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Article: Treatment strategy to optimize radiofrequency ablation for liver malignancies

TitleTreatment strategy to optimize radiofrequency ablation for liver malignancies
Authors
Issue Date2006
PublisherElsevier Inc.. The Journal's web site is located at http://www.jvir.org/
Citation
Journal Of Vascular And Interventional Radiology, 2006, v. 17 n. 4, p. 671-683 How to Cite?
AbstractPURPOSE: The purposes of this study were to investigate a treatment strategy to increase liver tumor necrosis and minimize complications with ultrasound-guided percutaneous radiofrequency (RF) ablation and to evaluate its therapeutic efficacy. MATERIALS AND METHODS: A total of 332 patients with 503 liver malignancies underwent RF ablation according to a mathematical protocol with adjunctive measures. In the 332 patients, 205 had 308 hepatocellular carcinomas (HCCs) with a mean largest diameter of 4.1 cm and 127 had 195 metastatic liver carcinomas (MLCs) with a mean largest diameter of 3.9 cm. In patients with HCC, 60 (29.3%) had stage I/II disease and 145 (70.7%) had stage III/IV disease. Depending on tumor size, shape, and location, a defined treatment strategy was adopted that consisted of a mathematical protocol, an individualized protocol, and adjunctive measures. The mathematical protocol was followed for tumors larger than 3.5 cm. The individualized protocol was used for tumors located adjacent to the diaphragm, gastrointestinal tract, or gallbladder. Some adjunctive measures such as supplementary fine needle localization, local saline solution injection, and feeding vessel ablation were used to deal with different features of these liver tumors. Patients were followed regularly to assess treatment efficiency, and the tumor was considered to have early complete necrosis if no viability was found on enhanced computed tomography 1 month after RF ablation. RESULTS: In this series, the early necrosis rates were 95.8% for HCC (295 of 308 tumors), 94.9% for MLC (185 of 195 tumors), 91.3% for tumors larger than 3.5 cm (189 of 207 tumors), 90.7% for tumors near the gastrointestinal tract (49 of 54 tumors), 91.5% for tumors near the diaphragm (86 of 94 tumors), and 90.6% for tumors near the gallbladder (48 of 53 tumors). The local recurrence rates were 10.7% for HCC (33 of 308 tumors) and 14.9% for MLC (29 of 195 tumors). The 1-, 2-, and 3-year overall survival rates were 89.6%, 69.4%, and 59.6%, respectively, for HCC and 80.3%, 52.8%, and 30.9%, respectively, for MLC. The 1-, 2-, and 3-year survival rates in 60 patients with stage I/II HCC were 93.7%, 87.1%, and 76.2%, respectively. The incidence of major complications was 1.4% (eight of 574 sessions), which included of three hemorrhages, four injuries to adjacent structures, and one case of needle tract seeding. CONCLUSION: In RF ablation of hepatic tumors, application of a proper protocol and adjunctive measures play important roles in improving tumor necrosis rate and minimizing potential complications. © SIR, 2006.
