Radiofrequency Ablation of Hepatocellular Carcinoma with a Saline Solution Perfusion Device: A Pilot Study

Hänsler, J.; Frieser, M.; Schaber, S.; Kutschall, C.; Bernatik, T.; Müller, Wolfgang; Becker, Dirk; Hahn, Eckhart G.; Strobel, D

doi:10.1097/01.rvi.0000071096.76348.3b

Cited by 31 publications

(8 citation statements)

References 13 publications

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“…TACE is also able to invalidate the CT follow-up because of the residual Lipiodol fragments in the lesion area; this obstacle to imaging procedures could be, as suggested by Hansler [31], responsible for an increase in the incidence of local recurrences.…”

Section: Discussionmentioning

confidence: 98%

Radiofrequency thermal ablation (RFA) after transarterial chemoembolization (TACE) as a combined therapy for unresectable non-early hepatocellular carcinoma (HCC)

et al. 2005

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The treatment of unresectable "non-early" (according to the BCLC classification) hepatocellular carcinoma (HCC) in cirrhotic patients with transcatheter arterial chemoembolization (TACE) followed by radiofrequency ablation (RFA) is retrospectively evaluated and possible prognostic factors of this combined therapy are investigated. Forty-six consecutive cirrhotic patients (Child-Pugh class A or B) with solitary or oligonodular HCC underwent RFA after TACE. The treated lesions were 51 overall (size 30-80 mm, mean 48.9). RFA was performed by a multitined expandable electrodes device after one TACE administration. Local efficacy was evaluated with multiphasic computed tomography (CT) performed an average of 2 months after treatment and then during follow-up. Patient survival rate was also evaluated (follow-up time 1-51 months, mean 15 months). Technical success (defined as complete devascularization during the arterial phase) was achieved in 34/51 lesions (66.7%) at the first CT check and in 29/51 (56.9%) during the succeeding follow-up. Among the considered prognostic factors, only lesion diameter (< or > = 50 mm) was statistically significant in the Fisher's exact test in terms of local control (85.2 vs. 45.8% at first CT, p=.0065; 70.4 vs. 41.7% during follow-up, p=.051). There were two major complications (6.5%): one hepatic failure and one death. A Kaplan-Meier analysis showed survival rates of 89.7% at 12 months and 67.1% at 24 months. Combined therapy for non-early HCC shows a relatively high complete local response (especially in lesions less than 5 cm in diameter) and promising mid-term clinical success. Its overall usefulness has yet to be established by a larger series and risk-benefit analysis.

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Section: Discussionmentioning

confidence: 98%

Radiofrequency thermal ablation (RFA) after transarterial chemoembolization (TACE) as a combined therapy for unresectable non-early hepatocellular carcinoma (HCC)

et al. 2005

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“…It is well known that RFA can induce an unspecific immune stimulation [4] . Thus thermal coagulation causes an inflammatory reaction with lymphoplasmacellular infiltration that can be visualized as a hypervascular rim in contrast CT and contrast-enhanced ultrasound [19] . This We could recently demonstrate a specific T cell response towards the VX2-tumor implanted in rabbit livers after RFA was performed [5] .…”

Section: Discussionmentioning

confidence: 99%

Activation and dramatically increased cytolytic activity of tumor specific T lymphocytes after radio-frequency ablation in patients with hepatocellular carcinoma and colorectal liver metastases

Hänsler

Wissniowski²,

Schuppan³

et al. 2006

WJG

116

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to 0.109 (± 0.005) for CD4 + and 0.11 (± 0.012) for CD8 + T cells against HCC, and to 0.115 (± 0.031) for CD4 + and 0.15 (± 0.02) for CD8 + cells for colorectal metastases (P < 0.0001). No increased SI was observed with nonmalignant tumor tissue at all time points. Before RFA cytolytic activity against the respective cancer cells was low with 2.62 (± 0.37) relative luminescence units (RLU), but rose more than 100 fold 4 and 8 wk after RFA. Spontaneous release was < 2% of maximum release in all experiments. CONCLUSION:Patients with primary and secondary tumors of the liver show a significant tumor-specific cytotoxic T-cell stimulation with a dramatically increased tumor specific cytolytic activity of CD8 + T cells after RFA. INTRODUCTIONOpen surgery is still the gold standard for the treatment of hepatocellular carcinoma (HCC) and liver metastases of colorectal cancer. However, more than 75% of these patients are non-resectable for various reasons, such as size and location of the tumor. Radio-frequency thermal ablation (RFA) is a common therapy option for unresectable liver tumors. Thus it was shown that RFA and laserinduced thermo-therapy (LiTT) can achieve survival times comparable to surgery in selected patients [1][2][3] . RFA uses a radio-frequency current to induce coagulation necrosis which results in a local thermal necrosis accompanied by Activation and dramatically increased cytolytic activity of tumor specific T lymphocytes after radio-frequency ablation in patients with hepatocellular carcinoma and colorectal liver metastases www

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“…However, several studies describe techniques by which this method can be employed in treatment of larger tumors with similar results. Hansler et al 81 used a saline perfusion device to elicit a complete response in 85% of patients with a mean tumor size of 3.1 cm, including 8 with tumors between 3 and 4.5 cm. Technological advances, including increasing larger arrays are theoretically able to handle increasing larger lesions satisfactorily, but data are sparse.…”

Section: Thermal Ablationmentioning

confidence: 99%

Management of Hepatocellular Carcinoma

Cormier

Thomas

Chari

et al. 2006

Journal of Gastrointestinal Surgery

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Radiofrequency Ablation of Hepatocellular Carcinoma with a Saline Solution Perfusion Device: A Pilot Study

Cited by 31 publications

References 13 publications

Radiofrequency thermal ablation (RFA) after transarterial chemoembolization (TACE) as a combined therapy for unresectable non-early hepatocellular carcinoma (HCC)

Radiofrequency thermal ablation (RFA) after transarterial chemoembolization (TACE) as a combined therapy for unresectable non-early hepatocellular carcinoma (HCC)

Activation and dramatically increased cytolytic activity of tumor specific T lymphocytes after radio-frequency ablation in patients with hepatocellular carcinoma and colorectal liver metastases

Management of Hepatocellular Carcinoma

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