Radiofrequency ablation of unresectable liver tumors: factors associated with incomplete ablation or local recurrence

Ayav, Ahmet; Germain, A; Marchal, Frédéric; Tierris, Ioannis; Laurent, V.; Bazin, Christophe; Yua, Yuan; Robert, Laurence; Brunaud, Laurent; Bresler, L.

doi:10.1016/j.amjsurg.2009.11.009

Cited by 72 publications

(60 citation statements)

References 21 publications

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“…1) are well known factors that have been associated with local tumor control. A tumor size up to 3 cm is now established to be the ideal candidate for RFA, with oncologic outcomes similar to those achieved by surgical resection [16,19,[26][27][28][29]. A recent prospective study documented a local tumor progression (LTP) rate of 3% within 12 months and a local tumor PFS over 95% at 30 months after ablation of CLM with margins over 5 mm and biopsy-proven complete tumor necrosis [30].…”

Section: Radiofrequency Ablationmentioning

confidence: 99%

Thermal Ablation in the Management of Colorectal Cancer Patients with Oligometastatic Liver Disease

Petre

Sofocleous

2017

Visc Med

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Background: Surgical resection of limited colorectal liver disease improves long-term survival and can be curative in a subset of selected cases. Image-guided percutaneous ablation therapies have emerged as safe and effective alternative options for selected patients with unresectable colorectal liver metastases (CLM) that can be ablated with margins. Ablation causes focal destruction of tissue and has increasingly been shown to provide durable eradication of tumors. Methods: A selective review of literature was conducted in PubMed, focusing on recent studies reporting on the safety, efficacy, and long-term outcomes of percutaneous ablation modalities in the treatment of CLM. The present work gives an overview of the different ablation techniques, their current clinical indications, and reported outcomes from most recently published studies. The ‘test of time' concept for using ablation as a first local therapy is also described. Results: There are several thermal ablative tools currently available, including radiofrequency ablation (RFA), microwave ablation, and cryoablation. Most data to date originated from the application of RFA. Adjuvant thermal ablation in the treatment of oligometastatic colon cancer liver disease offers improved oncologic outcomes. The ideal CLM amenable to percutaneous ablation is a solitary tumor with the largest diameter up to 3 cm that can be completely ablated with a sufficient margin. 5-year overall survival rates up to 70% after ablation of unresectable CLM have been reported. Pathologic confirmation of complete tumor necrosis with margins over 5 mm provides best long-term local tumor control by thermal ablation. Conclusion: Current evidence suggests that percutaneous ablation as adjuvant to chemotherapy improves oncologic outcomes of patients with CLM. For small tumors that can be ablated completely with clear margins, percutaneous ablation may offer outcomes similar to those of surgery.

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Section: Radiofrequency Ablationmentioning

confidence: 99%

Thermal Ablation in the Management of Colorectal Cancer Patients with Oligometastatic Liver Disease

Petre

Sofocleous

2017

Visc Med

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“…Residual unablated tissue is a relatively common occurrence after laparoscopic RFA in patients with HCC lesions larger than 3 cm in diameter. 20,21 Therefore, liver ablation must be cautiously considered for liver tumors larger than 3 cm, due to the higher probability of incomplete ablation. Additionally, care must be taken to avoid thermal injury to the major bile ducts, especially when RFA is used in close proximity to the hepatic hilum.…”

Section: Discussionmentioning

confidence: 99%

Longterm survival outcomes of patients undergoing treatment with radiofrequency ablation for hepatocellular carcinoma and metastatic colorectal cancer liver tumors

Sucandy

Cheek

Golas

et al. 2016

HPB

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“…The open approaches allowed ablation by means of multiple needle electrode punctures at different angles, which prevented dead ends inside tumors as much as possible. Ayav et al (2010) reported that the rate of incomplete ablation by the percutaneous approach was as high as 18% compared with 13.8% for the open approach. Contradictorily, a lower recurrence rate was at the expense of greater trauma.…”

Section: Discussionmentioning

confidence: 99%

Comparison of laparoscopic hepatectomy, percutaneous radiofrequency ablation and open hepatectomy in the treatment of small hepatocellular carcinoma

Lai

Jin

Liang

et al. 2016

J. Zhejiang Univ. Sci. B

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Abstract:Objective: Three mainstream techniques-laparoscopic hepatectomy (LH), percutaneous radiofrequency ablation (pRFA), and open hepatectomy (OH)-were compared in this study, in terms of their efficacies in the treatment of small hepatocellular carcinoma (HCC). Methods: A comparative study was performed within a total of 94 patients diagnosed with small HCC in our hospital from 2005 to 2010, who underwent LH (28), RFA (33), or OH (33). They had either a single tumor lesion of less than 5 cm or up to three nodules with diameters of less than 3 cm each. Outcomes were carefully evaluated throughout a 3-year follow-up interval and statistically interpreted. Results: The pRFA group had a significantly lower disease-free survival rate compared with the two surgical groups (P=0.001) and significantly shorter overall survival (P=0.005), while the LH group and the OH group had no difference in survival results. For patients younger than 60 years old, surgical approaches offered a better long-term overall survival prognosis (P=0.008). There were no statistically significant differences among the three groups in overall survival for elderly patients (P=0.104). Conclusions: Among patients with small HCC, LH may provide better curative effects than pRFA without increasing complication rates. pRFA leads to faster recurrence than surgical resections. LH has similar therapeutic effects to OH and causes less trauma. For patients younger than 60 years old, LH may be the best curative treatment. Elderly patients may choose either surgery or pRFA.

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Radiofrequency ablation of unresectable liver tumors: factors associated with incomplete ablation or local recurrence

Cited by 72 publications

References 21 publications

Thermal Ablation in the Management of Colorectal Cancer Patients with Oligometastatic Liver Disease

Thermal Ablation in the Management of Colorectal Cancer Patients with Oligometastatic Liver Disease

Longterm survival outcomes of patients undergoing treatment with radiofrequency ablation for hepatocellular carcinoma and metastatic colorectal cancer liver tumors

Comparison of laparoscopic hepatectomy, percutaneous radiofrequency ablation and open hepatectomy in the treatment of small hepatocellular carcinoma

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