Okan AKHAN, Devrim AKINCI, Türkmen ÇİFTÇİ Malignant liver tumor percutaneous ablation Radiology, Hacettepe University Medical School, Turkey-Special Topics Clinical J Radiol 2016; 9 (2): 1-8
Abstract :
In the treatment of malignant liver tumors, the development of local ablation techniques applied percutaneously with imaging is the most important development in the field of radiology in the last 20 years. Among these techniques, radiofrequency ablation and microwave ablation are used as primary ablation methods in many institutions since their effectiveness and reliability have been proven. This review focuses on the treatment of primary and metastatic liver tumors with imaging methods guided percutaneous ablation.
The result:
Local ablation procedures performed percutaneously with the guidance of imaging methods have been used successfully for the last 20 years in the treatment of primary and metastatic malignant tumors of the liver. In particular, the clinical success of the RFA method in the treatment of very early and early stage HCC has been proven by numerous studies. Thanks to these studies, RFA has taken its place as the standard percutaneous ablation method in the treatment algorithms of liver tumors. Also, with the MWA method developed in recent years and offered for clinical use, clinical results can be obtained that are comparable to either surgical resection or RFA. In the near future, it is inevitable for percutaneous ablation to coincide with surgical resection in the treatment of limited primary or metastatic liver tumors.
References: 1.Orlando A, Leandro G, Olivo M, et al. Radiofrequency thermal ablation vs. percutaneous ethanol injection for small hepatocellular carcinoma in cirrhosis: metaanalysis of randomized controlled trials. Am J Gastroenterol 2009; 104 (2): 514-24. 2. Ahmed M, Brace CL, Lee FT, et al. Principles of and advances in percutaneous ablation. Radiology 2011; 258 (2): 351-69. 3. Association For The Study Of The Liver; European Organization For Research and Treatment of Cancer. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. European J Hepatol 2012; 56 (4): 908-43. 4. Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med 1996; 334 (11): 693-9. 5. Wiesner R, Edwards E, Freeman R, et al. United Network for Organ Sharing Liver Disease Severity Score Committee. Model for end- stage liver disease (MELD) and allocation of donor livers. Gastroenterology 2003; 124 (1): 91-6. 6. Lencioni R, Cioni D, Crocetti L, et al. Earlystage hepatocellular carcinoma in patients with cirrhosis: long-term results of percutaneous image-guided radiofrequency ablation. Radiology 2005; 234 (3): 961-7. 7. Foltz G. Image-Guided Percutaneous Ablation of Hepatic Malignancies. Semin Intervent Radiol 2014; 31: 180-6. 8. Bruix J, Sherman M; American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma: an update. Hepatology 2011; 53 (3): 1020-2. 9. de Lope CR, Tremosini S, Forner A, et al. Management of HCC. J Hepatol 2012; 56 (Suppl 1): S75-S87. 10. Chen MS, Li JQ, Zheng Y, et al. A prospective randomized trial comparing percutaneous local ablative ther- apy and partial hepatectomy for small hepatocellular carcinoma. Ann Surg 2006; 243: 321-8. 11. Lu MD, Kuang M, Liang LJ, et al. Surgical resection versus percutaneous thermal ablation for early-stage hepatocellular carcinoma: a randomized clinical trial. Zhonghua Yi Xue Za Zhi 2006; 86: 801-5. REFERENCES Okan AKHAN et al. Malignant liver tumors: percutaneous ablation Turkey-Special Topics Clinical J Radiol 2016; 9 (2) 8 12 Livraghi T1, Meloni F, Di Stasi, M, et al. Sustained complete response and complications rates after radiofrequency ablation of very early hepatocellular carcinoma in cirrhosis: Is resection still the treatment of choice? Hepatology 2008; 47 (1): 82-9. 13. McCormack L, Petrowsky H, Clavien PA. Surgical therapy of hepatocellular carcinomas. Eur J Gastroenterol Hepatol 2005; 17: 497-503. 14. Paquet KJ, Gad HA, Lazar A. Analysis of factors affecting outcome after hepatectomy of patients with cirrhosis and small hepatocellular carcinoma. Eur J Surg 1998; 164: 513-9. 15. Minagawa M, Ikai I, Matsuyama Y, et al. Staging of hepatocellular carcinoma: assessment of the Japanese TNM and AJCC / UICC TNM systems in a cohort of 13,772 patients in Japan. Ann Surg 2007; 245: 909-2. 16. Peng ZW, Lin XJ, Zhang YJ, et al. Radiofrequency ablation versus hepatic resection for the treatment of hepatocellular carcinomas 2 cm or smaller: a retrospective comparative study. Radiology 2012; 262 (3): 1022-33. 17. Forner A, Llovet JM, Bruix J. Hepatocellular carcinoma. Lancet 2012; 379 (9822): 1245-55. 18. Li D, Kang J, Golas BJ, et al. Minimally invasive local therapies for liver cancer. Cancer Biol Med 2014; 11 (4): 217-36. 19. Ding J, Jing X, Liu J, et al. Complications of thermal ablation of hepatic