Underwent Radiofrequency Ablation Therapy Research Articles

Treatment of Warthin's Tumors of the Parotid Gland With Radiofrequency Ablation: A Systematic Review of the Current Literature.

Objective: Warthin's tumors of the parotid gland can be safely observed. Definitive treatment usually requires parotidectomy under general anesthesia. The decision to operate on Warthin's tumors of the parotid gland can be complicated in patients who wish to avoid risks of surgery and general anesthesia. This systematic review explores the potential of radiofrequency ablation (RFA) as a minimally invasive alternative. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) model was used to collect 3 relevant studies that focused on RFA treatment for Warthin's tumors. The cumulative averages for tumor size and cosmetic scores were then quantified for patients with Warthin's tumors who underwent RFA therapy. The PRISMA systematic review method was employed to the PubMed and EMBASE databases. The comprehensive search term "Warthin Tumor Treatment" yielded 1299 articles from the years 1955 to 2023, 3 of which met inclusion criteria and were then selected. Results: The 3 quantitative studies collectively assessed 37 patients with Warthin's tumors treated with RFA. Patients experienced an average tumor size reduction of 85.03% at 12 months post-RFA. There were minimal complications associated with RFA in these patients. Conclusion: This study suggests that RFA is an alternative to parotidectomy for the symptomatic treatment of Warthin's tumors. RFA procedures demonstrated substantial tumor size reduction with few complications. However, further meta-analysis and comparison with alternative treatments is warranted to establish RFA's role in treatment of Warthin's tumors. The study is limited by its reliance on only 2 databases and a lack of comprehensive examination of different RFA settings.

Factors affecting lower extremity venous insufficiency recurrence following radiofrequency ablation.

To clarify possible factors for recurrence of venous insufficiency following radiofrequency ablation (RFA) for the treatment of lower extremity chronic venous insufficiency (CVI). Patients with lower extremity CVI who underwent RFA therapy were reviewed for inclusion in the study. Patients' characteristics, operative parameters and follow-up outcomes were recorded. Patients were divided into two groups (patients with successful RFA and patients with recurrent venous insufficiency). Groups were compared according to patient demographic features, treated vein characteristics, operative data and follow-up duration. In total, 313 patients matched the study inclusion criteria and 48 patients encountered RFA failure during follow-up. Mean BMI and ratio of COPD were significantly higher in patients with RFA failure (p = .002 and p = .007). The CEAP classification was significantly different between the groups (p = .007). Mean follow-up time was significantly longer in patients with RFA failure (p = .011). Presence of COPD and BMI ≥30kg/m2 increased RFA failure 4.187 times and 2.255 times, respectively (p = .002 and p = .022). Additionally, CEAP C4 significantly increased RFA failure (p = .001). Lastly, longer follow-up time was a predictive factor for RF failure (p = .024). Our study findings demonstrated for the first time that obesity, presence of COPD, presence of veins classified as CEAP C4 before RFA, and follow-up period longer than 48months were predictive factors for venous insufficiency recurrence following RFA.

Effect of Nursing Strategies on the Performance and Satisfaction of Patients with Hepatocellular Carcinoma undergoing Radiofrequency Ablation Therapy

Effect of Nursing Strategies on the Performance and Satisfaction of Patients with Hepatocellular Carcinoma undergoing Radiofrequency Ablation Therapy

Endoscopic eradication therapy for Barrett’s esophagus–related neoplasia: a final 10-year report from the UK National HALO Radiofrequency Ablation Registry

