1.Radiofrequency Ablation for Treating Liver Metastases from a Non-Colorectal Origin.
Bo La YUN ; Jeong Min LEE ; Ji Hyun BAEK ; Se Hyung KIM ; Jae Young LEE ; Joon Koo HAN ; Byung Ihn CHOI
Korean Journal of Radiology 2011;12(5):579-587
OBJECTIVE: We wanted to assess the safety and efficacy of performing radiofrequency ablation (RFA) in patients with non-colorectal liver metastases. MATERIALS AND METHODS: In this retrospective study, 25 patients with 40 hepatic metastases (M:F = 17:8; mean age, 57 years; tumor size, 0.5-5.0 cm) from a non-colorectal origin (stomach, biliary, breast, pancreas, kidney and skin) were treated with RFA. The RFA procedures were performed using either an internally cooled electrode or a clustered electrode under ultrasound or CT guidance. Contrast-enhanced CT scans were obtained immediately after RFA and follow-up CT scans were performed within three months after ablation and subsequently at least every six months. The intrahepatic disease-free interval was estimated and the overall survival from the time of the initial RFA was analyzed using the Kaplan-Meier method. RESULTS: No intraprocedural deaths occurred, but four major complications developed, including abscesses (n = 3) and pneumothorax (n = 1). Technical effectiveness was determined on the initial follow-up images. During the follow-up period (range, 5.9-68.6 months; median time, 18.8 months) for 37 tumors in 22 patients where technical effectiveness was achieved, 12 lesions (32%, 12 of 37) showed local tumor progression and new intrahepatic metastases occurred in 13 patients (59%, 13 of 22). The median intrahepatic disease-free interval was 10.1 months. The 1-year, 3-year and 5-year overall survival rates after RFA were 86%, 39% and 19%, respectively. CONCLUSION: RFA showed intermediate therapeutic effectiveness for the treatment of non-colorectal origin liver metastases.
Adult
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Aged
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Aged, 80 and over
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*Catheter Ablation/adverse effects
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Disease Progression
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Disease-Free Survival
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Female
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Humans
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Liver Neoplasms/mortality/radiography/*secondary/*surgery
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Male
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Middle Aged
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Neoplasm Recurrence, Local
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Radiography, Interventional
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Tomography, X-Ray Computed
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Ultrasonography, Interventional
2.Combination transarterial chemoembolization and radiofrequency ablation therapy for early hepatocellular carcinoma.
Myeong Jun SONG ; Si Hyun BAE ; June Sung LEE ; Sung Won LEE ; Do Seon SONG ; Chan Ran YOU ; Jong Young CHOI ; Seung Kew YOON
The Korean Journal of Internal Medicine 2016;31(2):242-252
BACKGROUND/AIMS: We compared the recurrence of hepatocellular carcinoma (HCC) and the survival of patients who received radiofrequency ablation (RFA) after transarterial chemoembolization (TACE) with patients treated with TACE or RFA alone. METHODS: This study included 201 patients with HCC, who were consecutively enrolled at Seoul St. Mary's Hospital between December 2004 and February 2010. Inclusion criteria were a single HCC < or = 5.0 cm or up to three HCCs < or = 3.0 cm. We used a propensity score model to compare HCC patients (n = 87) who received RFA after TACE (TACE + RFA) with those who received TACE (n = 71) or RFA alone (n = 43). RESULTS: The median follow-up period was 33.3 months (range, 6.8 to 80.9). The TACE + RFA group showed significantly lower local recurrence than the RFA or TACE groups (hazard ratio [HR], 0.309; 95% confidence interval [CI], 0.130 to 0.736; p = 0.008; and HR, 0.352; 95% CI, 0.158 to 0.787; p = 0.011, respectively). The overall survival was significantly better in the TACE + RFA group compared to the RFA group (HR, 0.422; 95% CI, 0.185 to 0.964; p = 0.041). However, the survival benefit was not different between the TACE + RFA and TACE groups (p = 0.124). Subgroup analysis showed that among patients with a tumor size < 3 cm, the TACE + RFA group had significantly better long-term survival than those in the TACE or RFA groups (p = 0.017, p = 0.004, respectively). CONCLUSIONS: TACE + RFA combination treatment showed favorable local recurrence and better overall survival rates in early-stage HCC patients. Patients with tumors < 3 cm are likely to benefit more from TACE + RFA combination treatment. Additional studies are needed for the selection of suitable HCC patients for TACE + RFA treatment.
Adult
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Aged
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Aged, 80 and over
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Carcinoma, Hepatocellular/mortality/pathology/*therapy
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*Catheter Ablation/adverse effects/mortality
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*Chemoembolization, Therapeutic/adverse effects/mortality
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Chemotherapy, Adjuvant
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Disease-Free Survival
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Female
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Humans
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Kaplan-Meier Estimate
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Liver Neoplasms/mortality/pathology/*therapy
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Male
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Middle Aged
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*Neoadjuvant Therapy/adverse effects/mortality
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Neoplasm Recurrence, Local
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Neoplasm Staging
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Patient Selection
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Proportional Hazards Models
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Republic of Korea
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Retrospective Studies
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Risk Factors
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Time Factors
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Treatment Outcome
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Tumor Burden
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Young Adult