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 = 3), hepatocellular carcinoma (n = 1), hepatoblastoma (n = 2), myofibroblastic tumor (n = 1), hepatic metastases of extrahepatic tumors (n = 2) and infiltrative hepatic cysts associated with alveolar echinococcosis (n = 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.

中文翻译：

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儿童各种肝肿块的立体定向射频消融术。

背景和目标

手术切除是目前儿童肝肿瘤治疗的基石。在成年人中，射频消融（RFA）是针对小型局灶性肝肿瘤的已确立的微创治疗选择。具有术中图像融合功能的多探针立体定向RFA（SRFA）可以确认消融切缘，从而可以治疗较大的病灶。我们描述了我们在患有肝脏肿块的儿童中使用SRFA的经验。

方法

SRFA在中位年龄为14岁（范围0.5-17.0岁），肝腺瘤（n  = 3），肝细胞癌（n  = 1），肝母细胞瘤（n  = 2），肌纤维母细胞瘤（n  = 1），肝外肿瘤的肝转移（n  = 2）和与肺泡棘球co病相关的浸润性肝囊肿（n  = 1）。总体而言，在11个疗程中治疗了15个病变，平均病变大小为2.6 cm（范围0.7-9.5 cm）。

结果

技术成功率是100％，生存率也是如此。干预后没有遇到高于II级（Clavien和Dindo）的短暂不良反应。中位住院时间为5 d（2-33 d）。在随后接受移植肝切除术的两名患者中，组织学证实完全消融。后续影像学研究（中位数55个月，范围18-129个月）显示，任何患者均无局部或远处疾病复发。

结论

SRFA是患有不同病因肝肿瘤的小儿患者的有效微创治疗选择。