Balloon-Occluded Radiofrequency Ablation as Bridge to TACE in the Treatment of Advanced HCC with Arterioportal Shunt.

Carcinoma, Hepatocellular / diagnostic imaging Chemoembolization, Therapeutic / methods Combined Modality Therapy Humans Liver Neoplasms / diagnostic imaging Radiofrequency Ablation Radiopharmaceuticals Retrospective Studies Treatment Outcome
HCC RFA ablation arterioportal shunt chemoembolization combined therapy

Journal

Current radiopharmaceuticals
ISSN: 1874-4729
Titre abrégé: Curr Radiopharm
Pays: United Arab Emirates
ID NLM: 101468718

Informations de publication

Date de publication:
2022
Historique:
received: 10 09 2021
revised: 30 12 2021
accepted: 18 01 2022
pubmed: 26 2 2022
medline: 29 7 2022
entrez: 25 2 2022
Statut: ppublish

Résumé

Transarterial chemoembolization is the most widely used palliative treatment for unresectable hepatocellular carcinoma; however, arterioportal shunt represents a contraindication to this treatment. The study aims to assess the feasibility of balloon-occluded radiofrequency ablation in the transitory resolution of an extensive arterioportal shunt in patients with advanced hepatocellular carcinoma as a bridge to safe and effective transarterial chemoembolization. 12 consecutive patients advanced multinodular unilobar unresectable hepatocellular carcinoma with a target lesion larger than 5 cm (mean diameter 7.7 ± 1.4 cm), not suitable to transarterial chemoembolization due to extensive arterioportal shunt, were recruited. Balloon-occluded radiofrequency ablation of the hepatic area surrounding the shunt during occlusion of the artery supplying the shunt was performed, followed by lobar conventional chemoembolization. Intra/periprocedural complications were evaluated. Technical success was defined by the result of radiofrequency ablation in terms of immediate disappearance, reduction, or persistence of the shunt. Local efficacy of chemoembolization was evaluated at 1-month computed tomography according to m-RECIST criteria. Technical success was achieved in all patients. No major complications were observed. 1- month follow-up showed a mean necrotic diameter of 6.3 cm (range: 3.8-8.7 cm), with an acceptable procedural result and persistence of the shunt. An overall response rate was obtained in all patients, with 25% complete response and 75% partial response. Balloon-occluded radiofrequency ablation of an arterioportal shunt in patients with advanced hepatocellular carcinoma can temporarily reduce shunting, allowing to perform safe and therapeutically useful chemoembolization, with satisfactory control of tumor growth.

Sections du résumé

BACKGROUND BACKGROUND
Transarterial chemoembolization is the most widely used palliative treatment for unresectable hepatocellular carcinoma; however, arterioportal shunt represents a contraindication to this treatment.
OBJECTIVE OBJECTIVE
The study aims to assess the feasibility of balloon-occluded radiofrequency ablation in the transitory resolution of an extensive arterioportal shunt in patients with advanced hepatocellular carcinoma as a bridge to safe and effective transarterial chemoembolization.
METHODS METHODS
12 consecutive patients advanced multinodular unilobar unresectable hepatocellular carcinoma with a target lesion larger than 5 cm (mean diameter 7.7 ± 1.4 cm), not suitable to transarterial chemoembolization due to extensive arterioportal shunt, were recruited. Balloon-occluded radiofrequency ablation of the hepatic area surrounding the shunt during occlusion of the artery supplying the shunt was performed, followed by lobar conventional chemoembolization. Intra/periprocedural complications were evaluated. Technical success was defined by the result of radiofrequency ablation in terms of immediate disappearance, reduction, or persistence of the shunt. Local efficacy of chemoembolization was evaluated at 1-month computed tomography according to m-RECIST criteria.
RESULTS RESULTS
Technical success was achieved in all patients. No major complications were observed. 1- month follow-up showed a mean necrotic diameter of 6.3 cm (range: 3.8-8.7 cm), with an acceptable procedural result and persistence of the shunt. An overall response rate was obtained in all patients, with 25% complete response and 75% partial response.
CONCLUSION CONCLUSIONS
Balloon-occluded radiofrequency ablation of an arterioportal shunt in patients with advanced hepatocellular carcinoma can temporarily reduce shunting, allowing to perform safe and therapeutically useful chemoembolization, with satisfactory control of tumor growth.

