CT-Guided Microwave Ablation of Liver Tumors in Anatomically Challenging Locations.
Cardiovasc Intervent Radiol
; 41(10): 1520-1529, 2018 Oct.
Article
em En
| MEDLINE
| ID: mdl-29948004
ABSTRACT
PURPOSE:
To assess the feasibility and outcome of microwave ablation (MWA) of hepatic tumors in anatomically challenging locations. MATERIALS ANDMETHODS:
A total of 94 patients with 174 hepatic tumors referred for CT-guided MWA were included in this retrospective institutional review board-approved study. One hundred and twenty-five tumors (median size 17 mm, range 12-24 mm) with subcapsular location (n = 91) and/or in which a transpleural approach was applied (n = 53) were identified (group 1) and compared to tumors with a central intrahepatic location (group 2; n = 49, median size 19 mm, range 12-23 mm). Technical success, complications and local tumor progression (LTP) were evaluated. Risk factors were analyzed using univariate analysis, logistic regression and Kaplan-Meier curves (p < 0.05 deemed significant).RESULTS:
Technical success was 100% in both groups. In group 1, complications occurred in n = 31 tumors (24.8%; pneumothorax n = 20; hematoma n = 11). Complications occurred significantly less often in group 2 (8.2%; n = 4 (hematoma); p = 0.011). There were no major complications. Transpleural approach and number of capsule punctures were identified as risk factors for complications (all p < 0.05). Median follow-up was 265 days. LTP was comparable between both groups (13.6 vs. 10.2%; p = 0.41). Use of hydrodissection was the only independent factor associated with LTP (p = 0.03, HR 3.29).CONCLUSION:
CT-guided hepatic MWA of subcapsular tumors and subdiaphragmatic tumors requiring a direct or transpleural approach is feasible with increased minor but not major complications. LTP did not differ significantly between both groups.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Tomografia Computadorizada por Raios X
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Cirurgia Assistida por Computador
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Neoplasias Hepáticas
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Micro-Ondas
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Cardiovasc Intervent Radiol
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Alemanha