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No‐touch ablation in hepatocellular carcinoma has the potential to prevent intrasubsegmental recurrence to the same degree as surgical resection.
- Source :
- Hepatology Research; Feb2019, Vol. 49 Issue 2, p164-176, 13p
- Publication Year :
- 2019
-
Abstract
- Aim: The aim of this study was to clarify the utility of a no‐touch pincer ablation procedure that uses bipolar electrodes to prevent intrasubsegmental tumor recurrence after radiofrequency ablation (RFA) for patients with hepatocellular carcinoma (HCC) compared to surgical resection. Methods: We evaluated 175 consecutive patients with HCC (single nodule, tumor diameter ≤ 30 mm) who underwent surgical resection (146 received partial resection) and 313 patients who received RFA; 277 patients received touch ablation using a monopolar or bipolar RFA device, and 36 received no‐touch ablation using a bipolar RFA device. Pretreatment arterial and portal phase dynamic computed tomography (CT) or magnetic resonance imaging (MRI) images were classified into four enhancement patterns: Type 1 and Type 2 are homogeneous enhancement patterns without or with increased arterial blood flow, respectively; Type 3 is a heterogeneous enhancement pattern with a septum‐like structure; and Type 4 is an irregularly shaped ring structure enhancement pattern. Results: Cumulative recurrence rates significantly differed between procedures (surgical resection, 7.5%; no‐touch ablation, 2.9%; and touch ablation, 17.7% at the third year; P = 0.005). Multivariate Cox proportional hazards analysis revealed that enhancement pattern type (Type 3: hazard ratio [HR], 2.95; P = 0.002; and Type 4: HR, 3.88, P = 0.002), treatment procedure (touch ablation: HR, 3.36; P < 0.001), and serum α‐fetoprotein level (≥30 μg/L: HR, 1.87; P = 0.009) were significant predictors of intrasubsegmental recurrence. No significant differences between no‐touch ablation and surgical resection were observed. Conclusion: The no‐touch pincer ablation procedure has the potential to prevent intrasubsegmental recurrence after RFA for patients with HCC to the same degree as partial resection. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 13866346
- Volume :
- 49
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- Hepatology Research
- Publication Type :
- Academic Journal
- Accession number :
- 134665841
- Full Text :
- https://doi.org/10.1111/hepr.13254