Long-term durability data for effectiveness of radiofrequency ablation (RFA) to prevent esophageal adenocarcinoma in patients with dysplastic Barrett's esophagus (BE) are lacking. We prospectively collected data from 2535 patients with BE (mean length, 5.2 cm; range, 1-20) and neoplasia (20% low-grade dysplasia, 54% high-grade dysplasia, 26% intramucosal carcinoma) who underwent RFA therapy across 28 UK hospitals. We assessed rates of invasive cancer and performed detailed analyses of 1175 patients to assess clearance rates of dysplasia (CR-D) and intestinal metaplasia (CR-IM) within 2 years of starting RFA therapy. We assessed relapses and rates of return to CR-D (CR-D2) and CR-IM (CR-IM2) after further therapy. CR-D and CR-IM were confirmed by an absence of dysplasia and intestinal metaplasia on biopsy samples taken at 2 consecutive endoscopies. Ten years after starting treatment, the Kaplan-Meier (KM) cancer rate was 4.1% with a crude incidence rate of .52 per 100 patient-years. CR-D and CR-IM after 2 years of therapy were 88% and 62.6%, respectively. KM relapse rates were 5.9% from CR-D and 18.7% from CR-IM at 8 years, with most occurring in the first 2 years. Both were successfully retreated with rates of CR-D2 of 63.4% and CR-IM2 of 70.0% 2 years after retreatment. EMR before RFA increased the likelihood of rescue EMR from 17.2% to 41.7% but did not affect the rate of CR-D, whereas rescue EMR after RFA commenced reduced CR-D from 91.4% to 79.7% (χ2P< .001). RFA treatment is effective and durable to prevent esophageal adenocarcinoma. Most treatment relapses occur early and can be successfully retreated.

Efficiency of Prophylactic Ablation of the Tributary Venous Pathways Draining Around the Saphenofemoral Junction to Decrease the Rate of Future Varicose Vein and Symptoms Occurence

There are various other collaterals draining into the venous system around the saphenofemoral junction in addition to the great saphenous vein. We aimed to determine the efficiency of prophylactic ablation of tributary veins in long term varicose vein and symptom recurrence. Two hundred and sixty-three consecutive patients whom underwent radiofrequency ablation therapy for the treatment of superficial venous reflux disease were investigated. There were 129 patients who received isolated great saphenous vein ablation (Group A) where as 134 patients underwent ablation of the other tributary veins in addition to the great saphenous vein (Group B) between June 2015 and January 2017. The tributary superficial veins; refluxing and/or not refluxing, draining into the saphenofemoral junction were selectively catheterized and ablated in Group B. Patients are followed at least 1 year after the procedures regulary and researched for recurrence of varciose veins and symptoms. Gender, mean age, body mass index, diameter of the great saphenous veins, small saphenous vein disease, and grade of deep venous insufficiency did not differ significantly between the two groups. The mean number of tributary veins were similar in both groups (n: 1.9 ± 0.4 in Group A vs. n: 1.8 ± 0.7 in Group B) which were detected preoperatively as well as during the procedure. The mean number of ablated tributary venous pathways could be 1.4 ± 0.6 in Group B. During the follow up period symptoms related with varicose veins recurred in 19 patients in Group A where as in 7 patients in Group B (P < 0.05). Three of these symptomatic patients in Group B were the ones in whom the tributary pathways could not be catheterized ablated where as 14 patients in Group A were diagnosed with newly refluxing tributary pathways. All the symptomatic patients in both groups were managed medically and/or with additional interventions. The absence of any fascial unsheathing and the parietal weakness are suggestive of a lower resistance of the tributary veins wall, so collapse and size of veins make it more complex to catheterization regarding to great saphenous vein. Ablation of the tributary superficial venous pathways during the treatment of great saphenous vein reflux disease decreased the rate of recurrence of superficial venous reflux disease and patients symtoms in our modest cohort.

Postoperative acute multiple organ failure after hepatectomy in a Nigerian male with sickle cell trait: a case report

