Laparoscopic microwave thermosphere ablation of malignant liver tumors: an initial clinical evaluation

Berber, Eren

doi:10.1007/s00464-015-4261-3

Cited by 19 publications

(30 citation statements)

References 21 publications

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“…As a follow up to our first clinical report [14], this study demonstrates that the Thermosphere technology used is capable of creating spherical ablation zones with a single antenna safely and effectively. The low rate of local tumor recurrence in short-term follow up is promising, but needs to be validated in future studies.…”

Section: Resultsmentioning

confidence: 99%

Laparoscopic microwave thermosphere ablation of malignant liver tumors: An analysis of 53 cases

Zaidi

Okoh

Yiğitbaş

et al. 2015

Journal of Surgical Oncology

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Section: Resultsmentioning

confidence: 99%

Laparoscopic microwave thermosphere ablation of malignant liver tumors: An analysis of 53 cases

Zaidi

Okoh

Yiğitbaş

et al. 2015

Journal of Surgical Oncology

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“…In the RFA and MWA_B groups there was no difference in R (AZ:E) between these types of tumor. MWA_B utilizes thermal, field, and wavelength control to produce spherical ablation zones, which might have contributed to the apparent insensitivity to the presence of a heat-sink [17]. The fact that no heat-sink effects were observed in the RFA group was somewhat unexpected and may have been because only 8 of 30 tumors in that group were classified as potentially ‘high’ heat-sink tumors.…”

Section: Discussionmentioning

confidence: 99%

The relationship between applied energy and ablation zone volume in patients with hepatocellular carcinoma and colorectal liver metastasis

et al. 2018

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ObjectivesTo study the ratio of ablation zone volume to applied energy in computed tomography (CT)-guided radiofrequency ablation (RFA) and microwave ablation (MWA) in patients with hepatocellular carcinoma (HCC) in a cirrhotic liver and in patients with colorectal liver metastasis (CRLM).MethodsIn total, 90 liver tumors, 45 HCCs in a cirrhotic liver and 45 CRLMs were treated with RFA or with one of two MWA devices (MWA_A and MWA_B), resulting in 15 procedures for each tumor type, per device. Device settings were recorded and the applied energy was calculated. Ablation volumes were segmented on the contrast-enhanced CT scans obtained 1 week after the procedure. The ratio of ablation zone volume in milliliters to applied energy in kilojoules was determined for each procedure and compared between HCC (RHCC) and CRLM (RCRLM), stratified according to ablation device.ResultsWith RFA, RHCC and RCRLM were 0.22 mL/kJ (0.14–0.45 mL/kJ) and 0.15 mL/kJ (0.14–0.22 mL/kJ; p = 0.110), respectively. With MWA_A, RHCC was 0.81 (0.61–1.07 mL/kJ) and RCRLM was 0.43 (0.35–0.61 mL/kJ; p = 0.001). With MWA_B, RHCC was 0.67 (0.41–0.85 mL/kJ) and RCRLM was 0.43 (0.35–0.61 mL/kJ; p = 0.040).ConclusionsWith RFA, there was no significant difference in energy deposition ratio between tumor types. With both MWA devices, the ratios were higher for HCCs. Tailoring microwave ablation device protocols to tumor type might prevent incomplete ablations.Key Points • HCCs and CRLMs respond differently to microwave ablation • For MWA, CRLMs required more energy to achieve a similar ablation volume • Tailoring ablation protocols to tumor type might prevent incomplete ablations

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“…There are limited previous studies that specifically evaluate MWA performed via MIS for HCC. A prospective study of 18 patients with small HCC lesions was the first to report the safety and efficacy of laparoscopic MWA 30 . While the study demonstrated a satisfactory safety profile and the ability to successfully achieve tumor destruction, it did not report on any long‐term follow‐up 30 .…”

Section: Discussionmentioning

confidence: 99%

“…A prospective study of 18 patients with small HCC lesions was the first to report the safety and efficacy of laparoscopic MWA 30 . While the study demonstrated a satisfactory safety profile and the ability to successfully achieve tumor destruction, it did not report on any long‐term follow‐up 30 . A prior retrospective review of 35 patients compared the use of laparoscopic MWA versus laparoscopic RFA, with 13 patients receiving MWA 31 .…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive microwave ablation provides excellent long‐term outcomes for otherwise inaccessible hepatocellular cancer

Altman

Coughlan

Shukla

et al. 2020

Journal of Surgical Oncology

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Background and Objectives: Thermal ablation can be used as a bridge to transplant or with curative intent for hepatocellular carcinoma (HCC). We report our experience with laparoscopic ablation of HCC in patients deemed inaccessible by the percutaneous approach.Methods: We performed a retrospective review of surgical ablations from 2009 to 2017. Patient demographics, disease and treatment characteristics, and outcomes were abstracted from the medical record. Kaplan-Meier modeling was performed for survival and recurrence.Results: Thirty-three patients were included with a median age of 62 (interquartile range [IQR], 57-67). Most patients were male (76%) and Caucasian (70%). Ninety-seven percent had underlying cirrhosis. Median model for end stage liver disease-sodium was 9.5 (IQR,(8)(9)(10)(11)(12). The median maximal diameter of ablated lesions was 2.6 cm (IQR, 1.8-3.0). Thirty-nine lesions were ablated; 97% were completed laparoscopically. The median maximal diameter of the ablation zone was 4.8 cm (IQR, 3.8-5.7) with a median difference of ablation zone to the tumor of 2.0 cm (IQR, 1.5-2.75). Twelve patients received additional treatment. Median disease-free survival was 66.7 months and median follow-up 42.9 months. Disease recurrence occurred in 13 patients (39%)systemic recurrence in 6%, intrahepatic recurrence in 27% and local recurrence in 6%.Conclusion: Laparoscopic thermal ablation of HCC is safe and provides good oncologic outcomes for otherwise inaccessible tumors. K E Y W O R D S disease recurrence, hepatocellular carcinoma, laparoscopic surgery, minimally invasive surgery, thermal ablation

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Laparoscopic microwave thermosphere ablation of malignant liver tumors: an initial clinical evaluation

Abstract: To the best of our knowledge, this is the first report of a new thermosphere MWA technology in the laparoscopic treatment of malignant liver tumors. The results demonstrate the safety of the technology, with satisfactory spherical ablation zones seen on post-procedural CT scans.

Cited by 19 publications

References 21 publications

Laparoscopic microwave thermosphere ablation of malignant liver tumors: An analysis of 53 cases

Laparoscopic microwave thermosphere ablation of malignant liver tumors: An analysis of 53 cases

The relationship between applied energy and ablation zone volume in patients with hepatocellular carcinoma and colorectal liver metastasis

Minimally invasive microwave ablation provides excellent long‐term outcomes for otherwise inaccessible hepatocellular cancer

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