Radiofrequency ablation for postoperative recurrences of intrahepatic cholangiocarcinoma
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Most recurrent intrahepatic cholangiocarcinoma (RICC) lost the opportunity of radical resection while most nonsurgical management failed to prolong patients’ survival. The efficacy and safety of radiofrequency ablation (RFA) as a local treatment for recurrent hepatocellular carcinoma have been confirmed by many clinical studies. The purpose of this study was to evaluate the efficacy, long-term survival and complications of RFA for RICC.
A total of 12 patients with 19 RICCs after radical resection were included in this study. The tumors were 1.9–6.8 cm at the maximum diameter (median, 3.2±1.6 cm). All patients were treated with ultrasound guided RFA. There were two RFA approaches including percutaneous and open.
A total of 18 RFA treatment sessions were performed. Ablation was successful (evaluated by 1-month CT after the initial RFA procedure) in 18 (94.7%) of 19 tumors. By a median follow-up period of 29.9 months after RFA, 5 patients received repeated RFA because of intrahepatic lesion recurrence. The median local recurrence-free survival period and median event-free survival period after RFA were 21.0 months and 13.0 months, respectively. The median overall survival was 30 months, and the 1- and 3-year survival rates were 87.5% and 37.5%, respectively. The complication rate was 5.6% (1/18 sessions). The only one major complication was pleural effusion requiring thoracentesis.
This study showed RFA may effectively and safely manage RICC with 3-year survival of 37.5%. It provides a treatment option for these RICC patients who lost chance for surgery.
- Nakajima T, Kondo Y, Miyazaki M, et al. A histopathologic study of 102 cases of intrahepatic cholangiocarcinoma: histologic classification and modes of spreading. Hum Pathol 1988; 19: 1228–1234. CrossRef
- Lim JH, Park CK. Pathology of cholangiocarcinoma. Abdom Imaging 2004; 29: 540–547.
- Endo I, Gonen M, Yopp AC, et al. Intrahepatic cholangiocarcinoma: rising frequency, improved survival, and determinants of outcome after resection. Ann Surg 2008; 248: 84–96. CrossRef
- DeOliveira ML, Cunningham SC, Cameron JL, et al. Cholangio-carcinoma: thirty-one-year experience with 564 patients at a single institution. Ann Surg 2007; 245: 755–762. CrossRef
- Konstadoulakis MM, Roayaie S, Gomatos IP, et al. Fifteen-year, single-center experience with the surgical management of intrahepatic cholangiocarcinoma: operative results and long-term outcome. Surgery 2008; 143: 366–374. CrossRef
- Saiura A, Yamamoto J, Kokudo N, et al. Intrahepatic cholangio-carcinoma: analysis of 44 consecutive resected cases including 5 cases with repeat resections. Am J Surg 2011; 201: 203–208. CrossRef
- Weber SM, Jarnagin WR, Klimstra D, et al. Intrahepatic cholangio-carcinoma: resectability, recurrence pattern, and outcomes. J Am Coll Surg 2001; 193: 384–391. CrossRef
- Ohtsuka M, Kimura F, Shimizu H, et al. Significance of repeated resection for recurrent intrahepatic cholangiocarcinoma. Hepatogastroenterology 2009; 56: 1–5.
- Casaril A, Abu Hilal M, Harb A, et al. The safety of radiofrequency thermal ablation in the treatment of liver malignancies. Eur J Surg Oncol 2008; 34: 668–672. CrossRef
- Choi D, Lim HK, Kim MJ, et al. Recurrent hepatocellular carcinoma: percutaneous radiofrequency ablation after hepatectomy. Radiology 2004; 230: 135–141. CrossRef
- Yang W, Chen MH, Yin SS, et al. Radiofrequency ablation of recurrent hepatocellular carcinoma after hepatectomy: therapeutic efficacy on early- and late-phase recurrence. AJR Am J Roentgenol 2006; 186: S275–283. CrossRef
- Edmondson HA, Steiner PE. Primary carcinoma of the liver. A study of 100 cases among 48,900 necropsies. Cancer 1954; 7: 462–503. CrossRef
- Chen MH, Yang W, Yan K, et al. Large liver tumors: protocol for radiofrequency ablation and its clinical application in 110 patients. Radiology 2004; 232: 260–271. CrossRef
- Chen MH, Yang W, Yan K, et al. Radiofrequency ablation of problematically located hepatocellular carcinoma: tailored approach. Abdom Imaging 2008; 33: 428–436. CrossRef
- Frericks BB, Ritz JP, Roggan A, et al. Multipolar radiofrequency ablation of hepatic tumors: initial experience. Radiology 2005; 237: 1056–1062. CrossRef
- Goldberg SN, Grassi CJ, Cardella JF, et al. Image-guided tumor ablation: standardization of terminology and reporting criteria. J Vasc Interv Radiol 2009; 20(Suppl): S377–390. CrossRef
- Zgodzinski W, Espat NJ. Radiofrequency ablation for incidentally identified primary intrahepatic cholangiocarcinoma. World J Gastroenterol 2005; 11: 5239–5240.
