Percutaneous ultrasound-guided thermal ablation for intrahepatic cholangiocarcinoma

Abstract

Objective: The objective of this study was to evaluate the treatment efficacy and overall survival (OS) of percutaneous ultrasound-guided thermal ablation by means of microwave ablation or radiofrequency ablation for intrahepatic cholangiocarcinoma (ICC). Methods: 18 patients with 25 ICC nodules underwent ultrasound-guided thermal ablation with curative intention. 8 patients were primary cases and 10 were recurrent cases after curative resection. The local treatment response, complications and survivals were analysed. Results: Complete ablation was achieved in 23 (92.0%, 23/25) nodules (diameter, 0.7-4.3 cm; mean, 2.5¡0.9 cm) and incomplete ablation was found in 2 (8.0%, 2/25) larger tumours (6.4 and 6.9 cm in diameter). No death associated with the treatment was found. The major complication rate was 5.5% (1/18). The follow-up periods ranged from 1.3 to 86.2 months (mean, 20.5¡26.3 months; median, 8.7 months). OS rates for all patients at 6, 12, 36 and 60 months were 66.7%, 36.3%, 30.3% and 30.3%, respectively. By univariate analysis, the patient source (primary or recurrent case) was found to be a significant prognostic factor for OS rates (p50.001). The patient source (p50.001) and the number of nodules (p50.038) were found to be significant prognostic factors for recurrence-free survival. OS rates for the primary ICC at 6, 12, 36 and 60 months were 87.5%, 75.0%, 62.5% and 62.5%, respectively. Conclusion: Percutaneous ultrasound-guided thermal ablation is a safe and effective therapeutic technique for ICC. Acceptable survival can be achieved in primary ICCs, whereas the prognosis of recurrent ICCs is relatively poor.

Guidelines for the diagnosis and treatment of cholangiocarcinoma: an update

“…In a Chinese study, 18 patients (8 primary and 10 recurrent cases after resection) with 25 intrahepatic CC nodules underwent US-guided thermal ablation with curative intention 120. Complete ablation was achieved in 23 (92%) nodules (diameter 0.7–4.3 cm) and incomplete ablation was found in the remaining two tumours which were larger (6–7 cm).…”

Ablative therapies for intrahepatic cholangiocarcinoma

“…Therefore, in most previous studies, the efficacies of ablation therapies were mainly investigated among patients with unresectable ICC or recurrent ICC after surgery (12)(13)(14)(15)(16)(17)(18)(19)(20)(21) only used in limited cases. RFA is usually performed under ultrasound guidance, and sufficient ablative margins of at least 0.5 to 1.0 cm surrounding tumors are required to secure the complete ablation of tumor nodules.…”

Chemoembolization with Drug-eluting Microspheres Loaded with Doxorubicin for the Treatment of Cholangiocarcinoma

“…Target methods, aiming to direct the treatment locally inside the tumor, are valid alternatives to systemic chemotherapy for unresectable CCA, including thermal ablation with radiofrequency ablation or microwave ablation, and chemoembolization (21)(22)(23). Figure …”