Abstract
To assess the clinical efficiency of ultrasound-guided percutaneous microwave ablation (US-PMWA) assisted by three-dimensional (3D) visualization operative treatment planning system and percutaneous transhepatic cholangial drainage with intraductal chilled saline perfusion (PTCD-ICSP) for larger hepatic hilum hepatocellular carcinoma (HH-HCC) (D ≥ 3 cm). The combination therapy was performed in 14 patients from Sep 2011 to May 2017. The major outcomes for assessment were biliary duct complications, local tumor recurrence, distant recurrence and overall survival rates. Median follow-up period was 26 months. The series of 3D visualization operative treatment planning, PTCD-ICSP and US-PMWA were successfully performed and complete ablation was achieved in all cases. The mean session for one tumor was 1.0 ± 0.4. The mean ablation time for per tumor was 1805 ± 567s. The saline volume used for the PTCD-ICSP was 250–450 ml per session. The 1-, 2-, and 3-year local tumor recurrence rates were 7.1%, 14.3%, and 35.7%, the 1-, 2-, and 3-year distant recurrence rates were 0%, 14.3%, and 28.6%, and 1-, 2-, and 3-year overall survival rates were 100%, 92.9%, and 71.4%, respectively. No severe complications related to ablation occurred.ConclusionsUS-PMWA assisted by 3D visualization operative treatment planning system and PTCD-ICSP appears to be a safe, effective and innovative technique for management for larger HH-HCCs, which improved the prognosis.
Highlights
Hepatocellular carcinoma (HCC) is a common malignancy with dismal prognosis, which listed the fifth most common cancer in men and seventh in women [1,2,3]
The saline volume used for the PTCD-ICSP was 250–450 ml per session
ultrasound-guided percutaneous microwave ablation (US-PMWA) assisted by 3D visualization operative treatment planning system and PTCD-ICSP appears to be a safe, effective and innovative technique for management for larger hepatic hilum hepatocellular carcinoma (HH-HCC), which improved the prognosis
Summary
Hepatocellular carcinoma (HCC) is a common malignancy with dismal prognosis, which listed the fifth most common cancer in men and seventh in women [1,2,3]. Liver transplantation and surgical resection are the optimal treatments. The majority of HCC patients have a background of chronic liver diseases, especially cirrhosis. A substantial proportion of patients are not eligible for candidate for lack of liver source and impaired liver function and/or multinodularity of tumor. In such www.impactjournals.com/oncotarget patients, mini-invasive treatments have been applied widely in clinic, such as transcatheter arterial chemoembolization (TACE), ethanol injection (EI), microwave ablation (MWA) and radiofrequency ablation (RFA) [4,5]. Even surgical resection faces difficulty because of the unique anatomy and high recurrence rate [8]. Image-guided percutanous ablation which has been increasingly accepted for its advantages of mini-invasion, favorable efficacy and good reproducibility would be a better choice [7, 9,10]
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