Identifiants

DOI: 10.2174/1874471015666220223102426 PMID: 35209837
pubmed: 35209837
pii: CRP-EPUB-121086
doi: 10.2174/1874471015666220223102426
doi:

Substances chimiques

Radiopharmaceuticals 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

194-198

Informations de copyright

Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.

Auteurs

Roberto Iezzi (R)

Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia - U.O.C. Radiologia Diagnostica e Interventistica Generale, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, Rome 00168, Italy.
Università Cattolica del Sacro Cuore, Rome, Italy.

Alessandro Posa (A)

Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia - U.O.C. Radiologia Diagnostica e Interventistica Generale, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, Rome 00168, Italy.

Marco Santoro (M)

Diagnostic Imaging, Azienda USL di Pescara, Pescara, Italy.

Alessandro Tanzilli (A)

Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia - U.O.C. Radiologia Diagnostica e Interventistica Generale, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, Rome 00168, Italy.

Lucia Cerrito (L)

Dipartimento di Scienze Mediche e Chirurgiche - U.O.C. Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, Rome 00168, Italy.

Francesca Romana Ponziani (FR)

Dipartimento di Scienze Mediche e Chirurgiche - U.O.C. Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, Rome 00168, Italy.

Maurizio Pompili (M)

Università Cattolica del Sacro Cuore, Rome, Italy.
Dipartimento di Scienze Mediche e Chirurgiche - U.O.C. Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, Rome 00168, Italy.

Antonio Grieco (A)

Università Cattolica del Sacro Cuore, Rome, Italy.
Dipartimento di Scienze Mediche e Chirurgiche - U.O.C. Medicina Interna e del Trapianto di Fegato, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, Rome 00168, Italy.

Gian Ludovico Rapaccini (GL)

Università Cattolica del Sacro Cuore, Rome, Italy.
Dipartimento di Scienze Mediche e Chirurgiche - U.O.C. Gastroenterologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, Rome 00168, Italy.

Antonio Gasbarrini (A)

Università Cattolica del Sacro Cuore, Rome, Italy.
Dipartimento di Scienze Mediche e Chirurgiche - U.O.C. Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, Rome 00168, Italy.

Riccardo Manfredi (R)

Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia - U.O.C. Radiologia Diagnostica e Interventistica Generale, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, Rome 00168, Italy.
Università Cattolica del Sacro Cuore, Rome, Italy.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

questionsmedicales.fr › Maladies de l'appareil digestif › Maladies du foie › Tumeurs du foie › Carcinome hépatocellulaire › Balloon-Occluded Radiofrequency Ablation as...
questionsmedicales.fr › Thérapeutique › Occlusion thérapeutique › Embolisation thérapeutique › Chimioembolisation thérapeutique › Balloon-Occluded Radiofrequency Ablation as...
questionsmedicales.fr › Thérapeutique › Association thérapeutique › Balloon-Occluded Radiofrequency Ablation as...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Balloon-Occluded Radiofrequency Ablation as...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladies du foie › Tumeurs du foie › Balloon-Occluded Radiofrequency Ablation as...
questionsmedicales.fr › Procédures de chirurgie opératoire › Techniques d'ablation › Ablation par radiofréquence › Balloon-Occluded Radiofrequency Ablation as...
questionsmedicales.fr › Actions chimiques et utilisations › Utilisations spécialisées de produits chimiques › Produits chimiques de laboratoire › Indicateurs et réactifs › Radiopharmaceutiques › Balloon-Occluded Radiofrequency Ablation as...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Balloon-Occluded Radiofrequency Ablation as...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Balloon-Occluded Radiofrequency Ablation as...