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No-Touch Multi-bipolar Radiofrequency Ablation for the Treatment of Subcapsular Hepatocellular Carcinoma ≤ 5 cm Not Puncturable via the Non-tumorous Liver Parenchyma.
CardioVascular and Interventional Radiology ( IF 2.9 ) Pub Date : 2019-10-31 , DOI: 10.1007/s00270-019-02357-9
Arthur Petit 1 , Arnaud Hocquelet 2 , Gisèle N'kontchou 3 , Eloi Varin 1 , Nicolas Sellier 1 , Olivier Seror 1, 4, 5 , Olivier Sutter 1, 4
Affiliation  

PURPOSE The percutaneous ablation of subcapsular hepatocellular carcinoma (S-HCC) may involve a risk of complications such as hemorrhage and tumor seeding, mainly linked to the direct tumor puncture often inevitable with mono-applicator ablation devices. The purpose of this study was to assess the efficacy and safety of no-touch multi-bipolar radiofrequency ablation (NTMBP-RFA) for the treatment of S-HCC ≤ 5 cm not puncturable via the non-tumorous liver parenchyma. MATERIALS AND METHODS Between September 2007 and December 2014, 58 consecutive patients (median age: 63 years [46-86], nine females) with 59 S-HCC ≤ 5 cm (median diameter: 25 mm [10-50 mm]), not puncturable via the non-tumorous liver parenchyma, were treated with NTMBP-RFA. Response and follow-up were assessed by CT or MRI. Complications were graded using the Cardiovascular and Interventional Radiological Society of Europe classification. Overall local tumor progression (OLTP)-free survival was assessed using the Kaplan-Meier method. A Cox proportional model evaluated the factors associated with OLTP. Signs of peritoneal or parietal tumor seeding were noted during follow-up imaging studies. RESULTS A complete ablation was achieved in 57/58 patients (98.3%) after one (n = 51) or two (n = 6) procedures. Three patients (5.2%) experienced complications (sepsis, cirrhosis decompensation; CIRSE grade 2 or 3). After a median follow-up period of 30.5 months [1-97], no patients had tumor seeding. The 1, 2 and 3-year OLTP-free survival rates were 98%, 94% and 91%, respectively. No factors were associated with OLTP. CONCLUSION NTMBP-RFA is a safe and effective treatment for S-HCC not puncturable via the non-tumorous liver parenchyma.

中文翻译:

非接触式多双极射频消融术用于治疗≤5 cm的亚囊性肝细胞癌,不能通过非肿瘤性肝实质进行穿刺。

目的经皮消融包膜下肝细胞癌(S-HCC)可能会引起并发症,如出血和肿瘤播种,这主要与直接通过单施药消融装置不可避免地穿刺肿瘤有关。这项研究的目的是评估非接触式多双极射频消融术(NTMBP-RFA)治疗通过非肿瘤性肝实质无法穿刺的S-HCC≤5 cm的疗效和安全性。材料与方法从2007年9月至2014年12月,有58位S-HCC≤5 cm(中位直径:25 mm [10-50 mm])的连续患者(中位年龄:63岁[46-86],9位女性),不能通过非肿瘤肝实质穿刺的患者,用NTMBP-RFA治疗。通过CT或MRI评估反应和随访情况。使用欧洲心血管和介入放射学会分类对并发症进行分级。使用Kaplan-Meier方法评估整体无局部肿瘤进展(OLTP)的存活率。Cox比例模型评估了与OLTP相关的因素。在随访影像学研究中发现了腹膜或顶叶肿瘤播种的迹象。结果在一次(n = 51)或两次(n = 6)手术后,57/58例患者(98.3%)完全消融。三名患者(5.2%)经历了并发症(败血症,肝硬化失代偿; CIRSE 2或3级)。在中位随访期30.5个月[1-97]之后,没有患者进行肿瘤播种。无OLTP的1年,2年和3年生存率分别为98%,94%和91%。OLTP没有相关因素。
更新日期:2020-01-17
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