Percutaneous Cryoablation of Liver Tumors: Initial Experience from a Tertiary Care Center in India.

BCLC, Barcelona Clinic Liver Cancer CA, Cryoablation CT, Computed Tomography HCC, Hepatocellular Carcinoma LTP, Local Tumor Progression MWA, Microwave Ablation RFA, Radiofrequency Ablation US, Ultrasound ablation cryoablation hepatocellular carcinoma

Journal

Journal of clinical and experimental hepatology
ISSN: 0973-6883
Titre abrégé: J Clin Exp Hepatol
Pays: India
ID NLM: 101574137

Informations de publication

Date de publication:
Historique:
received: 26 05 2020
accepted: 12 10 2020
entrez: 17 5 2021
pubmed: 18 5 2021
medline: 18 5 2021
Statut: ppublish

Résumé

Percutaneous ablation is an important part of management strategy for liver tumors. While radiofrequency ablation and microwave ablation are the most widely used ablative techniques, cryoablation (CA) has several technical advantages but has been underused till recently. In this study, we report the initial experience with percutaneous CA of liver tumors. This was a retrospective evaluation of consecutive patients with liver tumors who underwent percutaneous CA between October 2018 and August 2019. The ablation procedures were performed under combined ultrasound and computed tomography guidance using argon-helium-based CA systems. The baseline tumor characteristics (including size and location), Barcelona Clinic Liver Cancer stage, and Child-Pugh score were recorded. Each patient underwent a follow-up after 1 month and at 3 months subsequently. Technical success, complete response, local tumor progression, and overall survival were evaluated. Nine patients (mean age, 62.4 years, median age, 66 years, five men and four women) with 10 liver tumors (mean size, 2.22 cm) underwent CA. Seven (77.8%) patients had hepatocellular carcinoma (HCC), and 2 patients had solitary liver metastasis. One patient with HCC had two lesions, while the rest had only one lesion. Of the two metastatic lesions, one was from carcinoma of the cervix and the other was from jejunal neuroendocrine tumor. Five tumors were located adjacent to the gallbladder, two lesions were adjacent to the right portal vein, two lesions were subcapsular, and one lesion was adjacent to the stomach. Technical success was achieved in all the patients. Complete response was achieved in 7 (77.8%) patients. The median follow-up period was 7 months (range, 3-12 months). There was no local tumor progression and no death during the follow-up period. No procedure-related complication was seen. Percutaneous CA of hepatic tumors is technically feasible and is a safe and effective ablative technique.

Sections du résumé

BACKGROUND BACKGROUND
Percutaneous ablation is an important part of management strategy for liver tumors. While radiofrequency ablation and microwave ablation are the most widely used ablative techniques, cryoablation (CA) has several technical advantages but has been underused till recently. In this study, we report the initial experience with percutaneous CA of liver tumors.
METHODS METHODS
This was a retrospective evaluation of consecutive patients with liver tumors who underwent percutaneous CA between October 2018 and August 2019. The ablation procedures were performed under combined ultrasound and computed tomography guidance using argon-helium-based CA systems. The baseline tumor characteristics (including size and location), Barcelona Clinic Liver Cancer stage, and Child-Pugh score were recorded. Each patient underwent a follow-up after 1 month and at 3 months subsequently. Technical success, complete response, local tumor progression, and overall survival were evaluated.
RESULTS RESULTS
Nine patients (mean age, 62.4 years, median age, 66 years, five men and four women) with 10 liver tumors (mean size, 2.22 cm) underwent CA. Seven (77.8%) patients had hepatocellular carcinoma (HCC), and 2 patients had solitary liver metastasis. One patient with HCC had two lesions, while the rest had only one lesion. Of the two metastatic lesions, one was from carcinoma of the cervix and the other was from jejunal neuroendocrine tumor. Five tumors were located adjacent to the gallbladder, two lesions were adjacent to the right portal vein, two lesions were subcapsular, and one lesion was adjacent to the stomach. Technical success was achieved in all the patients. Complete response was achieved in 7 (77.8%) patients. The median follow-up period was 7 months (range, 3-12 months). There was no local tumor progression and no death during the follow-up period. No procedure-related complication was seen.
CONCLUSION CONCLUSIONS
Percutaneous CA of hepatic tumors is technically feasible and is a safe and effective ablative technique.

Identifiants

pubmed: 33994713
doi: 10.1016/j.jceh.2020.10.005
pii: S0973-6883(20)30155-9
pmc: PMC8103339
doi:

Types de publication

Journal Article

Langues

eng

Pagination

305-311

Informations de copyright

© 2020 Indian National Association for Study of the Liver. Published by Elsevier B.V. All rights reserved.

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Auteurs

Naveen Kalra (N)

Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Pankaj Gupta (P)

Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Tejeshwar Jugpal (T)

Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Shailendra S Naik (SS)

Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Ujjwal Gorsi (U)

Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Sreedhara B Chaluvashetty (SB)

Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Harish Bhujade (H)

Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Ajay Duseja (A)

Department of Hepatology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Virendra Singh (V)

Department of Hepatology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Radha K Dhiman (RK)

Department of Hepatology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Manavjit S Sandhu (MS)

Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Classifications MeSH