Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Monday, 03 / 30 / 2020

Articles

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

ORIGINAL ARTICLE

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

Antonio Giorgio*,1, Pietro Gatti2, Luca Montesarchio3, Bruno Santoro1, Andrea Dell’Olio4, Nicola Crucinio5, Carmine Coppola6, Ferdinando Scarano6, Fabio De Biase5, Emanuela Ciracì7, Stefano Semeraro7 and Valentina Giorgio8

1Liver Unit and Interventional Ultrasound Unit, Athena Clinical Institute, Piedimonte Matese (CE), Italy
2Internal Medicine Unit, Brindisi General Hospital, Brindisi, Italy
3General Surgery Unit, Polla General Hospital, Polla (SA), Italy
4Department of Radiology, Bisceglie Hospital - ASL BAT, Bisceglie, Italy
5Gastroenterology Unit, Foggia General Hospital, Foggia, Italy
6Department of Internal Medicine, Hepatology Interventional Unit, Gragnano Hospital, Gragnano (NA), Italy
7Internal Medicine Unit, Ostuni Hospital, Ostuni (BR), Italy
8Fondazione Policlinico A. Gemelli IRCCS, Department of Woman and Child Health and Public Health, Largo A Gemelli, Roma, Italy

*Correspondence to: Antonio Giorgio, Liver Unit and Interventional Ultrasound Unit, Athena Clinical Institute, Piedimonte Matese (CE) (81016), Italy. Tel: +39-823784666, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2019;7(4):287-292 DOI: 10.14218/JCTH.2019.00036
Received: August 14, 2019 Accepted: November 6, 2019 Published online: November 27, 2019

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.

Keywords

Intrahepatic cholangiocarcinoma, Thermal ablation, Microwaves, Radiofrequency, Percutaneous treatment

 

 

 

Journal of Clinical and Translational Hepatology 2019 vol. 7, 287-292  [ Html ] [ PDF Full-text ]

© The Authors 2019. This article is published under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC 4.0), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non-commercial and is otherwise in compliance with the license.

 

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