Persistent Identifierhttp://hdl.handle.net/10722/172919
ISSN
2015 Impact Factor: 2.57
2015 SCImago Journal Rankings: 1.210
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChen, MHen_US
dc.contributor.authorWei, Yen_US
dc.contributor.authorYan, Ken_US
dc.contributor.authorGao, Wen_US
dc.contributor.authorDai, Yen_US
dc.contributor.authorHuo, Len_US
dc.contributor.authorYin, SSen_US
dc.contributor.authorZhang, Hen_US
dc.contributor.authorPoon, RTPen_US
dc.date.accessioned2012-10-30T06:25:48Z-
dc.date.available2012-10-30T06:25:48Z-
dc.date.issued2006en_US
dc.identifier.citationJournal Of Vascular And Interventional Radiology, 2006, v. 17 n. 4, p. 671-683en_US
dc.identifier.issn1051-0443en_US
dc.identifier.urihttp://hdl.handle.net/10722/172919-
dc.description.abstractPURPOSE: The purposes of this study were to investigate a treatment strategy to increase liver tumor necrosis and minimize complications with ultrasound-guided percutaneous radiofrequency (RF) ablation and to evaluate its therapeutic efficacy. MATERIALS AND METHODS: A total of 332 patients with 503 liver malignancies underwent RF ablation according to a mathematical protocol with adjunctive measures. In the 332 patients, 205 had 308 hepatocellular carcinomas (HCCs) with a mean largest diameter of 4.1 cm and 127 had 195 metastatic liver carcinomas (MLCs) with a mean largest diameter of 3.9 cm. In patients with HCC, 60 (29.3%) had stage I/II disease and 145 (70.7%) had stage III/IV disease. Depending on tumor size, shape, and location, a defined treatment strategy was adopted that consisted of a mathematical protocol, an individualized protocol, and adjunctive measures. The mathematical protocol was followed for tumors larger than 3.5 cm. The individualized protocol was used for tumors located adjacent to the diaphragm, gastrointestinal tract, or gallbladder. Some adjunctive measures such as supplementary fine needle localization, local saline solution injection, and feeding vessel ablation were used to deal with different features of these liver tumors. Patients were followed regularly to assess treatment efficiency, and the tumor was considered to have early complete necrosis if no viability was found on enhanced computed tomography 1 month after RF ablation. RESULTS: In this series, the early necrosis rates were 95.8% for HCC (295 of 308 tumors), 94.9% for MLC (185 of 195 tumors), 91.3% for tumors larger than 3.5 cm (189 of 207 tumors), 90.7% for tumors near the gastrointestinal tract (49 of 54 tumors), 91.5% for tumors near the diaphragm (86 of 94 tumors), and 90.6% for tumors near the gallbladder (48 of 53 tumors). The local recurrence rates were 10.7% for HCC (33 of 308 tumors) and 14.9% for MLC (29 of 195 tumors). The 1-, 2-, and 3-year overall survival rates were 89.6%, 69.4%, and 59.6%, respectively, for HCC and 80.3%, 52.8%, and 30.9%, respectively, for MLC. The 1-, 2-, and 3-year survival rates in 60 patients with stage I/II HCC were 93.7%, 87.1%, and 76.2%, respectively. The incidence of major complications was 1.4% (eight of 574 sessions), which included of three hemorrhages, four injuries to adjacent structures, and one case of needle tract seeding. CONCLUSION: In RF ablation of hepatic tumors, application of a proper protocol and adjunctive measures play important roles in improving tumor necrosis rate and minimizing potential complications. © SIR, 2006.en_US
dc.languageengen_US
dc.publisherElsevier Inc.. The Journal's web site is located at http://www.jvir.org/en_US
dc.relation.ispartofJournal of Vascular and Interventional Radiologyen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshCarcinoma, Hepatocellular - Pathology - Surgery - Ultrasonographyen_US
dc.subject.meshCatheter Ablation - Methodsen_US
dc.subject.meshChi-Square Distributionen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshLiver Neoplasms - Pathology - Surgery - Ultrasonographyen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshNeoplasm Stagingen_US
dc.subject.meshSurvival Rateen_US
dc.subject.meshTreatment Outcomeen_US
dc.subject.meshUltrasonography, Doppler, Coloren_US
dc.subject.meshUltrasonography, Interventionalen_US
dc.titleTreatment strategy to optimize radiofrequency ablation for liver malignanciesen_US
dc.typeArticleen_US
dc.identifier.emailPoon, RTP: poontp@hkucc.hku.hken_US
dc.identifier.authorityPoon, RTP=rp00446en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1097/01.RVI.0000201985.61501.9Een_US
dc.identifier.pmid16614151-
dc.identifier.scopuseid_2-s2.0-33748679782en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33748679782&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume17en_US
dc.identifier.issue4en_US
dc.identifier.spage671en_US
dc.identifier.epage683en_US
dc.identifier.isiWOS:000236836700011-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridChen, MH=35247790300en_US
dc.identifier.scopusauthoridWei, Y=49762526400en_US
dc.identifier.scopusauthoridYan, K=8930306000en_US
dc.identifier.scopusauthoridGao, W=34770442400en_US
dc.identifier.scopusauthoridDai, Y=49761129900en_US
dc.identifier.scopusauthoridHuo, L=8613614000en_US
dc.identifier.scopusauthoridYin, SS=8930305900en_US
dc.identifier.scopusauthoridZhang, H=36078196500en_US
dc.identifier.scopusauthoridPoon, RTP=7103097223en_US

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