First Experience of Ultrasound-guided Percutaneous Ablation for Recurrent Hepatoblastoma after Liver Resection in Children

Abstract

This study aimed to summarize the first experience with ultrasound-guided percutaneous ablation treatment (PAT) for recurrent hepatoblastoma (HB) after liver resection in children. From August 2013 to October 2014, PAT was used to treat 5 children with a total of 8 recurrent HB (mean size, 1.4 ± 0.8 cm; size range, 0.7–3.1 cm), including 4 patients with 7 tumors in the liver and 1 patient with 1 tumor in the lung. Technical success was achieved in all patients (5/5, 100%). The complete ablation rate after the first ablation session was 80% (4/5) on a patient-by-patient basis and 87.5% (7/8) on a tumor-by-tumor basis. Only 1 patient developed a fever with temperature >39 °C; it lasted 4 days after radiofrequency ablation (RFA) and was resolved by conservative therapy. During the follow-up period, new intrahepatic recurrences after PAT were detected in two patients. One died due to tumor progression 4 months after ablation. The median overall survival time after PAT was 13.8 months. PAT is a safe and promising therapy for children with recurrent HB after liver resection, and further investigation in large-scale randomized clinical trials is required to determine its role in the treatment of this disease.

Interventional Radiology-Guided Procedures in the Treatment of Pediatric Solid Tumors: A Systematic Review and Meta-Analysis

“…Local tumor ablation can be carried out with either the insertion of a probe directly within the neoplastic tissue, the delivery of substances through the vascular system or extracorporeal percutaneous focused treatments. 17 Image-guided placement of probes can be used to ablate primary and metastatic tumors of liver, lung, kidney, bone, and others. 18 In current clinical practice, tumor ablation through probe insertion can be divided, depending on the mechanism it uses to cause injury, into thermal therapies, chemical ablative techniques, and irreversible electroporation.…”

Interventional Oncology for Hepatic Malignancy in Children

“…Only small case series exist in the literature to demonstrate the use of RFA for the treatment of recurrent or metastatic HB. [85][86][87] As such, further research is needed to guide the use of these ablative modalities in the primary treatment of hepatic malignancy in children.…”

Hepatic tumors

“…Rezeksiyon sonrası yineleyen hepatoblastom tedavisi tartışmalıdır. Ultrason rehberliğinde radyofrekans veya etanol enjeksiyonu ile perkütan ablasyon tedavisinin ümit verici olduğu belirtilmiştir (32) . Kemoterapi ve yine rezeksiyon yapılabilir (13) .…”