BackgroundSickle cell disease (SCD) is a monogenic disease characterized by sickle hemoglobin (HbS). Patients homozygous for HbS experience symptoms resulting from sickled erythrocytes no later than adolescence. However, heterozygous HbS carriers, or those with the so-called sickle cell trait (SCT), may undergo surgery without their hemoglobinopathy being known.Case presentationA 53-year-old Nigerian male with hepatitis C infection underwent radiofrequency ablation therapy for multiple hepatocellular carcinomas (HCCs) 17 months prior. Follow-up computed tomography (CT) revealed a solitary tumor (3.2 cm) in the medial section of the cirrhotic liver. The Child–Pugh score was five, and the indocyanine green retention rate at 15 min was 17.4%. The nontumorous liver of the medial section accounted for 10% of the total liver volume according to CT volumetry. With the diagnosis of recurrent HCC, left medial sectionectomy was performed under intermittent blood flow occlusion by Pringle’s maneuver. Intraoperative ultrasonography confirmed that hepatic blood flow had been preserved after hepatectomy. However, laboratory tests on postoperative day (POD) 1 revealed severe liver damage: aspartate aminotransferase 9250 IU/L, alanine aminotransferase 6120 IU/L, total bilirubin 2.8 mg/dL, and prothrombin time% 20.9%. The patient’s renal and respiratory functions also deteriorated; therefore, continuous hemodiafiltration and plasma exchange were initiated under mechanical ventilation. Whole-body contrast-enhanced CT showed no apparent ischemia of the remnant liver, but diffuse cerebral infarction was detected. Despite intensive treatments, he died of multiple organ failure on POD 20. The pathological examination of the resected specimen revealed that the intrahepatic peripheral vessels were occluded by sickled erythrocytes. Additionally, chromatographic analysis of hemoglobin detected the presence of abnormal hemoglobin, although microscopic examination of the peripheral blood erythrocytes did not show morphological abnormalities. Based on these findings, we determined that he had SCT and developed vaso-occlusive crisis involving multiple organs just after hepatectomy.ConclusionSCD is a rare disease in eastern Asia, but its prevalence is increasing globally. Surgeons should pay increased attention to this disease, especially when performing hepatectomy under blood flow occlusion.

Extrapolating Prognostic Factors of Primary Curative Resection to Postresection Recurrences Hepatocellular Carcinoma Treatable by Radiofrequency Ablation.

Objective Recurrence after curative resection for hepatocellular carcinoma (HCC) is a major cause of death from this disease. Factors of primary curative resection are available and potential in the prognosis of follow-up treatment. Our aim was to assess the prognostic significance of primary curative resection factors in recurrent HCC patients undergoing radiofrequency ablation therapy (RFA). Methods In this retrospective study, we assessed 235 patients who underwent limited RFA of HCC recurrences (tumors ≤ 5 cm; nodules ≤ 3) after primary curative resection. Factors of primary curative resection were collected, and overall survival and recurrence-free survival were evaluated by the Kaplan-Meier method. Univariate and multivariate analyses were used to identify significant prognostic factors. Results After a median follow-up of 36 months, 54 patients died, and 128 patients had hepatic recurrence. On univariate analyses, patients whose primary tumors were less differentiated (p = 0.032 and p = 0.048) and required less time to recur (p = 0.013 and p = 0.001) after curative resection displayed poorer overall survival and higher recurrence rates following RFA. On multivariate analyses, the pathologic tumor grade (p = 0.026 and p = 0.038) and recurrence-free survival after primary curative resection (p = 0.028 and p < 0.001) emerged as independent risk factors of survival and HCC recurrence. Conclusions Primary tumor differentiation and time to recurrence after curative resection are viable prognostic factors of overall survival and further recurrence risk in patients undergoing RFA of recurrent HCC.

Effect of Nursing Care Instructions on Outcomes of Patients with Hepatocellular Carcinoma Undergoing Radiofrequency Ablation Therapy

Effect of Nursing Care Instructions on Outcomes of Patients with Hepatocellular Carcinoma Undergoing Radiofrequency Ablation Therapy

Prognostic association of demographic and clinical factors with the change rates of symptoms and depression among patients with hepatocellular carcinoma.

To identify the predictive value of demographic and clinical factors for determining changes in physical and depressive symptom among hepatocellular carcinoma (HCC) patients over time. We performed a prospective cohort study of 128 patients newly diagnosed with HCC in Taiwan. Each patient had four time-point data after the follow-up. Patients' physical symptoms were evaluated with the Edmonton Symptom Assessment System (ESAS). Psychological symptoms were evaluated with the Hospital Anxiety and Depression Scale (HADS). Clinical factors and demographic characteristics were predictors of physical and psychological symptoms, as estimated by a generalized estimating equation (GEE). We found that patients who had a smoking habit and Barcelona Clinic Liver Cancer (BCLC) Stage B disease underwent radiofrequency ablation therapy (RFA) or liver resection, and those who had higher alanine aminotransferase (GPT) level reported more symptoms from baseline to 1month. Symptoms increased from baseline to 3months in elderly patients and patients with higher GPT levels. Additionally, patients who had jobs, underwent liver resection, and had BCLC Stage C disease had increased symptoms of depression from baseline to 1month; in particular, BCLC Stage D disease had negative long-term effects on depression scores from baseline to four-time points following therapy. Advanced BCLC stage and undergoing RFA or liver resection were most closely associated with worsening physical and psychological symptoms over time. Clinical professionals should pay attention to these factors that affect physical and psychological symptoms during treatment.

