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- Title
Percutaneous cryoablation for perivascular hepatocellular carcinoma: Therapeutic efficacy and vascular complications.
- Authors
Kim, Ran; Kang, Tae Wook; Cha, Dong Ik; Song, Kyoung Doo; Lee, Min Woo; Rhim, Hyunchul; Lim, Hyo Keun; Sinn, Dong Hyun
- Abstract
<bold>Objectives: </bold>To evaluate the therapeutic efficacy of and vascular complications associated with percutaneous cryoablation for the treatment of perivascular HCC.<bold>Methods: </bold>Between August 2015 and September 2017, 58 consecutive patients (48 men, 10 women; mean age, 61.1 years; age range, 44-84 years) who underwent percutaneous cryoablation were included. All patients had a single perivascular HCC (mean size, 1.3 cm; Barcelona clinic liver cancer-stage 0 or A) that was in contact with hepatic vessels, ≥ 3 mm or larger in axial diameter. Local tumour progression (LTP) was estimated by the Kaplan-Meier method. In addition, several procedure-related vascular complications were evaluated immediately after treatment and during follow-up CT: peritumoral vessel thrombosis; infarction; aggressive intrasegmental recurrence (AIR) (the simultaneous development of ≥ 3 nodular or infiltrative tumours). The follow-up CT was performed in all patients 1 month after the procedure, and every 3 months thereafter.<bold>Results: </bold>The median follow-up period was 22 months (range, 3-29 months). The technical success rate of cryoablation was 96.6% (56/58). The 1- and 2-year cumulative LTP rates were 3.6% and 14.6%, respectively. Although peritumoral vessel thrombosis occurred in 6.9% of cases (4/58), no cases of hepatic infarction were observed and AIR did not develop during follow-up. Half of the thombi in the peritumoral vessels immediately after cryoablation disappeared on follow-up CT images.<bold>Conclusion: </bold>Cryoablation could be an effective tool for the treatment of perivascular HCC with a very low risk of vascular complications.<bold>Key Points: </bold>• Cryoablation allowed a high technical success rate for perivascular HCC. • Only 6.9% developed peritumoral vessel thrombosis without major vascular complications like infarction. • Two-year cumulative LTP rate was 14.6%, without aggressive tumour recurrence on follow-up.
- Subjects
CATHETER ablation; KAPLAN-Meier estimator; SURGICAL complications; BLOOD vessels; MEDICAL care
- Publication
European Radiology, 2019, Vol 29, Issue 2, p654
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-018-5617-6