Intrahepatic Cholangiocarcinoma and Thermal Ablation: Long-term Results of An Italian Retrospective Multicenter Study

Giorgio, Antonio; Gatti, Pietro; Montesarchio, Luca; Santoro, B.; Dell’Olio, Andrea; Crucinio, Nicola; Coppola, Carmine; Scarano, Ferdinando; Biase, Fabio De; Ciracì, Emanuela; Semeraro, S; Giorgio, Valentina

doi:10.14218/jcth.2019.00036

Cited by 21 publications

(23 citation statements)

References 18 publications

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“…A larger, multicenter study was done in Italy, also comparing the two techniques. In total, 71 patients were treated, including 36 with RFA and 35 with MWA [29]. They concluded that patients treated with MWA for ICCA nodules <3 cm survived longer than patients treated with RFA (p < 0.005).…”

Section: Rfa Vs Mwamentioning

confidence: 99%

The Role of Conventional and Stereotactic Microwave Ablation for Intrahepatic Cholangiocarcinoma

Kim-Fuchs

Candinas

Lachenmayer

2021

JCM

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Background: The incidence and mortality of intrahepatic cholangiocarcinoma (ICCA) is increasing worldwide and curative treatment options are limited due to the aggressive tumor biology and often late diagnosis. Resection of the primary tumor remains the only curative therapy available, as the benefit of palliative chemotherapy and radiotherapy is relatively small. In contrast to hepatocellular carcinoma, minimal-invasive thermal tumor ablation, and in particular stereotactic tumor ablation for small primary cancers or metastases, is not established and data are scarce. Methods: We conducted a literature review in the field of ICCA ablation and retrospective analysis of 10 patients treated by stereotactic microwave ablation (SMWA) for either primary ICCA or liver metastases of ICCA. Results: While current guidelines have no consensus for ablation of primary ICCA, some state that it might be an option in inoperable patients or those with recurrent disease. The literature review revealed 11 studies on microwave ablation for ICCA reporting that MWA for ICCA ≤ 5 cm might be safe and could be a treatment option for patients who are not candidates for surgery. No data has been published on stereotactic microwave ablation (SMWA) for ICCA. The analyses of our own data of 10 patients treated by SMWA for primary ICCA (n = 5) or recurrent ICCA (n = 5) show that the treatment is safe and efficient with short hospital stays and low complication rates. Conclusion: Although thermal ablation, and in particular SMWA, might be a minimally invasive and tissue-sparing curative treatment alternative for small ICCA in the diseased liver and ICCA metastases, the oncologic benefit still needs to be shown in larger studies with longer follow-up.

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Section: Rfa Vs Mwamentioning

confidence: 99%

The Role of Conventional and Stereotactic Microwave Ablation for Intrahepatic Cholangiocarcinoma

Kim-Fuchs

Candinas

Lachenmayer

2021

JCM

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“…In particular, thermal ablation may not be indicated in case of relevant extrahepatic disease, class C Child-Pugh, major invasion of bile duct or vessel invasion or in case haemorrhagic diathesis or decompensated liver. While HCC has been traditionally the only primary hepatic malignancy to be treated percutaneously, more reports are now available for the treatment of non-resectable primary or recurrent cholangiocarcinoma [29]. A recent meta-analysis on the topic reported a pooled 1, 3, and 5-overall survival (OS) rates of 76% (95% confidence interval [CI]: 68–83%), 33% (21–44%) and 16% (7–26%) [30].…”

Section: Advances In Liver Imaging and Guidancementioning

confidence: 99%

The What, the Why, and the How of Liver Ablations: A Practical Guide for the Medical Oncologist

et al. 2021

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Interventional oncology plays a major role within modern oncological patient management. Image-guided thermal ablation has been recognized as a successful local therapeutic option in patients with primary and secondary malignant liver diseases, as also recalled by the recent European Society of Medical Oncology (ESMO) guidelines on colorectal metastases. As image-guided treatments may be as effective as surgery in selected patients with liver lesions, the clinical oncologist should be familiar with the indications, risks, and technical aspects of liver ablation in order to provide their patients with the best outcomes. This article provides a broad overview of the most commonly used ablation techniques and highlights the most relevant technical aspects such as the ideal setting in the operating theatre; which image-guided methods are available, including the growing application of fusion imaging; or contrast-enhanced ultrasound for guiding/monitoring the procedure. A further aim is to expand the knowledge among medical oncologists about liver ablation procedures and to provide insights into the future perspectives of percutaneous minimally invasive procedures in the liver.

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“…Some studies have shown that precoagulatedassisted LR can lead to severe postoperative complications, such as abdominal abscesses, bile fistula, and bile duct damage [10]. Some studies have also shown that MW-assisted LR (MW-LR) or RF-assisted LR (RF-LR) enables minimum blood loss and improves resection margins [11,12]. Therefore, in theory, this procedure may be beneficial for the survival of patients with HCC.…”

Section: Introductionmentioning

confidence: 99%

Water-cooled microwave ablation array for bloodless rapid transection of the liver

Yang

Chen³

et al. 2021

International Journal of Hyperthermia

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Background: Microwaves (MWs) deliver relatively high temperatures into biological tissue and cover a large ablation zone. This study aims to evaluate the efficacy and effectiveness of water-cooled doubleneedle MW ablation arrays in assisting the hepatic transection of an in vivo pig model. Methods: Our research program comprised computer modeling, tissue-mimicking phantom experiments, and in vivo pig liver experiments. Computer modeling was based on the finite element method (FEM) to evaluate ablation temperature distributions. In tissue-mimicking phantom and in vivo pig liver ablation experiments, the performances of the water-cooled MW ablation array and conventional clamp crushing liver resection were compared. Results: FEM showed that the maximum lateral ablation diameter at 100 W output and a duration of 60 s was 3 cm (assessed at 50 C isotherm). In the phantom, the maximum transverse ablation diameter of the double-needle MW ablation increased rapidly to 3 cm in 60 s at 50 W. The blood loss and blood loss per transection area in Group A were significantly lower than those in Group B (18 (7-26) ml vs. 34 (19-57) ml, and 2.4 (2-3.1) ml/cm 2 vs. 6.9 (3.2-8.3) ml/cm 2 , respectively) (p < 0.05). The transection speed in Group A (2.6(1.9-3.8) cm 2 /min) was significantly faster than that in Group B (1.7(1.1-2.2) cm 2 / min) (p < 0.05). Conclusion:In this experimental model, the new water-cooled MW array-assisted liver resection (LR) has the potential advantage of less blood loss and rapid removal than the conventional LR.

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Intrahepatic Cholangiocarcinoma and Thermal Ablation: Long-term Results of An Italian Retrospective Multicenter Study

Cited by 21 publications

References 18 publications

The Role of Conventional and Stereotactic Microwave Ablation for Intrahepatic Cholangiocarcinoma

The Role of Conventional and Stereotactic Microwave Ablation for Intrahepatic Cholangiocarcinoma

The What, the Why, and the How of Liver Ablations: A Practical Guide for the Medical Oncologist

Water-cooled microwave ablation array for bloodless rapid transection of the liver

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