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Erschienen in: Abdominal Radiology 6/2015

01.08.2015

Ablation therapy of hepatocellular carcinoma: a comparative study between radiofrequency and microwave ablation

verfasst von: Thomas J. Vogl, Parviz Farshid, Nagy N. N. Naguib, Stefan Zangos, Boris Bodelle, Jijo Paul, Emannuel C. Mbalisike, Martin Beeres, Nour-Eldin A. Nour-Eldin

Erschienen in: Abdominal Radiology | Ausgabe 6/2015

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Abstract

Purpose

The aim of the study is to retrospectively evaluate and compare the therapeutic response of Radiofrequency (RF) and Microwave (MW) ablation therapy of hepatocellular carcinoma (HCC).

Materials and Methods

53 consecutive patients (42 males, 11 females; mean age 59 years, range: 40–68, SD: 4.2) underwent CT-guided percutaneous RF and MW ablation of 68 HCC liver lesions. The morphologic tumor response (number, location and size) was evaluated by magnetic resonance imaging. The follow-up protocol was 24 h post-ablation then within 3 monthly intervals post-ablation in the first year and 6 monthly intervals thereafter.

Results

Complete therapeutic response was noted in 84.4% (27/32) of lesions treated with RFA and in 88.9% (32/36) of lesions treated with MW ablation (P = 0.6). Complete response was achieved in all lesions ≤2.0 cm in diameter in both groups. There was no significant difference in rates of residual foci of HCC lesions between RF and MW ablation groups (P = 0.15, Log-rank test). Recurrence rate for 3, 6, 9, and 12 months in patients with HCC who underwent RF ablation compared with MW ablation were 6.3%, 3.1%, 3.1% versus 0%, 5.6%, 2.8%, and 2.8%. Progression-Free Survival rates for treated patients with RF ablation of 1, 2, and 3 years were 96.9%, 93.8%, and 90.6% and treated with MW ablation therapy were 97.2%, 94.5%, and 91.7, respectively (P = 0.98).