- Chou FF, Sheen-Chen SM, Chen YS, et al. Surgical treatment of cholangiocarcinoma. Hepatogastroenterology 1997; 44: 760–765.
- Gerhards MF, van Gulik TM, González González D, et al. Results of postoperative radiotherapy for resectable hilar cholangiocarcinoma. World J Surg 2003; 27: 173–179.
- Serafini FM, Sachs D, Bloomston M. et al. Location, not staging, of cholangiocarcinoma determines the role for adjuvant chemoradiation therapy. Am Surg 2001; 67: 839–843.
- Pitt HA, Nakeeb A, Abrams RA, et al. Perihilar cholangiocarcinoma. Postoperative radiotherapy does not improve survival. Ann Surg 1995; 221: 788–797.
- Yonemoto N, Furuse J, Okusaka T, et al. A multi-center retrospective analysis of survival benefits of chemotherapy for unresectable biliary tract cancer. Jpn J Clin Oncol. 2007; 37: 843–851. CrossRef
- Thongprasert S. The role of chemotherapy in cholangiocarcinoma. Ann Oncol 2005; 16(Suppl 2): ii93–ii96. CrossRef
- Glimelius B, Hoffman K, Sjödén PO, et al. Chemotherapy improves survival and quality of life in advanced pancreatic and biliary cancer. Ann Oncol 1996; 7: 593–600.
- Okusaka T, Ishii H, Funakoshi A, et al. Phase II study of single-agent gemcitabine in patients with advanced biliary tract cancer. Cancer Chemother Pharmacol 2006; 57: 647–653. CrossRef
- Kornek GV, Schuell B, Laengle F, et al. Mitomycin C in combination with capecitabine or biweekly high-dose gemcitabine in patients with advanced biliary tract cancer: a randomized phase II trial. Ann Oncol 2004; 15: 478–483. CrossRef
- Herber S, Otto G, Schneider J, et al. Transarterial Chemoembolization (TACE) for Inoperable Intrahepatic Cholangiocarcinoma. Cardiovasc Intervent Radiol 2007; 30: 1156–1165. CrossRef
- Vogl TJ, Schwarz W, Eichler K, et al. Hepatic intraarterial chemotherapy with gemcitabine in patients with unresectable cholangiocarcinomas and liver metastases of pancreatic cancer: a clinical study on maximum tolerable dose and treatment efficacy. J Cancer Res Clin Oncol 2006; 132: 745–755. CrossRef
- Burger I, Hong K, Schulick R, et al. Transcatheter arterial chemoembolization in unresectable cholangiocarcinoma: initial experience in a single institution. J Vasc Interv Radiol 2005; 16: 353–361. CrossRef
- Slakey DP. Radiofrequency ablation of recurrent cholangiocarcinoma. Am Surg 2002; 68: 395–397.
- Oshima S, Takaishi K, Kurokawa E, et al. A case of successful management of recurrent intrahepatic cholangiocarcinoma by repeated radiofrequency ablations. Gan To Kagaku Ryoho (in Japanese) 2009; 36: 2404–2406.
- Kim JH, Won HJ, Shin YM, et al. Radiofrequency ablation for recurrent intrahepatic cholangiocarcinoma after curative resection. Eur J Radiol 2010. Oct 13. [Epub ahead of print]
- Chiou YY, Hwang JI, Chou YH, et al. Percutaneous ultrasound-guided radiofrequency ablation of intrahepatic cholangiocarcinoma. Kaohsiung J Med Sci 2005; 21: 304–309. CrossRef
- Poon RT, Ng KK, Lam CM, et al. Learning curve for radiofrequency ablation of liver tumors: prospective analysis of initial 100 patients in a tertiary institution. Ann Surg 2004; 239: 441–449. CrossRef
- Choy PY, Koea J, McCall J, et al. The role of radiofrequency ablation in the treatment of primary and metastatic tumours of the liver: initial lessons learned. N Z Med J 2002; 115: U128.
- Mulier S, Mulier P, Ni Y, et al. Complications of radiofrequency coagulation of liver tumors. Br J Surg 2002; 89: 1206–1222. CrossRef
- Liang P, Wang Y, Yu X, et al. Malignant liver tumors: treatment with percutaneous microwave ablation—complications among cohort of 1136 patients. Radiology 2009; 251: 933–940. CrossRef
- Radiofrequency ablation for postoperative recurrences of intrahepatic cholangiocarcinoma
Chinese Journal of Cancer Research
Volume 23, Issue 4 , pp 295-300
- Cover Date
- Print ISSN
- Online ISSN
- Chinese Anti-Cancer Association
- Additional Links
- Intrahepatic cholangiocarcinoma
- Radiofrequency ablation
- Author Affiliations
- 1. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Ultrasound, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, 100142, China
- 2. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Surgery, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, 100142, China