Evaluation of chronic inflammation in the aetiology of venous insufficiency by investigating cytomegalovirus DNA.

IntroductionLower extremity venous insufficiency is a significant health problem with economic and sociological consequences, lowering the quality of life, and sometimes leading to serious complications. The aim of this study is to evaluate the cytomegalovirus (CMV) effect on chronic inflammation in the aetiology of chronic venous insufficiency.Material and methodsBetween November 2017 and August 2018, 468 patients who underwent radio-frequency ablation therapy and phlebectomy were included in the study. PCR analyses for CMV DNA were performed on the venous tissue samples. Patients with post-thrombotic syndrome were excluded from the study. After ethical approval, the relationship between the presence of CMV DNA, gender, body mass index, and bilaterality of chronic venous insufficiency were investigated.ResultsWhen the relationship between CMV DNA and gender or body mass index was examined, a significant relationship was not detected. But when the patients with bilateral chronic venous insufficiency and patients with unilateral chronic venous insufficiency were compared regarding CMV DNA positivity, the patients with bilateral chronic venous insufficiency had significantly higher CMV DNA positivity (p = 0.002). Also, the incidence of venous ulcers in the CMV DNA exposed group was significantly higher.ConclusionsIn the literature there are many studies showing that CMV triggers atherosclerosis, but there is no study in which CMV directly produces chronic venous insufficiency. The high rates of positivity suggest that CMV, which is the basis of chronic inflammation, may be a significant factor in the aetiology of chronic venous insufficiency.