Conclusion

In conclusion, RF and MW ablation therapy showed no significant difference in the treatment of HCC regarding the complete response, rates of residual foci of untreated disease, and recurrence rate.
Literatur
1.
Zurück zum Zitat Yau T, Chan P, Epstein R, Poon RT (2009) Management of advanced hepatocellular carcinoma in the era of targeted therapy. Liver Int 29(1):10–17PubMedCrossRef Yau T, Chan P, Epstein R, Poon RT (2009) Management of advanced hepatocellular carcinoma in the era of targeted therapy. Liver Int 29(1):10–17PubMedCrossRef
2.
Zurück zum Zitat Adam A (2002) Interventional radiology in the treatment of hepatic metastases. Cancer Treat Rev 28(2):93–99PubMedCrossRef Adam A (2002) Interventional radiology in the treatment of hepatic metastases. Cancer Treat Rev 28(2):93–99PubMedCrossRef
3.
Zurück zum Zitat Yamagiwa K, Shiraki K, Yamakado K, et al. (2008) Survival rates according to the Cancer of the Liver Italian Program scores of 345 hepatocellular carcinoma patients after multimodality treatments during a 10-year period in a retrospective study. J Gastroenterol Hepatol 23(3):482–490PubMedCrossRef Yamagiwa K, Shiraki K, Yamakado K, et al. (2008) Survival rates according to the Cancer of the Liver Italian Program scores of 345 hepatocellular carcinoma patients after multimodality treatments during a 10-year period in a retrospective study. J Gastroenterol Hepatol 23(3):482–490PubMedCrossRef
4.
Zurück zum Zitat Shiina S, Tagawa K, Niwa Y, et al. (1993) Percutaneous ethanol injection therapy for hepatocellular carcinoma: results in 146 patients. AJR Am J Roentgenol 160:1023–1028PubMedCrossRef Shiina S, Tagawa K, Niwa Y, et al. (1993) Percutaneous ethanol injection therapy for hepatocellular carcinoma: results in 146 patients. AJR Am J Roentgenol 160:1023–1028PubMedCrossRef
5.
Zurück zum Zitat Kotoh K, Sakai H, Sakamoto S, et al. (1994) The effect of percutaneous ethanol injection therapy on small solitary hepatocellular carcinoma is comparable to that of hepatectomy. Am J Gastroenterol 89:194–198PubMed Kotoh K, Sakai H, Sakamoto S, et al. (1994) The effect of percutaneous ethanol injection therapy on small solitary hepatocellular carcinoma is comparable to that of hepatectomy. Am J Gastroenterol 89:194–198PubMed
6.
Zurück zum Zitat Livraghi T, Giorgio A, Marin G, et al. (1995) Hepatocellular carcinoma and cirrhosis in 746 patients: long-term results of percutaneous ethanol injection. Radiology 197:101–108PubMedCrossRef Livraghi T, Giorgio A, Marin G, et al. (1995) Hepatocellular carcinoma and cirrhosis in 746 patients: long-term results of percutaneous ethanol injection. Radiology 197:101–108PubMedCrossRef
7.
Zurück zum Zitat Rossi S, Stasi MD, Buscarini E, et al. (1996) Percutaneous RF interstitial thermal ablation in the treatment of hepatic cancer. AJR Am J Roentgenol 167:759–768PubMedCrossRef Rossi S, Stasi MD, Buscarini E, et al. (1996) Percutaneous RF interstitial thermal ablation in the treatment of hepatic cancer. AJR Am J Roentgenol 167:759–768PubMedCrossRef
8.
Zurück zum Zitat Solbiati L, Ierace T, Goldberg SN, et al. (1997) Percutaneous US-guided RF tissue ablation of liver metastasis: results of treatment and follow-up in 16 patients. Radiology 202:195–203PubMedCrossRef Solbiati L, Ierace T, Goldberg SN, et al. (1997) Percutaneous US-guided RF tissue ablation of liver metastasis: results of treatment and follow-up in 16 patients. Radiology 202:195–203PubMedCrossRef
9.
Zurück zum Zitat Livraghi T, Goldberg SN, Monti F, et al. (1997) Saline-enhanced radio-frequency tissue ablation in the treatment of liver metastases. Radiology 202:205–210PubMedCrossRef Livraghi T, Goldberg SN, Monti F, et al. (1997) Saline-enhanced radio-frequency tissue ablation in the treatment of liver metastases. Radiology 202:205–210PubMedCrossRef
10.
Zurück zum Zitat Morris-Stiff G, Gomez D, de Liguori Carino N, Prasad KR (2009) Surgical management of hepatocellular carcinoma: Is the jury still out? Surg Oncol 18(4):298–321PubMedCrossRef Morris-Stiff G, Gomez D, de Liguori Carino N, Prasad KR (2009) Surgical management of hepatocellular carcinoma: Is the jury still out? Surg Oncol 18(4):298–321PubMedCrossRef
11.
Zurück zum Zitat Song DS, Bae SH (2012) Changes of guidelines diagnosing hepatocellular carcinoma during the last ten-year period. Clin Mol Hepatol 18:258–267PubMedCentralCrossRef Song DS, Bae SH (2012) Changes of guidelines diagnosing hepatocellular carcinoma during the last ten-year period. Clin Mol Hepatol 18:258–267PubMedCentralCrossRef
12.
Zurück zum Zitat Shock SA, Meredith K, Warner TF, et al. (2004) Microwave ablation with loop antenna: in vivo porcine liver model. Radiology 231:143–149PubMedCrossRef Shock SA, Meredith K, Warner TF, et al. (2004) Microwave ablation with loop antenna: in vivo porcine liver model. Radiology 231:143–149PubMedCrossRef
13.
Zurück zum Zitat Ruers TJM, de Jong KP, Ijzermans JNM (2005) Radiofrequency for the treatment of liver tumours. Dig Surg 22(4):245–253PubMedCrossRef Ruers TJM, de Jong KP, Ijzermans JNM (2005) Radiofrequency for the treatment of liver tumours. Dig Surg 22(4):245–253PubMedCrossRef
14.
Zurück zum Zitat Shibata T, Iimuro Y, Yamamoto Y, et al. (2002) Small hepatocellular carcinoma: comparison of radio-frequency ablation and percutaneous microwave coagulation therapy. Radiology 223(2):331–337PubMedCrossRef Shibata T, Iimuro Y, Yamamoto Y, et al. (2002) Small hepatocellular carcinoma: comparison of radio-frequency ablation and percutaneous microwave coagulation therapy. Radiology 223(2):331–337PubMedCrossRef
