학술논문
Long-term oncological results of percutaneous radiofrequency ablation for intrahepatic cholangiocarcinoma.
Document Type
Academic Journal
Author
Alitti C; Liver Unit, Avicenne Hospital, APHP, Paris Nord University, Bobigny, France.; Rode A; Department of Radiology, Hôpital Croix-Rousse, Hospices Civils de Lyon, Lyon, France.; Trillaud H; Department of Diagnostic and Interventional Radiology, University Hospital Bordeaux, Pessac, France.; Merle P; Cancer Research Center of Lyon (CRCL), INSERM U1052, Centre National de la Recherche Scientifique UMR5286, Lyon, France.; Department of Hepatology, Hôpital Croix-Rousse, Hospices Civils de Lyon, Lyon, France.; Blanc JF; Department of Hepatogastroenterology, CHU Bordeaux, Bordeaux, France.; Blaise L; Liver Unit, Avicenne Hospital, APHP, Paris Nord University, Bobigny, France.; Demory A; Liver Unit, Avicenne Hospital, APHP, Paris Nord University, Bobigny, France.; Nkontchou G; Liver Unit, Avicenne Hospital, APHP, Paris Nord University, Bobigny, France.; Grando V; Liver Unit, Avicenne Hospital, APHP, Paris Nord University, Bobigny, France.; Ziol M; Pathology Department and Centre de Resources Biologiques (BB-0033-00027) Hôpitaux Universitaires Paris-Seine-Saint-Denis Avicenne Avicenne Hospital, APHP, Bobigny, France.; Cordeliers Research Center, Sorbonne Université, Inserm, Université de Paris, Team «Functional Genomics of Solid Tumors», Equipe labellisée Ligue Nationale Contre le Cancer, Labex OncoImmunology, Paris, France.; Nahon P; Liver Unit, Avicenne Hospital, APHP, Paris Nord University, Bobigny, France.; Cordeliers Research Center, Sorbonne Université, Inserm, Université de Paris, Team «Functional Genomics of Solid Tumors», Equipe labellisée Ligue Nationale Contre le Cancer, Labex OncoImmunology, Paris, France.; Ganne-Carrié N; Liver Unit, Avicenne Hospital, APHP, Paris Nord University, Bobigny, France.; Cordeliers Research Center, Sorbonne Université, Inserm, Université de Paris, Team «Functional Genomics of Solid Tumors», Equipe labellisée Ligue Nationale Contre le Cancer, Labex OncoImmunology, Paris, France.; Petit A; Interventional Radiology Unit, Avicenne Hospital, APHP, Bobigny, France.; Seror O; Cordeliers Research Center, Sorbonne Université, Inserm, Université de Paris, Team «Functional Genomics of Solid Tumors», Equipe labellisée Ligue Nationale Contre le Cancer, Labex OncoImmunology, Paris, France.; Interventional Radiology Unit, Avicenne Hospital, APHP, Bobigny, France.; Sutter O; Interventional Radiology Unit, Avicenne Hospital, APHP, Bobigny, France.; Nault JC; Liver Unit, Avicenne Hospital, APHP, Paris Nord University, Bobigny, France.; Cordeliers Research Center, Sorbonne Université, Inserm, Université de Paris, Team «Functional Genomics of Solid Tumors», Equipe labellisée Ligue Nationale Contre le Cancer, Labex OncoImmunology, Paris, France.
Source
Publisher: Wiley-Blackwell Country of Publication: United States NLM ID: 101160857 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1478-3231 (Electronic) Linking ISSN: 14783223 NLM ISO Abbreviation: Liver Int Subsets: MEDLINE
Subject
Language
English
Abstract
Introduction: The effectiveness of percutaneous radiofrequency ablation (RFA) in intrahepatic cholangiocarcinomas (iCCA) remains insufficiently studied.
Methods: We conducted a retrospective study including patients with histologically proven iCCA within Milan criteria treated by percutaneous RFA from 2000 to 2022. The primary outcome was overall survival in treatment-naive patients and secondary outcomes included ablation completeness, adverse events, local and distant recurrence. A total of 494 patients with hepatocellular carcinoma (HCC) on cirrhosis treated by RFA were included as a comparison group. Oncological events were analysed using Kaplan-Meier, log-rank and univariate/multivariate Cox models.
Results: The main population included 71 patients, mostly cirrhotic (80%) with solitary tumours (66%) of a median size of 24 mm. Local recurrence was 45% at 5 years, lower in multibipolar versus monopolar RFA (22% vs. 55%, p = .007). In treatment-naive patients (n = 45), median overall and recurrence-free survivals were 26 and 11 months, respectively. Tumour size (p = .01) and Child-Pugh B (p = .001) were associated with death. The rate of distant recurrence was 59% at 5 years significantly lower for single tumours of less than 2 (p = .002) or 3 cm (p = .02). In cirrhotic patients naïve of previous treatment (n = 40), overall survival was shorter than in HCC (26 vs 68 months, p < .0001), with more local recurrences (p < .0001). Among distant recurrences, 50% were extrahepatic metastases compared to 12% in HCC (p < .001).
Conclusion: Multibipolar RFA provides better results in terms of tumour recurrence than monopolar RFA and could be used to treat small iCCA (<3 cm). Adjuvant chemotherapy should be discussed due to the frequent extra-hepatic metastasis at recurrence.
(© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Methods: We conducted a retrospective study including patients with histologically proven iCCA within Milan criteria treated by percutaneous RFA from 2000 to 2022. The primary outcome was overall survival in treatment-naive patients and secondary outcomes included ablation completeness, adverse events, local and distant recurrence. A total of 494 patients with hepatocellular carcinoma (HCC) on cirrhosis treated by RFA were included as a comparison group. Oncological events were analysed using Kaplan-Meier, log-rank and univariate/multivariate Cox models.
Results: The main population included 71 patients, mostly cirrhotic (80%) with solitary tumours (66%) of a median size of 24 mm. Local recurrence was 45% at 5 years, lower in multibipolar versus monopolar RFA (22% vs. 55%, p = .007). In treatment-naive patients (n = 45), median overall and recurrence-free survivals were 26 and 11 months, respectively. Tumour size (p = .01) and Child-Pugh B (p = .001) were associated with death. The rate of distant recurrence was 59% at 5 years significantly lower for single tumours of less than 2 (p = .002) or 3 cm (p = .02). In cirrhotic patients naïve of previous treatment (n = 40), overall survival was shorter than in HCC (26 vs 68 months, p < .0001), with more local recurrences (p < .0001). Among distant recurrences, 50% were extrahepatic metastases compared to 12% in HCC (p < .001).
Conclusion: Multibipolar RFA provides better results in terms of tumour recurrence than monopolar RFA and could be used to treat small iCCA (<3 cm). Adjuvant chemotherapy should be discussed due to the frequent extra-hepatic metastasis at recurrence.
(© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)