentioning

confidence: 99%

Radiofrequency ablation-combined multimodel therapies for hepatocellular carcinoma: Current status

2016

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“…Combination therapy of percutaneous ethanol injection with radiofrequency ablation (10)(11)(12)(13)(14) was done for HCC in the posterior segment of right lobe. NHL was treated with 3 courses of chemotherapy including cyclophosphamide, adriamycin, vincristine, and prednisolone (CHOP therapy).…”

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confidence: 99%

Coexistence of Splenic Non-Hodgkin's Lymphoma With Hepatocellular Carcinoma in a Patient With Chronic Hepatitis C

et al. 2006

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KEY WORDS: hepatitis C virus; non-Hodgkin's lymphoma; hepatocellular carcinoma; fine needle aspiration biopsy. (1), although there is no apparent evidence that HCV has direct oncogenic effects on hepatocytes. On the other hand, HCV involves many kinds of extrahepatic manifestations, including mixed cryoglobulinemia, Sjögren syndrome, interstitial pneumoniae, and chronic thyroiditis (2). Recently, strong association of HCV with non-Hodgkin's lymphoma (NHL) has been reported (3-9). Therefore, it has been suggested that chronic HCV infection may also contribute to the development of NHL. We report the case of a HCVinfected patient with coexistent splenic NHL with hepatocellular carcinoma (HCC). Fine needle splenic biopsy under the guidance of ultrasound imaging was a useful procedure for the diagnosis of the splenic lesion in the present case. Chronic hepatitis C virus (HCV) infection is believed to play important roles in hepatocarcinogenesis CASE REPORTA 63-year-old man diagnosed with HCV infection, diabetes mellitus, and hypertension consulted a physician with a chief complaint of left hypochondric pain. He hid not have a past history of blood transfusion. Abdominal ultrasound scanning revealed a space-occupying lesion (SOL) in the spleen as well as another SOL in the liver. The levels of serum α-fetoprotein (AFP) were also elevated. He was referred to Physical examination on admission revealed no conjunctival anemia and no jaundice. He had no abnormal cardiopulmonary findings. The abdomen was soft and flat, and liver margin was palpated 2 fingerbreadths below the right costal margin. The spleen was also palpable for two fingerbreadths below the left costal margin. Palmar erythema was noted. Ascites or edema was not obvious. Abnormal neurologic findings were not observed. Superficial lymph nodes, including the cervical, axillary, and inguinal lymph nodes, were not enlarged.Laboratory data on admission are presented in Table 1. Peripheral blood revealed a decrease in number of lymphocytes and mild anemia. Blood biochemistry revealed a slight decrease of serum albumin and cholinesterase and mild elevation of aspartate aminotransferase and lactate dehydrogenase. Fasting blood sugar and hemoglobin A1c were also slightly elevated. Serum AFP, AFP-L3 fraction, and plasma protein induced by vitamin K absence or antagonist-II (PIVKA-II) levels were markedly elevated. The level of soluble interleukin-2 receptor (sIL-2R) was also moderately increased. Antinuclear antibody was negative and cryoprecipitate was not tested in the patient. Hepatitis B virus surface antigen (HBsAg) was negative. HCV genotype and the viral load in the present case were 2a and 500 KIU/mL, respectively.Dynamic computed tomography (CT) findings of the abdomen were as follows: Liver tumor of approximately 4 cm in diameter with ringed enhancement in the early phase was detected in the posterior segment of the right lobe.

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“…To enhance the therapeutic effect of RFA, several treatment modalities have been applied additionally to local treatment. Combined use of transcatheter arterial chemoembolization or saline injection therapy with RFA has been reported to enlarge the extent of induced coagulation (27)(28)(29)(30)(31)(32)(33). As one of the optional combination therapies, we have shown that injection of ethanol prior to RFA (PEI-RFA) markedly enlarged the induced coagulated necrosis in human (20,21) and in bovine livers (33).…”

Section: Discussionmentioning

confidence: 81%

Thoracoscopic ethanol injection and radiofrequency ablation for the treatment of hepatocellular carcinoma located immediately under the diaphragm

Kurokohchi

Hirai²,

Ohgi³

et al. 2006

Int J Oncol

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Abstract. We previously reported that the combination therapy of percutaneous ethanol injection and radiofrequency ablation (PEI-RFA) was more effective than RFA alone in inducing wider coagulated necrosis for the treatment of hepatocellular carcinoma (HCC). In the present study, we thoracoscopically applied the combination therapy to the treatment of HCC located immediately under the diaphragm. RFA electrode and ethanol injection needle were inserted into the tumor through the right side of the diaphragm in 6 patients with HCC close to the diaphragm. In all cases, the tumor was completely ablated with enough safety margin around the tumor. No local tumor recurrence has been observed in a relatively short-time followup period. The volume of coagulated necrosis and the energy requirement for coagulation in thoracoscopic ethanol injection and RFA (T-EI-RFA) were comparable to those of PEI-RFA. Although HCC located immediately under the diaphragm is difficult to treat with a percutaneous approach due to the poor visualization by ultrasonography, T-EI-RFA is considered to be an effective treatment modality.

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Enlargement of thermal ablation zone by the combination of ethanol injection and radiofrequencyn ablation in excised bovine liver

Cited by 22 publications

References 0 publications

Radiofrequency ablation-combined multimodel therapies for hepatocellular carcinoma: Current status

Radiofrequency ablation-combined multimodel therapies for hepatocellular carcinoma: Current status

Coexistence of Splenic Non-Hodgkin's Lymphoma With Hepatocellular Carcinoma in a Patient With Chronic Hepatitis C

Thoracoscopic ethanol injection and radiofrequency ablation for the treatment of hepatocellular carcinoma located immediately under the diaphragm

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