15.
Zurück zum Zitat Lau WY, Lai ECH (2008) Hepatocellular carcinoma: current management and recent advances. Hepatobiliary Pancreat Dis Int 7(3):237–257PubMed Lau WY, Lai ECH (2008) Hepatocellular carcinoma: current management and recent advances. Hepatobiliary Pancreat Dis Int 7(3):237–257PubMed
16.
Zurück zum Zitat Livraghi T, Goldberg SN, Lazzaroni S, et al. (1999) Small hepatocellular carcinoma: treatment with radio-frequency ablation versus ethanol injection. Radiology 210:655–661PubMedCrossRef Livraghi T, Goldberg SN, Lazzaroni S, et al. (1999) Small hepatocellular carcinoma: treatment with radio-frequency ablation versus ethanol injection. Radiology 210:655–661PubMedCrossRef
17.
Zurück zum Zitat Xu H-X, Xie X-Y, Lu M-D, Chen J-W, et al. (2004) Ultrasound-guided percutaneous thermal ablation of hepatocellular carcinoma using microwave and radiofrequency ablation. Clin Radiol 59(1):53–61PubMedCrossRef Xu H-X, Xie X-Y, Lu M-D, Chen J-W, et al. (2004) Ultrasound-guided percutaneous thermal ablation of hepatocellular carcinoma using microwave and radiofrequency ablation. Clin Radiol 59(1):53–61PubMedCrossRef
18.
Zurück zum Zitat Helmberger T, Holzknecht N, Schopf U, et al. (2001) Radiofrequency ablation of liver metastases. Technique and initial results. Radiologe 41:69–76PubMedCrossRef Helmberger T, Holzknecht N, Schopf U, et al. (2001) Radiofrequency ablation of liver metastases. Technique and initial results. Radiologe 41:69–76PubMedCrossRef
19.
Zurück zum Zitat Lencioni R, Allgaier HP, Cioni D, et al. (2003) Small hepatocellular carcinoma in cirrhosis: randomized comparison of radiofrequency thermal ablation versus percutaneous ethanol injection. Radiology 228:235–240PubMedCrossRef Lencioni R, Allgaier HP, Cioni D, et al. (2003) Small hepatocellular carcinoma in cirrhosis: randomized comparison of radiofrequency thermal ablation versus percutaneous ethanol injection. Radiology 228:235–240PubMedCrossRef
20.
Zurück zum Zitat Lin SM, Lin CJ, Lin CC, et al. (2004) Radiofrequency ablation improves prognosis compared with ethanol injection for hepatocellular carcinoma < or = 4 cm. Gastroenterology 127:1714–1723PubMedCrossRef Lin SM, Lin CJ, Lin CC, et al. (2004) Radiofrequency ablation improves prognosis compared with ethanol injection for hepatocellular carcinoma < or = 4 cm. Gastroenterology 127:1714–1723PubMedCrossRef
21.
Zurück zum Zitat Shiina S, Teratani T, Obi S, et al. (2005) A randomized controlled trial of radiofrequency ablation versus ethanol injection for small hepatocellular carcinoma. Gastroenterology 129:122–130PubMedCrossRef Shiina S, Teratani T, Obi S, et al. (2005) A randomized controlled trial of radiofrequency ablation versus ethanol injection for small hepatocellular carcinoma. Gastroenterology 129:122–130PubMedCrossRef
22.
Zurück zum Zitat Gillams AR, Lees WR (2004) Radio-frequency ablation of colorectal liver metastases in 67 patients. Eur Radiol 14:2261–2267PubMedCrossRef Gillams AR, Lees WR (2004) Radio-frequency ablation of colorectal liver metastases in 67 patients. Eur Radiol 14:2261–2267PubMedCrossRef
23.
Zurück zum Zitat Jackobs TF, Hoffmann RT, Trumm C, et al. (2006) Radiofrequency ablation of colorectal liver metastases: mid-term results in 68 patients. Anticancer Res 26:671–680 Jackobs TF, Hoffmann RT, Trumm C, et al. (2006) Radiofrequency ablation of colorectal liver metastases: mid-term results in 68 patients. Anticancer Res 26:671–680
24.
Zurück zum Zitat Ballem Naveen, Berber Eren, Pitt Tracy, et al. (2008) Laparoscopic radiofrequency ablation of unresectable hepatocellular carcinoma: long-term follow-up. HPB (Oxford) 10(5):315–320CrossRef Ballem Naveen, Berber Eren, Pitt Tracy, et al. (2008) Laparoscopic radiofrequency ablation of unresectable hepatocellular carcinoma: long-term follow-up. HPB (Oxford) 10(5):315–320CrossRef
25.
Zurück zum Zitat Tobinaga Shuichi, Nanashima Atsushi, Araki Masato, et al. (2009) Evaluation of local coagulation therapy with hepatectomy for liver metastases. Gan To Kagaku Ryoho 36(12):2042–2044PubMed Tobinaga Shuichi, Nanashima Atsushi, Araki Masato, et al. (2009) Evaluation of local coagulation therapy with hepatectomy for liver metastases. Gan To Kagaku Ryoho 36(12):2042–2044PubMed
26.
Zurück zum Zitat Yi HM, Zhang W, Ai X, Li KY, Deng YB (2014) Radiofrequency ablation versus surgical resection for the treatment of hepatocellular carcinoma conforming to the Milan criteria: systemic review and meta-analysis. Int J Clin Exp Med 15:3150–3163 Yi HM, Zhang W, Ai X, Li KY, Deng YB (2014) Radiofrequency ablation versus surgical resection for the treatment of hepatocellular carcinoma conforming to the Milan criteria: systemic review and meta-analysis. Int J Clin Exp Med 15:3150–3163
Metadaten
Titel
Ablation therapy of hepatocellular carcinoma: a comparative study between radiofrequency and microwave ablation
verfasst von
Thomas J. Vogl
Parviz Farshid
Nagy N. N. Naguib
Stefan Zangos
Boris Bodelle
Jijo Paul
Emannuel C. Mbalisike
Martin Beeres
Nour-Eldin A. Nour-Eldin
Publikationsdatum
01.08.2015
Verlag
Springer US
Erschienen in
Abdominal Radiology / Ausgabe 6/2015
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-015-0355-6

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