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Transcatheter CT Hepatic Arteriography Compared with Conventional CT Fluoroscopy Guidance in Percutaneous Thermal Ablation to Treat Colorectal Liver Metastases: A Single-Center Comparative Analysis of 2 Historical Cohorts.
Puijk, Robbert S; Nieuwenhuizen, Sanne; van den Bemd, Bente A T; Ruarus, Alette H; Geboers, Bart; Vroomen, Laurien G P H; Muglia, Riccardo; de Jong, Marcus C; de Vries, Jan J J; Scheffer, Hester J; van den Tol, Petrousjka M P; Meijerink, Martijn R.
Afiliação
  • Puijk RS; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers (location VUmc), De Boelelaan 1117, Amsterdam 1081 HV, The Netherlands. Electronic address: r.puijk@amsterdamumc.nl.
  • Nieuwenhuizen S; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers (location VUmc), De Boelelaan 1117, Amsterdam 1081 HV, The Netherlands.
  • van den Bemd BAT; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers (location VUmc), De Boelelaan 1117, Amsterdam 1081 HV, The Netherlands.
  • Ruarus AH; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers (location VUmc), De Boelelaan 1117, Amsterdam 1081 HV, The Netherlands.
  • Geboers B; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers (location VUmc), De Boelelaan 1117, Amsterdam 1081 HV, The Netherlands.
  • Vroomen LGPH; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers (location VUmc), De Boelelaan 1117, Amsterdam 1081 HV, The Netherlands.
  • Muglia R; Department of Diagnostic and Interventional Radiology, Humanitas Research Hospital, Rozzano, Milan, Italy.
  • de Jong MC; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers (location VUmc), De Boelelaan 1117, Amsterdam 1081 HV, The Netherlands.
  • de Vries JJJ; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers (location VUmc), De Boelelaan 1117, Amsterdam 1081 HV, The Netherlands.
  • Scheffer HJ; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers (location VUmc), De Boelelaan 1117, Amsterdam 1081 HV, The Netherlands.
  • van den Tol PMP; Department of Surgical Oncology, Amsterdam University Medical Centers (location VUmc), De Boelelaan 1117, Amsterdam 1081 HV, The Netherlands.
  • Meijerink MR; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers (location VUmc), De Boelelaan 1117, Amsterdam 1081 HV, The Netherlands.
J Vasc Interv Radiol ; 31(11): 1772-1783, 2020 11.
Article em En | MEDLINE | ID: mdl-32981819
ABSTRACT

PURPOSE:

To evaluate safety and efficacy of CT hepatic arteriography compared with conventional CT fluoroscopy guidance in percutaneous radiofrequency (RF) and microwave (MW) ablation to treat colorectal liver metastases (CRLM). MATERIALS AND

METHODS:

This single-center comparative, retrospective study analyzed data of 108 patients treated with 156 percutaneous ablation procedures (42 CT fluoroscopy guidance [25 RF ablation, 17 MW ablation]; 114 CT hepatic arteriography guidance [18 RF ablation, 96 MW ablation]) for 260 CRLM between January 2009 and May 2019. Local tumor progression-free survival (LTPFS) was assessed using univariate and multivariate Cox proportional hazard regression analyses. LTPFS and overall survival (OS) were estimated using the Kaplan-Meier method.

RESULTS:

There were no complications related to the transarterial catheter procedure. CT hepatic arteriography proved superior to CT fluoroscopy regarding 2-year LTPFS (18/202 [8.9%] vs 19/58 [32.8%]; P < .001, respectively). CT hepatic arteriography versus CT fluoroscopy (hazard ratio = 0.28; 95% confidence interval, 0.15-0.54; P < .001) and MW ablation versus RF ablation (hazard ratio = 0.52; 95% confidence interval, 0.24-1.12; P = .094) were positive predictors for longer LTPFS. Multivariate analysis revealed that CT hepatic arteriography versus CT fluoroscopy (hazard ratio = 0.41; 95% confidence interval, 0.19-0.90; P = .025) was associated with a significantly superior LTPFS. OS was similar between the 2 cohorts (P = .3).

CONCLUSIONS:

While adding procedure time and marginal patient burden, transcatheter CT hepatic arteriography-guided ablation was associated with increased local disease control and superior LTPFS compared with conventional CT fluoroscopy. CT hepatic arteriography represents a safe and valid alternative to CT fluoroscopy, as it reduces the number of repeat ablations required without adding risk or detrimental effect on survival.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Colorretais / Radiografia Intervencionista / Técnicas de Ablação / Angiografia por Tomografia Computadorizada / Neoplasias Hepáticas Tipo de estudo: Etiology_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: J Vasc Interv Radiol Assunto da revista: ANGIOLOGIA / RADIOLOGIA Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Colorretais / Radiografia Intervencionista / Técnicas de Ablação / Angiografia por Tomografia Computadorizada / Neoplasias Hepáticas Tipo de estudo: Etiology_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: J Vasc Interv Radiol Assunto da revista: ANGIOLOGIA / RADIOLOGIA Ano de publicação: 2020 Tipo de documento: Article