Radio-frequency thermal ablation of liver metastases with a cooled-tip electrode needle: results of a pilot clinical trial |
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Authors: | R Lencioni O Goletti N Armillotta A Paolicchi M Moretti D Cioni F Donati A Cicorelli S Ricci M Carrai P F Conte E Cavina C Bartolozzi |
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Institution: | (1) Division of Diagnostic and Interventional Radiology, Department of Oncology, University of Pisa, Via Roma 67, I-56 125 Pisa, Italy, IT;(2) Division of General and Emergency Surgery, Department of Surgery, University of Pisa, Via Roma 67, I-56 125 Pisa, Italy, IT;(3) Division of Medical Oncology, Department of Oncology, University of Pisa, Via Roma 67, I-56 125 Pisa, Italy, IT;(4) Division of Internal Medicine II, Santa Chiara Hospital, Via Roma 67, I-56 125 Pisa, Italy, IT |
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Abstract: | The aim of this study was to evaluate feasibility, safety, and effectiveness of radio-frequency (RF) thermal ablation, performed
by using a cooled-tip electrode needle, in the treatment of liver metastases. Twenty-nine patients (20 males and 9 females;
age range 43–77 years) with one to four hepatic metastases 1.1–4.8 cm in diameter (mean 2.9 ± 0.8 cm) from previously resected
intra-abdominal primary malignancies were treated. All patients were excluded from surgery and had partial or no response
to chemotherapy. Radio-frequency ablation was performed by using a 100-W generator and 17-gauge, dual-lumen, cooled-tip electrode
needles with a 2- to 3-cm exposed tip. Exposure time was 12 min for each needle insertion. Findings at spiral CT were used
to assess the therapeutic response. A total of 127 insertions were performed (mean 2.4 ± 1.7 insertions/lesion) during 84
treatment sessions (mean 1.6 ± 0.7 sessions/lesion) in absence of major complications. Complete tumor response (i. e., unenhancing
area of thermal necrosis larger than the treated tumor) was seen in 41 (77 %) of 53 lesions, including 33 (87 %) of 38 lesions
3 cm or less in diameter. After a mean follow-up period of 6.5 ± 2.1 months (range 3–9 months), recurrence of the treated
lesion was seen in 5 (12 %) of the 41 cases. New metastatic lesions appeared in 7 patients. Two patients died after 6 and
8 months, respectively. Of the 27 patients still in follow-up, 14 are currently free of disease. Radio-frequency thermal ablation
with a cooled-tip electrode needle is a safe and effective local treatment for hepatic metastases 3 cm or less in greatest
dimension.
Received: 5 September 1997: Revised: 8 January 1998: Accepted: 14 January 1998 |
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Keywords: | : Liver Interventional procedure Liver neoplasms Therapy Radio-frequency ablation |
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