Thermoablation for neoplasms of the hepatic caudate lobe under CT guidance

Abstract

Background: The goal of this study was to demonstrate the safety and efficacy of transdermal thermoablation (TTA) of the caudate lobe of the liver (CLL) with radiofrequency (RFA) and microwave ablation (MWA) Methods: From 2010-2013 14 consecutive patients were retrospectively included; 8 were male and 6 female of ages 60-80 years. Five patients suffered from primary hepatocellular carcinoma and nine from metastatic colorectal cancer. All of them had either inoperable tumors or had a poor performance status that precluded surgery. 3D-mapping of the lesions was done [1]. Efficacy was determined by changes in serum tumor markers and by consecutive CT scans at one month post-procedure and at 3-month intervals afterwards Results: RFA was performed in all patients and in combination with MWA in two patients with metastases. Median lesion diameter was 27mm (18-42mm). The approach was right in 12 and posterior in 2 patients. Median procedural time was 70min. Median hospitalization time was 1 day (1-3 d). In all cases an objective response was found and a complete necrosis was noted in 71.4% (10/14). Over a follow-up of 3 years, overall survival rate at 1- & 3-years was respectively 100% and 78.6% whereas disease-free survival was respectively 92.8% and 57.1%. There was no peri-procedural mortality or injury to major vascular-biliary structures Conclusion: TTA of lesions in CLL under CT-guidance after 3D-mapping, is despite challenges an alternative and in experienced hands a safe [2] method of treatment in poor surgical candidates References [1] Hirooka et al, (2009), Virtual puncture line in radiofrequency ablation for hepatocellular carcinoma of the caudate lobe, AJR Am J Roentgenol., W149-51, 2017-01-01 [2] Peng et al, (2008), Percutaneous radiofrequency ablation for the treatment of hepatocellular carcinoma in the caudate lobe, Eur J Surg Oncol, 166-72, 2017-01-01