Reiterative Radiofrequency Ablation in the Management of Pediatric Patients with Hepatoblastoma Metastases to the Lung, Liver, or Bone

Yevich, Steven; Calandri, Marco; Gravel, Guillaume; Fresneau, Brice; Brugières, Laurence; Valteau‐Couanet, Dominique; Branchereau, Sophie; Chardot, Christophe; Aerts, Isabelle; Baère, Thierry De; Tselikas, Lambros; Deschamps, Frédèric

doi:10.1007/s00270-018-2097-7

Cited by 28 publications

(28 citation statements)

References 37 publications

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“…As to our knowledge, this report is the first pediatric series of SRFA, performed in 11 sessions for 15 liver masses in 10 patients. We know of only three previous reports of SRFA or even RFA in pediatric liver lesions [8,9,24]. Patient selection for SRFA weighed the burdens and potential complications of primary surgery.…”

Section: Discussionmentioning

confidence: 99%

Stereotactic radiofrequency ablation of a variety of liver masses in children

Hetzer

Vogel

Entenmann

et al. 2020

International Journal of Hyperthermia

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Background and aims: Surgical resection is currently the cornerstone of liver tumor treatment in children. In adults radiofrequency ablation (RFA) is an established minimally invasive treatment option for small focal liver tumors. Multiprobe stereotactic RFA (SRFA) with intraoperative image fusion to confirm ablation margins allows treatment for large lesions. We describe our experience with SRFA in children with liver masses. Methods: SRFA was performed in 10 patients with a median age of 14 years (range 0.5-17.0 years) suffering from liver adenoma (n ¼ 3), hepatocellular carcinoma (n ¼ 1), hepatoblastoma (n ¼ 2), myofibroblastic tumor (n ¼ 1), hepatic metastases of extrahepatic tumors (n ¼ 2) and infiltrative hepatic cysts associated with alveolar echinococcosis (n ¼ 1). Overall, 15 lesions with a mean lesion size of 2.6 cm (range 0.7-9.5 cm) were treated in 11 sessions. Results: The technical success rate was 100%, as was the survival rate. No transient adverse effects higher than grade II (Clavien and Dindo) were encountered after interventions. The median hospital stay was 5 d (range 2-33 d). In two patients who subsequently underwent transplant hepatectomy complete ablation was histologically confirmed. Follow-up imaging studies (median 55 months, range 18-129 months) revealed no local or distant recurrence of disease in any patient. Conclusions: SRFA is an effective minimal-invasive treatment option in pediatric patients with liver tumors of different etiologies.

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Section: Discussionmentioning

confidence: 99%

Stereotactic radiofrequency ablation of a variety of liver masses in children

Hetzer

Vogel

Entenmann

et al. 2020

International Journal of Hyperthermia

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“…Radiofrequency ablation is a minimally invasive treatment technology for solid tumors developed in recent years, mainly based on that tumor cells are less resistant to heat than normal cells [32][33][34][35]. By raising the effective local temperature to 90-120℃, RFA could heat the tumor area, resulting in coagulation, degeneration and necrosis, therefore, it can reduce tumor burden and the risk of stent restenosis.…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency Ablation Combined with Stent Placement versus Stent Placement Alone for Malignant Biliary Obstruction: A Systematic Review and Meta-analysis

Chen

Zhu

Sun

2020

Preprint

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Background: Malignant biliary obstruction was typically diagnosed at an advanced stage due to painless jaundice. Stent placement is the therapy of choice in this set of patients. Radiofrequency ablation is an ablative therapy which has been well recognized for treating malignant biliary strictures. This meta-analysis aims to help to better understand the safety and efficacy of biliary Radiofrequency ablation combined with stent placement. Methods: Five databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and China National Knowledge Infrastructure) were searched for randomized controlled trials and observational studies up to April 2020. Results: The mean difference in survival time was 54.87 days (95% confidence interval CI, 34.6-75.14), meaning patients performed with radiofrequency ablation benefit more. Reconstructed Kaplan-Meier data showed improved survival in joint intervention with RFA (hazard ratio, 1.39; 95%CI, 1.34-1.75; P < .001). However, no survival benefit was observed in the extrahepatic distal cholangiocarcinoma. With regard to patency time, the mean difference was 42.88 days (95%CI, 34.02-51.37). Reconstructed Kaplan-Meier data showed improved survival in the radiofrequency ablation treated group (hazard ratio, 1.629; 95%CI, 1.35-1.96; P < .001). Concerning postoperative complications such as abdominal pain, cholangitis and pancreatitis, our analysis did not show a significant difference between the radiofrequency ablation treatment group and the controls. Conclusion: Radiofrequency ablation plus stent resulted in improved survival and stent patency, with longer median survival and patency time than stent alone.

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“…A local tumor control of 95% and a complete remission in four children who had a median follow-up period of 67 months were reported. 90 RFA holds the promise for a feasible and effective therapeutic approach in the multidisciplinary treatment of children presenting with hepatoblastoma. Larger scale studies would be desirable but are difficult to conduct in this rare tumor entity.…”

Section: Hepatoblastomamentioning

confidence: 99%

Ablation in Primary Liver Tumors

2019

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Minimal invasive thermal ablation techniques have a key role in the treatment regimen of primary liver tumors. These relatively low-risk procedures are established in nonresectable liver tumors and even challenge the surgical approach, which is regarded as first-line treatment in eligible patients.The location and size of the liver tumor, the applied ablation, and guidance technique are crucial for treatment outcome. The confirmation of an adequate ablation zone including sufficient tumor overlap and a safety margin (A0 ablation analogous to R0 resection) is crucial to minimize local recurrence rates and improve survival. A variety of different ablation devices is available. The outcome of conventional computed tomography- or ultrasound-guided thermal ablation in small lesions is well comparable to surgery. However, in liver lesions with large diameter overlapping ablation zones are required to ensure an adequate ablation margin. Therefore, stereotactic techniques in combination with a multiple needle approach, three-dimensional trajectory planning, and image fusion for intraoperative treatment evaluation have been successfully introduced.

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Reiterative Radiofrequency Ablation in the Management of Pediatric Patients with Hepatoblastoma Metastases to the Lung, Liver, or Bone

Cited by 28 publications

References 37 publications

Stereotactic radiofrequency ablation of a variety of liver masses in children

Stereotactic radiofrequency ablation of a variety of liver masses in children

Radiofrequency Ablation Combined with Stent Placement versus Stent Placement Alone for Malignant Biliary Obstruction: A Systematic Review and Meta-analysis

Ablation in Primary Liver Tumors

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