Thermal Ablation Versus Repeated Hepatic Resection for Recurrent Intrahepatic Cholangiocarcinoma
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Repeated hepatic resection (HR) and thermal ablation therapy (TAT) are increasingly being used to treat recurrent intrahepatic cholangiocarcinoma (RICC). This study compared the efficacy and safety of these procedures for RICC treatment.
Patients were studied retrospectively after curative resection of RICCs by repeated HR (n = 32) or TAT (n = 77). Treatment effectiveness and prognosis were compared between the two treatment groups.
The repeated HR and TAT groups did not differ in their overall survival (OS; p = 0.996) or disease-free survival (DFS; p = 0.692) rates. However, among patients with recurrent tumors >3 cm in diameter, patients in the repeated HR group had a higher OS rate than patients in the TAT group (p = 0.037). The number of recurrent tumors and the recurrence interval were significant prognostic factors for OS. The major complications incidence rate was greater in the repeated HR group than in the TAT group (p < 0.001).
Repeated HR and TAT are both effective treatments for RICC with similar overall efficacies. TAT should be preferred in any cases when the RICC is ≤3 cm in diameter and technically feasible. However, for large tumors (>3 cm), repeated HR may be a better choice.
- Khan SA, Thomas HC, Davidson BR, Taylor-Robinson SD. Cholangiocarcinoma. Lancet. 2005;366:1303–14. CrossRef
- Malhi H, Gores GJ. Cholangiocarcinoma: modern advances in understanding a deadly old disease. J Hepatol. 2006;45:856–67. CrossRef
- Chen LP, Li C, Wang C, Wen TF, Yan LN, Li B. Predictive factors of recurrence for patients with intrahepatic cholangiocarcinoma after hepatectomy. Hepatogastroenterology. 2012;59:1765–8. CrossRef
- 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
- Shimizu J, Dono K, Nagai K, et al. [A case of intrahepatic recurrence of intrahepatic cholangiocarcinoma treated with repeated hepatectomy]. Gan To Kagaku Ryoho. 2011;38:2469–71.
- Kurosaki I, Hatakeyama K. Repeated hepatectomy for recurrent intrahepatic cholangiocarcinoma: report of two cases. Eur J Gastroenterol Hepatol. 2005;17:125–30. CrossRef
- Morise Z, Sugioka A, Hoshimoto S, et al. Patient with advanced intrahepatic cholangiocarcinoma with long-term survival successfully treated with a combination of surgery and chemotherapy. J Hepatobiliary Pancreat Surg. 2008;15:545–8. CrossRef
- Ohtsuka M, Kimura F, Shimizu H, et al. Significance of repeated resection for recurrent intrahepatic cholangiocarcinoma. Hepatogastroenterology. 2009;56:1–5.
- Song SC, Heo JS, Choi DW, Choi SH, Kim WS, Kim MJ. Survival benefits of surgical resection in recurrent cholangiocarcinoma. J Korean Surg Soc. 2011;81:187–94. CrossRef
- Slakey DP. Radiofrequency ablation of recurrent cholangiocarcinoma. Am Surg. 2002;68:395–7.
- Genov I, Grigorov N, Mitova R, Golemanov B, Dinkov L. [Radiofrequency ablation of recurrent intrahepatic cholangiocarcinoma: a case report]. Khirurgiia (Sofiia). 2005;45–7.
- Rai R, Manas D, Rose J. Radiofrequency ablation of recurrent cholangiocarcinoma after orthotopic liver transplantation—a case report. World J Gastroenterol. 2005;11:612–3.
- 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. 2009;36:2404–6.