Su1118 APPEARANCE OR PROGRESSION OF DYSPLASIA AND CANCER IN BARRETT’S ESOPHAGUS UNDERGOING RADIOFREQUENCY ABLATION

Barrett’s esophagus (BE) is a known risk factor for esophageal adenocarcinoma (EAC). Radiofrequency ablation (RFA) has been associated with a high rate of complete eradication for dysplasia and intestinal metaplasia. Data are limited on patients who have progression of dysplasia or development of EAC while undergoing RFA therapy. We aimed to better characterize these patients. This was a retrospective review of medical records at a tertiary academic medical center. We included patients with at least one RFA treatment for BE without EAC. Patients achieving complete eradication of dysplasia were excluded. Data collected included demographics, date of BE diagnosis, endoscopy findings, anatomic pathology, location of the newly developed dysplasia, length of BE, RFA adjuvant therapies, and date of death. A total of 475 patients underwent RFA, of which 39 (8.2%) progressed to low grade dysplasia (LGD), high grade dysplasia (HGD) or EAC while undergoing therapy. The distribution of these changes is depicted in Table 1. Only 1 patient was female. Patient demographic data is found in Table 2. For those with HGD receiving RFA, 12.6% progressed into cancer. The majority of cancer developed in the distal esophagus (13/23 = 56.5 %). Seven patients (30.4 %) had their original HGD distributed over the entire BE segment prior to initial RFA. The progression was observed after an average of 3.0 RFA sessions. Twenty patients had endoscopic mucosal resection (EMR) and 2 had esophagectomy. Four (17.4 %) patients died. Eight patients achieved complete remission of intestinal metaplasia. For those who underwent RFA for LGD, 6 patients progressed to cancer and 6 to HGD. The rate of progression into cancer was significantly lower (5.1%) than those undergoing treatment for HGD (12.6%) (p= 0.04). The average number of RFA sessions before progression was 2.6. All 6 developed cancer in the distal BE segment and 5 of these patients had original low grade dysplasia in the distal BE segment. All 6 patients received adjuvant EMR and 2 esophagectomy. Two of these patients died. The 2 patients with short segment BE (2cm and 2.75 cm) progressed to cancer. Of the 4 patients with non-dysplastic Barrett’s who progressed while receiving RFA, the dysplasia appeared in the distal BE segment in 2, in the proximal in 1 and in the mid distal in 1. One patient developed cancer, but ultimately achieved complete remission of intestinal metaplasia. Our study shows that 8.2% of patients receiving RFA for BE have progression of dysplasia or development of cancer. Those at highest risk for progression are patients initially treated for HGD with 12.6% progressing to cancer after an average of 3.0 RFA sessions. Further studies are needed to determine why this progression occurred and how it can be avoided.Tabled 1Table 1. Number of patients with progression of dysplasia or progression to cancer based on initial indication for RFA therapy.Progression to:RFA for NDBE/ID (175)RFA for LGD (117)RFA for HGD (183)Indefinite DysplasiaLow grade Dysplasia1High Grade Dysplasia26Cancer16*23*Total4 (2.3%)12 (10.3%)23 (12.6%)Abbreviations: non-dysplastic Barrett’s esophagus (NDBE), indefinite dysplasia (ID), low grade dysplasia (LGD), high grade dysplasia (HGD). *P = 0.04 for progression into cancer between LGD and HGD groups Open table in a new tab Tabled 1Table 2. Characteristics of patients who had progression of dysplasia or development of cancer after RFA.RFA for NDBE/IDRFA for LGDRFA for HGDMean Age First Dysplasia or Mean Age First BE for NDBE (Range)64.5 (60-74)68.5 (54-78)72.3 (52-84)Mean Age Diagnosis Highest Progression (Range)68.5 (61-76)71.6 (57-81)74.2 (52-82)Mean Length BE Segment cm (Range)3.8 (2-5)7.0 (2-17)7.0 (1-14)Mean Number RFA Sessions Before Progression (Range)2.0 (1-3)2.6 (1-5)3.0 (1-11)Original Site of Dysplasia in Barrett’s Segment Before RFANAProximal11Proximal Mid10Mid04Mid Distal11Distal67Entire27Unknown13Site of Progression In EsophagusProximal124Proximal Mid003Mid023Mid Distal110Distal2713Adjuvant TherapyEMR2720ESD001Chemo-radiation002Brachytherapy002Esophagectomy022Cryotherapy123Radiation001Rate of CRIM128Deaths114Abbreviations: non-dysplastic Barrett’s esophagus (NDBE), indefinite dysplasia (ID), low grade dysplasia (LGD), high grade dysplasia (HGD), not applicable (NA), complete remission of intestinal metaplasia (CRIM). Open table in a new tab

P851Baseline left atrial strain predicts the rate of recurrences in patients with paroxysmal atrial fibrillation and low CHA2DS2-VASc score undergoing radiofrequency ablation therapy

P851Baseline left atrial strain predicts the rate of recurrences in patients with paroxysmal atrial fibrillation and low CHA2DS2-VASc score undergoing radiofrequency ablation therapy

Implication of Psoas Muscle Index on Survival for Hepatocellular Carcinoma Undergoing Radiofrequency Ablation Therapy.

Aims We aimed to retrospectively examine the impact of pretreatment psoas muscle index (PMI) as determined by computed tomography on survival for treatment naïve hepatocellular carcinoma (HCC) patients who underwent percutaneous radiofrequency ablation (RFA) therapy (n=182; 111 males and 71 females with median age of 70 years).Patients and methods Optimal cut-off points of PMI in male and female were calculated by receiver operating characteristic analysis for survival. We investigated parameters associated with overall survival (OS) in the univariate and multivariate analyses.Results The median follow-up period in this study was 4.28 years. For all cases, the 5-year cumulative OS rate after initial RFA was 69.2%. The median (range) value in PMI for male was 6.03 (1.63-9.90) cm2/m2 whereas that for female was 4.06 (1.21-7.32) cm2/m2. Maximum tumor size ranged from 0.7 cm to 3.5 cm (median, 1.5cm). There were 145 patients with single nodule and 37 with multiple nodules. The optimal cut-off point for PMI was 6.31 cm2/m2 in male and 3.91 cm2/m2 in female. The 5-year cumulative OS rates were 51.5% in the decreased PMI group (n=90) and 86.5% in the non-decreased PMI group (n=92) (P<0.0001). In patients with Child-Pugh A (n=137) and Child-Pugh B or C (n=45), similar results were obtained. In the multivariate analysis, presence of decreased PMI (P<0.0001), total bilirubin ≥1.2 mg/dl (P=0.0015) and des-γ-carboxy prothrombin ≥34 mAU/ml (P=0.0089) were found to be significant adverse predictors related to OS.Conclusion PMI can be useful for predicting outcomes in HCC patients undergoing percutaneous RFA therapy.

