Image-Guided Ablation of Recurrent or Unresectable Intrahepatic Cholangiocarcinoma |
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| Institution: | 1. Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts;2. Department of Biostatistics, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts;1. Liver Unit and HPB Oncology Area, Clínica Universidad de Navarra and CIBEREHD, Pamplona, Spain;2. Hepatology Program, Centro de Investigación Médica Aplicada, Universidad de Navarra, Pamplona, Spain;1. Department of Interventional Radiology, Saiseikai Yokohama Nanbu Hospital, Yokohama, Kanagawa, Japan;2. Department of Cardiovascular Surgery, Saiseikai Yokohama Nanbu Hospital, Yokohama, Kanagawa, Japan;1. Department of Vascular and Interventional Radiology, Hospital Alemán of Buenos Aires, Buenos Aires, Argentina;1. Kansai Rosai Hospital Cardiovascular Center, Amagasaki, Japan;2. Department of Metabolic Medicine, Suita, Japan;3. Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Suita, Japan;4. Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan;5. Department of Vascular Surgery, Kokura Memorial Hospital, Kitakyushu, Japan;6. Department of Vascular Surgery, Matsuyama Red Cross Hospital, Matsuyama, Japan;7. Department of Radiology, Nara Medical University, Kashihara, Japan;8. Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine, Kashihara, Japan;9. Department of Vascular Surgery, Shinsuma General Hospital, Kobe, Japan;10. Department of Cardiology, Tokyo Saiseikai Central Hospital, Tokyo, Japan;11. Division of Vascular Surgery, Saiseikai Central Hospital, Tokyo, Japan;1. Division of Interventional Radiology, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts;2. Division of Hematology, Department of Internal Medicine, Stanford University School of Medicine, Stanford, California;3. Division of Interventional Radiology, Department of Radiology, Stanford University School of Medicine, Stanford, California;4. Division of Vascular and Endovascular Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts |
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| Abstract: | PurposeTo assess the safety and effectiveness of image-guided ablation of recurrent or unresectable intrahepatic cholangiocarcinoma (ICC).Materials and MethodsIn this retrospective study, 25 patients (14 women; age, 36–84 years) underwent 37 image-guided liver tumor ablation procedures to treat 47 ICCs (May 2004 to January 2022). At initial diagnosis, 20 patients had Stage 1 or 2 disease and 5 had Stage 3 or 4 disease. Before ablation, 19 (76.0%) of the 25 patients had progressed through prior treatments, including resection (n = 11), chemotherapy (n = 11), transarterial embolization (n = 3), or radiotherapy (n = 1); 6 (24.0%) of the 25 patients were treatment naïve. Ablation modality selection was based on patient and tumor characteristics and operator preference. Primary outcomes included local progression–free survival (LPFS) and overall survival (OS) after ablation. Statistical analysis included Kaplan-Meier (KM) survival analyses and Cox proportional hazards models.ResultsThe mean ablated tumor size was 2.0 cm ± 1.2 (range, 0.5–5.0 cm). The 1-, 2-, and 5-year LPFS rates were 84.0% (95% CI, 72.9–96.8), 73.0% (95% CI, 59.0–90.4), and 59.5% (95% CI, 41.6–85.1), respectively. The 1-, 2-, and 5-year secondary LPFS rates were 89.5% (95% CI, 80.2–99.9), 81.9% (95% CI, 69.4–96.6), and 75.6% (95% CI, 60.2–94.9). The 1-, 2-, and 5-year LPFS rates for tumors ≤2 cm in size were all 95.8% (95% CI, 88.2–100.0). The 1-, 2-, and 5-year OS rates were 78.5% (95% CI, 63.5–97.2), 68.4% (95% CI, 51.3–91.1), and 43.5% (95% CI, 23.5–80.5). Larger tumor size was associated with decreased time to local progression (hazard ratio, 1.93; P = .012).ConclusionsPercutaneous ablation provided favorable intermediate to long-term disease control for patients with recurrent or inoperable cholangiocarcinoma. |
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| Keywords: | CT"} {"#name":"keyword" "$":{"id":"kwrd0015"} "$$":[{"#name":"text" "_":"computed tomography ICC"} {"#name":"keyword" "$":{"id":"kwrd0025"} "$$":[{"#name":"text" "_":"intrahepatic cholangiocarcinoma KM"} {"#name":"keyword" "$":{"id":"kwrd0035"} "$$":[{"#name":"text" "_":"Kaplan-Meier LPFS"} {"#name":"keyword" "$":{"id":"kwrd0045"} "$$":[{"#name":"text" "_":"local progression–free survival MR"} {"#name":"keyword" "$":{"id":"kwrd0055"} "$$":[{"#name":"text" "_":"magnetic resonance MWA"} {"#name":"keyword" "$":{"id":"kwrd0065"} "$$":[{"#name":"text" "_":"microwave ablation OS"} {"#name":"keyword" "$":{"id":"kwrd0075"} "$$":[{"#name":"text" "_":"overall survival PET"} {"#name":"keyword" "$":{"id":"kwrd0085"} "$$":[{"#name":"text" "_":"positron emission tomography PFS"} {"#name":"keyword" "$":{"id":"kwrd0095"} "$$":[{"#name":"text" "_":"progression-free survival RF"} {"#name":"keyword" "$":{"id":"kwrd0105"} "$$":[{"#name":"text" "_":"radiofrequency |
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