1. Percutaneous thermal segmentectomy for liver malignancies over 3 cm: mid-term oncological performance and predictors of sustained complete response from a multicentric Italian retrospective study.
- Author
-
Lucatelli P, Rocco B, Argirò R, Semeraro V, Lai Q, Bozzi E, Crociati S, Barone M, Posa A, Catalano C, Crocetti L, and Iezzi R
- Subjects
- Humans, Female, Male, Retrospective Studies, Aged, Middle Aged, Italy, Treatment Outcome, Microwaves therapeutic use, Aged, 80 and over, Tomography, X-Ray Computed methods, Risk Factors, Cholangiocarcinoma surgery, Cholangiocarcinoma diagnostic imaging, Magnetic Resonance Imaging methods, Adult, Liver Neoplasms surgery, Liver Neoplasms diagnostic imaging, Carcinoma, Hepatocellular surgery, Carcinoma, Hepatocellular diagnostic imaging
- Abstract
Introduction: Percutaneous thermal segmentectomy is a single-step combination of microwave ablation, performed during arterial occlusion obtained with a balloon micro catheter, followed in the same session by balloon-occluded TACE. The aim of this multicenter retrospective study is to report the mid-term oncological performance of this technique for liver malignancies > 3.0 cm and to identify risk factors for the loss of sustained complete response., Methods: Oncological results were evaluated with CT or MRI according to m-RECIST (HCC) and RECISTv1.1 (metastasis/intra-hepatic cholangiocarcinoma, iCC) at 1-month, 3-6-month and then at regular-6-month intervals. To identify predictive variables associated with not achieving or losing complete response two mixed-effects multivariable logistic regression models were constructed., Results: Sixty-three patients (40/23, male/female) with primary liver malignancies (HCC = 49; iCC = 4) and metastasis (n = 10) were treated. Median diameter of target lesion was 4.5 cm (range 3.0-7.0 cm). The median follow-up time was 9.2 months. At one-month follow-up, 79.4% of patients presented with a complete response and the remaining 20.6% were partial responders. At the 3-6-month follow-up, reached by 59 of the initial 63 patients, 83.3% showed a sustained complete response, while 10.2% had a partial response and 8.5% a local recurrence. At the last follow-up, 69.8% of the lesions showed a complete response. The initial diameter of the target lesion ≥ 5.0 cm was the only independent variable associated with the risk of failure in maintaining a complete response at 6 months (OR = 8.58, 95% CI 1.38-53.43; P = 0.02)., Conclusion: Percutaneous thermal segmentectomy achieves promising oncological results in patients with tumors > 3.0 cm, with tumor dimension ≥ 5.0 cm being the only risk factor associated with the failure of a sustained complete response., (© 2024. The Author(s).)
- Published
- 2024
- Full Text
- View/download PDF