The impact of clinically significant portal hypertension on the prognosis of patients with hepatocellular carcinoma after radiofrequency ablation: a propensity score matching analysis.

To assess the impact of clinically significant portal hypertension (CSPH) on the prognosis of patients with hepatocellular carcinoma (HCC) undergoing radiofrequency ablation (RFA). We retrospectively enrolled 280 treatment-naïve early-stage HCC patients who had Child-Pugh grade A or B and received upper gastrointestinal endoscopy at the time of HCC diagnosis. CSPH was defined as (1) a platelet count < 100,000/mm3 associated with splenomegaly and/or (2) the presence of oesophageal/gastric varices by endoscopy. Factors determining poor overall survival and recurrence after RFA were analysed by Cox proportional hazards model and propensity score matching analysis. A total of 192 (68.6%) patients had CSPH. The cumulative 5-year survival rates were 50.6% and 76.7% in patients with and without CSPH, respectively (p = 0.015). Based on multivariate analysis, age > 65years (hazard ratio (HR) 1.740, p = 0.025), serum albumin levels ≤ 3.5g/dL (HR 3.268, p < 0.001) and multiple tumours (HR 1.693, p = 0.046), but not CSPH, were independent risk factors associated with poor overall survival after RFA. Moreover, the overall survival rates were comparable between patients with and without CSPH after adjusting for confounding factors via propensity score matching analysis. CSPH was not associated with poor outcomes after RFA. • CSPH was common in HCC patients who underwent RFA therapy. • CSPH was not an independent risk factor in determining poor prognosis. • Serum albumin level was more important to determine the outcomes.

Anatomical hepatectomy for liver metastasis from rectal adenocarcinoma presenting with intrabiliary extension: a case report.

Liver metastases from colorectal carcinoma commonly form nodular lesions in the liver parenchyma. We report a case of liver metastasis from rectal adenocarcinoma that extended predominantly into the bile duct. A 62-year-old Japanese man underwent low anterior resection for rectal adenocarcinoma 9 years ago. Approximately 3 years later, he underwent radiofrequency ablation therapy for a metastatic liver tumor. Nine years after surgery, a tumor in liver segment III exhibiting intrabiliary extension was discovered; it was unclear if this was a metastatic liver tumor or intrahepatic cholangiocarcinoma. Accordingly, we performed a left hepatectomy with lymph node dissection. The tumor was negative for cytokeratins 7 and 20, and was histologically similar to the primary rectal adenocarcinoma; it was diagnosed as rectal carcinoma metastasis. The patient has survived for 3 years after the hepatic surgery, for 9 years after radiofrequency ablation therapy, and for 12 years after the primary surgery. This case shows that liver metastasis from colorectal carcinoma can present as a predominantly intrabiliary growth that mimics intrahepatic cholangiocarcinoma on imaging. Moreover, our case provides evidence for the superiority of anatomical hepatectomy over partial hepatectomy for metastatic liver tumors with intrabiliary growth arising from rectal adenocarcinomas.

