Percutaneous thermal ablation of hepatocellular carcinomas located in the hepatic dome using artificial carbon dioxide pneumothorax: retrospective evaluation of safety and efficacy

Autor: Eric Assenat, Daniel Verzilli, Georges-Philippe Pageaux, Margaux Hermida, Laure Escal, M A Pierredon-Foulongne, Lauranne Piron, Christophe Cassinotto, Boris Guiu, Samir Jaber
Přispěvatelé: Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), MORNET, Dominique
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Ablation Techniques
Male
Cancer Research
Percutaneous
Physiology
Radiofrequency ablation
030218 nuclear medicine & medical imaging
law.invention
0302 clinical medicine
law
Aged
80 and over
Microwave ablation
Liver Neoplasms
food and beverages
Pneumothorax
hepatocellular carcinoma
Middle Aged
3. Good health
Treatment Outcome
030220 oncology & carcinogenesis
Hepatocellular carcinoma
Catheter Ablation
Female
[SDV.IB]Life Sciences [q-bio]/Bioengineering
Radiology
radiofrequency ablation
Adult
medicine.medical_specialty
Carcinoma
Hepatocellular
Thermal ablation
[SDV.CAN]Life Sciences [q-bio]/Cancer
liver
03 medical and health sciences
Dome (geology)
[SDV.CAN] Life Sciences [q-bio]/Cancer
Physiology (medical)
otorhinolaryngologic diseases
medicine
Humans
Aged
Retrospective Studies
[SDV.IB] Life Sciences [q-bio]/Bioengineering
business.industry
fungi
[SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology
Carbon Dioxide
medicine.disease
[SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology
digestive system diseases
microwave ablation
business
Dome
Zdroj: International Journal of Hyperthermia
International Journal of Hyperthermia, Taylor & Francis, 2018, 35 (1), pp.90-96. ⟨10.1080/02656736.2018.1477206⟩
International Journal of Hyperthermia, 2018, 35 (1), pp.90-96. ⟨10.1080/02656736.2018.1477206⟩
ISSN: 0265-6736
1464-5157
DOI: 10.1080/02656736.2018.1477206⟩
Popis: International audience; Introduction: The targeting of hepatocellular carcinomas (HCC) in the hepatic dome can be challenging during percutaneous thermal ablation (PTA). The aims of this study were (1) to evaluate the safety and efficacy of PTA of HCC in the hepatic dome that cannot be visualized under US, using artificial CO2 pneumothorax and CT-guidance and (2) to compare the results with US-visible HCC located in the liver dome treated under US-guidance.Materials: Over a 32-month period, 56 HCC located in the hepatic dome were extracted from a prospectively maintained database. Twenty-eight cases (US-guidance group) were treated under US-guidance, while the others (n = 28, CT-CO2 group) were treated under CT-guidance using artificial CO2 pneumothorax after lipiodol tagging of the tumor. The primary technical success and complications rates of this technique were retrospectively assessed. Local tumor progression (LTP), intrahepatic distant recurrence (IDR), local recurrence-free survival (LRFS) and overall survival (OS) were also compared between both groups.Results: Primary technical success was 100% in both groups. No major complications occurred. After a median follow-up of 13.8 months (range, 1–33.4 months), LTP occurred in 10.7% (3/28) in CT-CO2 vs. 25% (7/28) in the US-guidance group (p = NS). IDR occurred in 39.3% (11/28) in CT-CO2 vs. 28.6% (8/28) in the US-guidance group (p = NS). Death occurred in 17.9% (5/28) of patients in both groups. LRFS and OS did not significantly differ using Kaplan-Meier survival estimates.Conclusion: CT-guided PTA after artificially induced CO2 pneumothorax is a safe and efficient technique to treat HCC located in the hepatic dome.
Databáze: OpenAIRE
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