- Kim JH, Won HJ, Shin YM, Kim PN, Lee SG, Hwang S. Radiofrequency ablation for recurrent intrahepatic cholangiocarcinoma after curative resection. Eur J Radiol. 2011;80:e221–5. CrossRef
- Fu Y, Yang W, Wu W, Yan K, Xing BC, Chen MH. Radiofrequency ablation for postoperative recurrences of intrahepatic cholangiocarcinoma. Chin J Cancer Res. 2011;23:295–300. CrossRef
- Nakajima Y, Ko S, Kanamura T, et al. Repeat liver resection for hepatocellular carcinoma. J Am Coll Surg. 2001;192:339–44. CrossRef
- Liang HH, Chen MS, Peng ZW, et al. Percutaneous radiofrequency ablation versus repeat hepatectomy for recurrent hepatocellular carcinoma: a retrospective study. Ann Surg Oncol. 2008;15:3484–93. CrossRef
- Matsuda M, Fujii H, Kono H, Matsumoto Y. Surgical treatment of recurrent hepatocellular carcinoma based on the mode of recurrence: repeat hepatic resection or ablation are good choices for patients with recurrent multicentric cancer. J Hepatobiliary Pancreat Surg. 2001;8:353–9. CrossRef
- Lee WS, Yun SH, Chun HK, et al. Clinical outcomes of hepatic resection and radiofrequency ablation in patients with solitary colorectal liver metastasis. J Clin Gastroenterol. 2008;42:945–9. CrossRef
- Mulier S, Ni Y, Jamart J, Michel L, Marchal G, Ruers T. Radiofrequency ablation versus resection for resectable colorectal liver metastases: time for a randomized trial? Ann Surg Oncol. 2008;15:144–57. CrossRef
- Kim KH, Yoon YS, Yu CS, et al. Comparative analysis of radiofrequency ablation and surgical resection for colorectal liver metastases. J Korean Surg Soc. 2011;81:25–34. CrossRef
- Goldberg SN, Grassi CJ, Cardella JF, et al. Image-guided tumor ablation: standardization of terminology and reporting criteria. Radiology. 2005;235:728–39. CrossRef
- Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13. CrossRef
- Taylor-Robinson SD, Toledano MB, Arora S, et al. Increase in mortality rates from intrahepatic cholangiocarcinoma in England and Wales, 1968–1998. Gut. 2001;48:816–20. CrossRef
- Patel T. Increasing incidence and mortality of primary intrahepatic cholangiocarcinoma in the United States. Hepatology. 2001;33:1353–7. CrossRef
- Kamphues C, Seehofer D, Eisele RM, et al. Recurrent intrahepatic cholangiocarcinoma: single-center experience using repeated hepatectomy and radiofrequency ablation. J Hepatobiliary Pancreat Sci. 2010;17:509–15. CrossRef
- Chiou YY, Hwang JI, Chou YH, Wang HK, Chiang JH, Chang CY. Percutaneous ultrasound-guided radiofrequency ablation of intrahepatic cholangiocarcinoma. Kaohsiung J Med Sci. 2005;21:304–9. CrossRef
- Giorgio A, Calisti G, De Stefano G, et al. Radiofrequency ablation for intrahepatic cholangiocarcinoma: retrospective analysis of a single centre experience. Anticancer Res. 2011;31:4575–80.
- Shen WF, Zhong W, Liu Q, Sui CJ, Huang YQ, Yang JM. Adjuvant transcatheter arterial chemoembolization for intrahepatic cholangiocarcinoma after curative surgery: retrospective control study. World J Surg. 2011;35:2083–91. CrossRef
- Wu ZF, Zhang HB, Yang N, Zhao WC, Fu Y, Yang GS. Postoperative adjuvant transcatheter arterial chemoembolisation improves survival of intrahepatic cholangiocarcinoma patients with poor prognostic factors: results of a large monocentric series. Eur J Surg Oncol. 2012;38:602–10. CrossRef
- Yu MA, Liang P, Yu XL, et al. Liver abscess as a complication of microwave ablation for liver metastatic cholangiocarcinoma after bilioenteric anastomosis. Int J Hyperthermia. 2011;27:503–9. CrossRef
- Thermal Ablation Versus Repeated Hepatic Resection for Recurrent Intrahepatic Cholangiocarcinoma
Annals of Surgical Oncology
Volume 20, Issue 11 , pp 3596-3602
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Industry Sectors
- Author Affiliations
- 1. Minimal Invasion Therapy Department 1, Eastern Hepatobiliary Surgery Hospital, Shanghai, China
- 2. Division of Interventional Ultrasound, Department of Hepatobiliary Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China