Abstract P1-02-07: Contrast-enhanced ultrasound for evaluation of therapeutic efficacy of radiofrequency ablation for primary breast cancer

Abstract &amp;lt;Purpose&amp;gt; To evaluate therapeutic efficacy of percutaneous ultrasound (US) guided radiofrequency (RF) ablation therapy for primary breast cancer using contrast-enhanced US. &amp;lt;Methods and Materials&amp;gt; The study was approved by the institutional ethics committee, and written informed consent was obtained. Between January 2012 and April 2014, 25 patients with biopsy-confirmed T1 breast cancer underwent RF ablation therapy in one institution. We examined 25 patients with 25 T1 breast cancers by contrast-enhanced MRI/CT, and contrast-enhanced US before and after RF ablation therapy. US guided RF abltion was performed using a 17-gauge internally cooled electrode (Cool-TipTM, Valleylab, Boulder, CO, USA) under general anesthesia. After injection 0.015mL/kg body weight of Sonazoid®(perflubutane), contrast-enhanced US was performed at a low mechanical index (0.17-0.24). Therapeutic success was defined as a lack of contrast enhancement by contrast-enhanced MRI, US and non-viable cancer tissues by US guided vacuum assisted biopsy (VAB) or core needle biopsy (CNB). &amp;lt;Results&amp;gt; Contrast-enhanced US and MRI four weeks or more after RF ablation therapy showed ablation zones and adequate tumor necrosis in all 25 cancer lesions treated. Contrast-enhanced US made it possible to see that tumor vessels of treated lesions had disappeared after treatment. Contrast enhanced MRI showed a lack of stain with ring-like enhancement of ablation zone and non-viable tissues were seen by VAB and/or CNB in 25 ablation zones. &amp;lt;Conclusion&amp;gt; Contrast-enhanced US using Sonazoid® was useful modalities for evaluating the efficacy of RF ablation therapy in breast cancer lesions. Citation Format: Toshikazu Ito, Jyunji Okayama, Kumiko Uji, Masaaki Izukura. Contrast-enhanced ultrasound for evaluation of therapeutic efficacy of radiofrequency ablation for primary breast cancer [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-02-07.

Prevalence of “Familial Barrettʼs Esophagus” amongst Patients Undergoing Radiofrequency Ablation Therapy for Dysplastic Barrettʼs Esophagus

Purpose: Prevalence of Barrett's Esophagus (BE) in western countries is between 1.6% and 6.8%, and the risk of cancer in patients with BE is approximately 0.5% per year. Familial aggregation of BE may result from complex interactions between the causal genes and risk factors aggregating within families. The aim of this study was to determine the prevalence of “Familial Barrett's Esophagus” amongst the patients undergoing radiofrequency ablation therapy for dysplastic BE. Methods: Clinico-demographic features of consecutive patients diagnosed with dysplastic BE at our center from January, 2009 to March, 2013 were reviewed. Data regarding occurrence of BE or esophageal adenocarcinoma (EAC) in first and second degree relatives were abstracted to study the epidemiology of familial aggregation using a case-control design. Differences between patients with and without familial aggregation were compared using two sample t-test and Fisher's exact test. Results: Of 170 patients with confirmed tissue diagnosis of BE with dysplasia, 20 (12%) had a firstdegree relative, and three (1.77%) had a more distant relative diagnosed with BE or EAC. Comparison of patients with first degree relatives to those without demonstrated an association between female gender and familial aggregation (Table 1). However, the degree of dysplasia, short and long segment BE did not differ between the two groups (Table 1). In addition, patients with “Familial Barrett's Esophagus” were similar to those without with respect to other clinico-demographic features (Table 1).Table 1: Clinico-demographic features in patients with Familial BE and non-Familial BEConclusion: Our data shows that up to 12% of patients with dysplastic BE had positive family history for BE or EAC. Female with dysplastic BE were more likely to have “Familial Barrett's Esophagus” as opposed to men with dysplastic BE. Further longitudinal studies are required to understand natural history of BE with familial aggregation in comparison with sporadic occurrence.

Serum alpha-fetoprotein response can predict prognosis in hepatocellular carcinoma patients undergoing radiofrequency ablation therapy

