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Intrahepatic Cholangiocarcinoma and Thermal Ablation: Long-term Results of An Italian Retrospective Multicenter Study.

Authors
  • Giorgio, Antonio1
  • Gatti, Pietro2
  • Montesarchio, Luca3
  • Santoro, Bruno1
  • Dell'Olio, Andrea4
  • Crucinio, Nicola5
  • Coppola, Carmine6
  • Scarano, Ferdinando6
  • Biase, Fabio De5
  • Ciracì, Emanuela7
  • Semeraro, Stefano7
  • Giorgio, Valentina8
  • 1 Liver Unit and Interventional Ultrasound Unit, Athena Clinical Institute, Piedimonte Matese (CE), Italy. , (Italy)
  • 2 Internal Medicine Unit, Brindisi General Hospital, Brindisi, Italy. , (Italy)
  • 3 General Surgery Unit, Polla General Hospital, Polla (SA), Italy. , (Italy)
  • 4 Department of Radiology, Bisceglie Hospital - ASL BAT, Bisceglie, Italy. , (Italy)
  • 5 Gastroenterology Unit, Foggia General Hospital, Foggia, Italy. , (Italy)
  • 6 Department of Internal Medicine, Hepatology Interventional Unit, Gragnano Hospital, Gragnano (NA), Italy. , (Italy)
  • 7 Internal Medicine Unit, Ostuni Hospital, Ostuni (BR), Italy. , (Italy)
  • 8 Fondazione Policlinico A. Gemelli IRCCS, Department of Woman and Child Health and Public Health, Largo A Gemelli, Roma, Italy. , (Italy)
Type
Published Article
Journal
Journal of clinical and translational hepatology
Publication Date
Dec 28, 2019
Volume
7
Issue
4
Pages
287–292
Identifiers
DOI: 10.14218/JCTH.2019.00036
PMID: 31915596
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Background and Aims: Despite resection being considered the treatment of choice for intrahepatic cholangiocarcinoma (ICC), percutaneous thermal ablation can be an alternative treatment for patients unfit for surgery. Our aim was to compare long-term results of percutaneous sonographically-guided radiofrequency ablation (RFA) with high-powered microwave ablation (MWSA) in treatment of ICC. Methods: Results of 71 ICC patients with 98 nodules treated with RFA (36 patients) or MWSA (35 patients) between January 2008 and June 2018 in 5 Interventional Ultrasound centers of Southern Italy were retrospectively reviewed. Cumulative overall survival curves were calculated with the Kaplan-Meyer method and differences with the log-rank test. Eleven possible factors affecting survival were analyzed. Results: Overall survival of the entire series was 88%, 65%, 45% and 34% at 12, 36, 60 and 80 months, respectively. Patients treated with MWSA survived longer than patients treated with RFA (p < 0.005). The MWSA group with ICC nodules ≤3 cm or nodules up to 4 cm survived longer than the RFA group (p < 0.0005). In patients with nodules >4 cm, no significant difference was found. Disease-free survival and progression-free survival were better in the MWSA group compared to the RFA group (p < 0.005). Diameter of nodules and MWSA were independent factors predicting a better survival. No major complications were observed. Conclusions: MWSA is superior to RFA in treating ICC unfit for surgery, achieving better long-term survival in small (≤3 cm) ICC nodules as well as nodules up to 4 cm of neoplastic tumors and should replace RFA. © 2019 Authors.

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