To evaluate the clinical inference of serum alpha-fetoprotein (AFP) response in hepatocellular carcinoma (HCC) patients undergoing percutaneous radiofrequency ablation (RFA). Three hundred and thirteen previously untreated HCC patients were enrolled in the study. The optimal AFP response was defined as >20% decrease from baseline after 1 month of RFA for those with a baseline AFP level of ≥100ng/ml. The impact of AFP response on prognosis was analysed and prognostic factors were assessed. After a median follow-up of 26.7±19.1 months, 49 patients died and 264 patients were alive. The cumulative 5 year survival rates were 75.3 and 57.4% in patients with an initial AFP of <100ng/ml and ≥100ng/ml, respectively (p=0.003). In the 58 patients with a baseline AFP of ≥100ng/ml and initial completed tumour necrosis after RFA, the cumulative 5 year survival rates were 62.4 and 25.7% in optimal and non-optimal AFP responders, respectively (p=0.001). By multivariate analysis, the prothrombin time international normalized ratio >1.1 (p=0.009), non-optimal AFP response (p=0.023), and creatinine >1.5mg/dl (p=0.021) were independent risk factors predictive of poor overall survival. Besides, the cumulative 5 year recurrence rates were 83.4 and 100% in optimal and non-optimal AFP responders, respectively (p<0.001). Multivariate analysis demonstrated platelet count ≤10(5)/mm(3) (p=0.048), tumour size >2cm (p=0.027), and non-optimal AFP response (p<0.001) were independent risk factors associated with tumour recurrence after RFA. Serum AFP response may be a useful marker for predicting prognosis in HCC patients undergoing RFA.

Probe-based Confocal Laser Endomicroscopy to Guide Endoscopic Therapy in Barrettʼs Esophagus with High-grade Dysplasia

Purpose: Probe-based confocal laser endomicroscopy (pCLE) is a novel imaging technique which utilizes a low-power laser light passed through a fiberoptic bundle, within a mini-probe that is advanced into the working channel, to obtain microscopic images of the mucosa. This allows the endoscopist to evaluate the microarchitecture of GI epithelium in real time. At this time pCLE can not replace histopathology, but pCLE can provide diagnostic information as well as guide therapeutic management in patients with Barretts esophagus (BE) with high-grade dysplasia (HGD). Methods: We describe a retrospective case series in which four patients with BE and biopsy-proven HGD underwent endoscopy with pCLE to direct real time endoscopic ablation therapy and/or endoscopic mucosal resection (EMR), which was performed in conjunction with pCLE. Results: Three of the four patients had pCLE showing features of high-grade dysplasia prior to treatment at the same session. After either EMR or radio frequency ablation (RFA), pCLE was again used to evaluate the margins after therapy to assure accuracy. In one case, pCLE had features of dysplasia at the margin and further repeat EMR was immediately performed. Patient 4 had a history of short segment BE with focus of non-nodular HGD, which was earlier treated with RFA with two endoscopic treatment sessions. On current endoscopy this patient had a normal appearing esophagus, but pCLE found features of BE in discrete areas and targeted biopsies were performed, which confirmed BE. This patient subsequently underwent radiofrequency ablation therapy of the residual areas of BE. (See Table 1).Table: Table. Summary of results of pCLE findings and endoscopic therapyConclusion: In patients with BE and dysplasia, pCLE can be an effective diagnostic tool used to target biopsies and to guide and assess efficacy of endoscopic therapy of BE with EMR or RFA.

Survival after radiofrequency ablation for 100 cases of lung neoplasms

背景与目的手术切除是治疗肺部肿瘤的首选治疗手段，而对高龄、肺功能差的患者，射频消融治疗是一个很好的选择。本文总结了射频消融治疗100例肺部肿瘤的远期疗效和并发症。方法对不能手术的100例肺部肿瘤患者行射频消融治疗，定期复查胸部增强CT扫描、肿瘤SPECT或PET显像并随访，观察远期疗效及并发症。结果100例肺部肿瘤病例的106个病灶接受了射频消融治疗。其中男性62例，女性38例，年龄36岁-91岁，平均66.6岁。原发性肺癌86例，肺转移瘤14例。所有病例完成射频消融治疗，无严重并发症和围手术期死亡。全组总生存时间为13.0个月，1年生存率51.0%，2年生存率32.5%，原发性肺癌与肺转移瘤相比无统计学差异（P=0.922）。早期肺癌的中位生存时间为28个月，2年总生存率为57.7%。结论CT引导下射频消融治疗肺癌具有安全、有效、定位准确和微创的优点，是不能耐受手术的早期肺癌患者的选择之一，对中晚期肺癌是一种局部减瘤手段。